Cultural Tailoring and Implementation Science for Cardiometabolic Interventions in Asian Americans: A Systematic Review

Abstract

Aim: The purpose of this systematic review was to identify key factors that lead to variations in outcome in cardiometabolic interventions among Asian Americans.

Design: Systematic review.

Review methods and data sources: In October 2022, a systematic search was conducted in the following databases: CINAHL, Cochrane, PsycINFO, PubMed and Web of Science. Results of database searches were uploaded to Rayyan for screening of titles, abstracts and full texts. Based on inclusion and exclusion criteria, twelve studies published across seventeen articles between 2002 and 2021 were included in this review. These studies were assessed for bias using the Revised Cochrane Risk of Bias tool.

Results: Cultural tailoring was an element of 91.7% of the studies. More than one-third of the studies utilized community health workers to build relationships with the communities being studied. Overall, lifestyle interventions targeted for Asian American populations led to improvements in both physical and psychosocial outcomes such as mental health, self-efficacy, disease knowledge, behavior change and/or quality of life.

Conclusion: This systematic review of interventions targeting cardiometabolic outcomes among Asian American populations reveals many gaps in the existing literature. For one, there is limited research on the association of various sociodemographic variables with participants' success and/or retention in health intervention studies among Asian American populations. Interventions utilizing technology have also been lacking with this population and are a potential tool for improving health outcomes.

Impact and implications: Diabetes and cardiovascular disease are both ranked in the top five causes of Asian American deaths. The reviewed articles' findings were mixed but suggest that culturally tailored interventions aimed to improve the cardiometabolic health of Asian Americans are generally effective. As we move forward, this body of research serves as a crucial foundation for shaping the future of culturally tailored interventions, guiding nurse researchers to develop more effective strategies for treating and preventing these prevalent and cardiometabolic conditions.

Reporting method: Completed PRISMA checklist is available upon request.

No patient or public contribution: This systematic review better informs future directions for person-centred, community-based and participatory research.

Keywords: Asian American, Native Hawaiian and Pacific Islander; diabetes mellitus; hypertension; implementation science; systematic review.

FIGURE 1

Search strategy PRISMA diagram. From: Page et al. (2021).