Culturally Tailored Self-Management Interventions for South Asians With Type 2 Diabetes: A Systematic Review.

Nevin Navodia, Olive Wahoush, Tricia Tang, Jennifer Yost, Sarah Ibrahim, Diana Sherifali

Journal: Canadian journal of diabetes 2020;43(6):445-452

PMID: 31375180

Abstract

Diabetes mellitus is one of the most common chronic diseases worldwide and a leading cause of morbidity and mortality. A high prevalence of type 2 diabetes mellitus has been noted among the South Asian population, in general, and migrant South Asians. Self-management is considered a proponent to the management of diabetes. Although empirical evidence supports such interventions, little is known regarding the cultural congruency of such interventions for diverse cultural and ethnic groups, particularly South Asians. Our purpose was to determine the effectiveness of diabetes self-management education (DSME) and diabetes self-management support (DSMS), interventions on migrant South Asian's glycated hemoglobin (A1C) levels and whether DSME and DSMS interventions are culturally tailored to the migrant South Asian population. In this study, a systematic review, with narrative synthesis, was conducted. Data were extracted on the study, participant, and intervention characteristics and the cultural congruity using Leininger's sunrise model. Four studies meeting the inclusion criteria were included. Overall, most (75%) of the DSME and DSMS interventions were not effective in reducing A1C levels. Specific to cultural congruity of the interventions, all studies delivered the intervention based on the participant's preferred language and incorporated culturally sensitive dietary information primarily by persons of the same cultural and ethnic background. However, little information was presented on the provision and integration of culturally congruent care. Findings highlight the importance of rethinking the way in which South Asians are labelled as a homogenous group and accounting for such differences when adapting and designing culturally tailored DSME and or DSMS interventions in clinical practice.

Copyright © 2019 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Address: Diabetes Complications & Preventions Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.; School of Nursing, McMaster University, Hamilton, Ontario, Canada.; Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.; M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States of America.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.; School of Nursing, McMaster University, Hamilton, Ontario, Canada; Diabetes Care and Research Program, Hamilton Health Sciences, Hamilton, Ontario, Canada. Electronic address: [email protected].
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