Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups

Abstract

Culturally appropriate diabetes health education appears to have short term effects on glycaemic control and knowledge of diabetes and healthy lifestyles. None of the studies were long-term, and so clinically important long-term outcomes could not be studied. No studies included an economic analysis. The heterogeneity of studies made subgroup comparisons difficult to interpret with confidence. There is a need for long-term, standardised multi-centre RCTs that compare different types and intensities of culturally appropriate health education within defined ethnic minority groups.

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

“…We identified 14,841 references for screening, of which 17 were included in this meta-review [99][100][101][102][103][104][105][106][107][108][109][110][111][112][113][114][115] ( Figure 10). A total of 322 RCTs were included within these 17 systematic reviews.…”

“…Four reviews were identified which focused on culturally specific interventions. 103,105,108,112 Two of these looked at a specific ethnic minority: South Asians living in western countries 105 and Latinos living in the USA. 112 The remaining two reviews looked more broadly at interventions which were culturally or religiously tailored.…”

“…112 The remaining two reviews looked more broadly at interventions which were culturally or religiously tailored. 103,108 The RCTs identified in these two reviews overlapped significantly, exploring interventions with African American, Hispanic American, British South Asian, Surinam Asian and Portuguese Canadian populations. These culturally specific interventions were most often delivered by link workers, bilingual/bicultural community health workers (CHWs), or bilingual/bicultural professional or non-professional educators.…”

“…However, the evidence for the effectiveness of such interventions in affecting any long-term improvement in blood glucose control is less strong, with only one review finding a statistically significant result favouring the intervention, 114 and the remaining three reviews suggesting a tendency to benefit from the intervention which failed to reach significance. 101,103,108 However, the only review to find a significant benefit long term 114 pooled data from 11 RCTs, whereas the other three reviews exploring long-term effectiveness included data from between two and four RCTs. Thus, the absence of significant findings may be due to a lack of statistical power ( Figures 12 and 13).…”

Effect of individualized diabetes education for type 2 diabetes mellitus: a single-center randomized clinical trial

“…7 Most current diabetes education programs are knowledge based and have emphasis on lifestyle changes, self-care and active participation in disease management. 1,2,8 These education sessions were often delivered to a group of patients. 1,2.8 There is little information about the effect of individualized and personality specific diabetes education on the management outcomes of T2DM.…”