Consideration of ethnicity in guidelines and systematic reviews promoting lifestyle interventions: a thematic analysis

Davidson, Emma; Liu, Jing Jing; Bhopal, Raj; White, Martin; Johnson, Mark Rd; Netto, Gina; Kakde, Smitha; Yousuf, Umar; Sheikh, Aziz

doi:10.1093/eurpub/ckt093

Cited by 23 publications

(16 citation statements)

References 35 publications

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“…However, the Indian Consensus Group strongly emphasized that application of revised guidelines on a countrywide basis is also likely to have a deceleration effect on the escalating problem of T2DM and cardiovascular disease in India; thus, such a step may be economically beneficial in the long run. Additionally, despite recognition of the health challenges in ethnic health in developed countries (e.g., the United Kingdom), there is a lack of guidance on how best to promote lifestyle changes in ethnic minority populations, 41 and research is needed to evolve cost-effective interventions.…”

Section: Ethnicity and Bmi: Contentious Issuesmentioning

confidence: 99%

Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement

Misra

2015

Diabetes Technology & Therapeutics

211

130

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Definitions for overweight and obesity are universally applied using body mass index (BMI), based on morbidity and mortality data derived from white populations. However, several studies have shown higher body fat, excess metabolic perturbations, and cardiovascular risk factors at lower value of BMI in Asian versus white populations. Definitive guidelines have been published to classify a BMI of ‡23 kg/m 2 and ‡25 kg/m 2 as overweight and obese, respectively, by the Indian Consensus Group (for Asian Indians residing in India) and a BMI of ‡23 kg/m 2 for screening for diabetes by the National

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Section: Ethnicity and Bmi: Contentious Issuesmentioning

confidence: 99%

Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement

Misra

2015

Diabetes Technology & Therapeutics

211

130

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“…Some cultural barriers may be specific to certain ethnic minority groups. Grouping all ethnic minority groups together may be contentious, as they may differ in terms of health patterns and the effects of interventions, making it difficult to provide generic recommendations (Davidson et al, 2013). In fact the definitions of ethnic minority groups, culture and cultural barriers have been restricted in this review, as they have diverse interpretations.…”

Section: Strengths and Limitations Of The Reviewmentioning

confidence: 99%

Cultural barriers impeding ethnic minority groups from accessing effective diabetes care services: a systematic review of observational studies

Zeh¹,

Sandhu²,

Cannaby³

et al. 2014

Divers Equal Health Care

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“…Creating resources in different languages and content material aimed at different cultures/ethnicities (e.g. US DPP also available in Spanish [48]) could facilitate this [40,49,50].…”

Section: Implications For Practitioners and Policymakersmentioning

confidence: 99%

Stakeholders’ perceptions and experiences of the National Health Service diabetes prevention programme in England: qualitative study with service users, intervention providers and deliverers, commissioners and referrers

Rodrigues

Haste

Penn

et al. 2020

BMC Health Serv Res

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Background: The National Health Service diabetes prevention programme in England, (NHS DPP) aims to identify people at high risk of type 2 diabetes (T2D) and offer them a face-to-face, group-based, behaviour change intervention for at least 9 months. The NHS DPP was rolled out in phases. We aimed to elicit stakeholders' perceptions and experiences of the factors influencing implementation of, and participation in, the programme during the development phase. Methods: Individual, semi-structured telephone interviews were conducted with 50 purposively sampled stakeholders: service users (n = 20); programme commissioners (n = 7); referrers (n = 8); and intervention deliverers (n = 15). Topic guides were structured using a pragmatic, theory-informed approach. Analysis employed the framework method. (Continued on next page)Results: We identified factors that influenced participation: Risk communication at referralstakeholders identified point of referral as a window of opportunity to offer brief advice, to provide an understanding of T2D risk and information about the programme; Perceived impact of the NHS DPP -service users highlighted the positive perceived impact on their behaviour change, the peer support provided by participating in the programme, the option to involve a relative, and the 'knock on' effect on others. Service users also voiced disappointment when blood test results still identified them at high risk after the programme; and Behavioural maintenance -participants highlighted the challenges linked to behavioural maintenance (e.g. discontinuation of active support). Factors influencing implementations were also identified: Case findingstakeholders suggested that using community involvement to identify service users could increase reach and ensure that the workload was not solely on GP practices; Adaptability: intervention deliverers acknowledged the need to tailor advice to service users' preferences and needs; Accountabilitythe need to acknowledge who was responsible for what at different stages of the NHS DPP pathway; and Fidelitystakeholders described procedures involved in monitoring service users' satisfaction, outcome data collection and quality assurance assessments. Conclusions:The NHS DPP offers an evidence-informed behavioural intervention for T2D prevention. Better risk communication specification could ensure consistency at the referral stage and improve participation in the NHS DPP intervention. Cultural adaptations and outreach strategies could ensure the NHS DPP contributes to reducing health inequalities.

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Consideration of ethnicity in guidelines and systematic reviews promoting lifestyle interventions: a thematic analysis

Cited by 23 publications

References 35 publications

Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement

Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement

Cultural barriers impeding ethnic minority groups from accessing effective diabetes care services: a systematic review of observational studies

Stakeholders’ perceptions and experiences of the National Health Service diabetes prevention programme in England: qualitative study with service users, intervention providers and deliverers, commissioners and referrers

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