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

摘要: Background Ethnic minority groups in upper-middle and high income countries tend to be socio-economically disadvantaged have higher prevalence of type 2 diabetes than the majority population. Objectives To assess effectiveness culturally appropriate health education on important outcome measures diabetes. Search strategy We searched The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, SIGLE reference lists articles. also contacted authors field handsearched commonly encountered journals. Selection criteria RCTs for people over 16 years with mellitus from named ethnic resident or countries. Data collection analysis Two independently assessed trial quality extracted data. Where there were disagreements selection papers inclusion, all four discussed studies. study additional information when data appeared missing needed clarification. Main results Eleven trials involving 1603 included, ten providing suitable entry into meta-analysis. Glycaemic control (HbA1c), showed an improvement following at three months (weight mean difference (WMD) - 0.3%, 95% CI -0.6 -0.01), six (WMD -0.6%, -0.9 -0.4), compared who received 'usual care'. This effect was not significat 12 post intervention -0.1%, -0.4 0.2). Knowledge scores improved (standardised (SMD) 0.6, 0.4 0.7), (SMD 0.5, 0.3 0.7) twelve 0.4, 0.1 0.6) intervention. Other both clinical (such as lipid levels, blood pressure) patient centred (quality life measures, attitude empowerment self-efficacy) no significant groups. Authors' conclusions Culturally appears short term effects glycaemic knowledge healthy lifestyles. None studies long-term, so clinically long-term outcomes could studied. No included economic analysis. heterogeneity made subgroup comparisons difficult interpret confidence. There is a need standardised multi-centre that compare different types intensities within defined -------------------------------------------------------------------------------- Plain language summary In countries, often suffer local They come lower socio-economic backgrounds, attendant difficulties accessing good care. some cases, cultural communication barriers increase problems communities experience education, vital aspect contributing towards understanding, use services, behaviour change healthier this review, 'culturally appropriate' taken any which has been specifically tailored needs target group. review found eleven randomised controlled (RCTs) world literature met (participants group living middle country, age, mellitus, receiving intervention). sugar participants, those 'usual' care, post-intervention, potential importance if sustained. about diabetes, lifestyles improved. other such cholesterol, pressure weight improvement, nor improvements patients. Studies tended duration, longer measured. addition, selected by measured, development diabetic complications, death rates, costs programmes. variation between studies, terms aspects populations being studied, duration offered variety measured differences timings these measurements after make interpretation findings limited. Although it potentially more effective care' improving probable benefits patients, (using same measures), are full evaluation costs.