Review articleDiabetes Prevention in U.S. Hispanic Adults: A Systematic Review of Culturally Tailored Interventions
Section snippets
Context
Prevalence of Type 2 diabetes has risen markedly in recent decades. Hispanics/Latinos (hereafter referred to as “Hispanics”) and other racial/ethnic minorities in the U.S. exhibit higher prevalence of diabetes than their non-minority counterparts1, 2; have poorer glucose control once diagnosed; and experience disparities in quality of life, diabetes-related organ and vascular complications, depression, cardiovascular disease, and mortality once diagnosed.2, 3, 4 Though Hispanic and Hispanic
Literature Search
This systematic literature review was conducted and reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.12 Comprehensive search strategies were designed for electronic databases (PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials [CENTRAL], Web of Science, and PsycINFO) to capture all studies from database inception to June 2016. Searches incorporated medical subject heading (MeSH) and keyword terms in three
Study Characteristics
The literature search identified 215 unique publications, 12 of which were included in the final review (Figure 1). Characteristics of the 12 studies are presented in Table 2. Five studies were RCTs, six were single-group pre−post uncontrolled trials, and one study utilized a quasi-experimental community comparison group design. Studies were published between 2008 and 2016. One study included the school-aged children of participants15; only adult/parent data were included this review. Another
Discussion
Of the 12 interventions included in this review, nine resulted in significant reductions in weight and two in HbA1c, suggesting that adapted or culturally tailored diabetes prevention interventions for Hispanic individuals may be somewhat effective in reducing diabetes risk indicators. Although only five interventions (38%) were tested using a randomized controlled design, the gold standard methodology for evaluation of health behavior interventions and the strongest evidence for efficacy,19, 20
Conclusions
Culturally tailored diabetes prevention interventions for Hispanics appear to be modestly effective in reducing risk for Type 2 diabetes via reduction of weight and HbA1c. Evidence is weaker for the ability of these interventions to influence physical activity and dietary intake. A major limitation in this intervention literature, as a whole, is the exclusive use of self-report and the frequent use of study-specific, non-validated measures to assess behavior change. The completion of 12
Acknowledgments
Jessica L. McCurley was supported during the preparation of this article by research and training grants from the NIH/National Heart, Lung, and Blood Institute (5T32HL079891-06), the Fogarty International Center, the University of California Global Health Institute (R25 TW009343), and the University of California Health Initiative of the Americas. The remaining authors were supported by grants from the NIH/National Institute of Nursing Research (1 R01 NR014866-02, Gallo, Gutierrez; 1 R01
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2022, Nursing OutlookCitation Excerpt :Bernal et al. (1995), for example, identified eight dimensions (see Table 1) for the ecological validity of interventions’ cultural appropriateness (van Berkel et al., 2020). However, in meta-analytic reviews of culturally tailored diabetes interventions for U.S. Hispanic adults (Hildebrand et al., 2020; McCurley et al. (2017), authors have repeatedly found great variability in tailoring strategies, often with fewer than three cultural adaptations. Furthermore, the lack of rigorous empirical study of cultural tailoring methodology is a major barrier to the development of sophisticated, useful methods (Butler et al., 2016).
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