A review of systematic reviews evaluating diabetes interventions: focus on quality of life and disparities.
This article reviews the literature on definitions and issues related to measurement of quality of life in people with diabetes and summarizes reviews of evidence of intervention studies, with a particular focus on interventions targeted for underserved and minority populations.



An integrative literature review of reviews was conducted on adult diabetes interventions and outcomes. Five electronic databases were searched. Eligible publications were those published between 1999 and 2006 that described outcome measures. Twelve review articles are included.



Review studies were heterogeneous in terms of intervention type, content, participants, setting, and outcome measures. Interventions used variable operational definitions and frequently lacked adequate description; therefore, comparisons of findings proved difficult. A clinical outcome, A1C, was the most frequently assessed, with little inclusion of quality-of-life measures. Several reviews and independent studies did not explicitly consider interventions aimed at the underserved. When quality of life was considered, measures and operational definition of domains were limited.



Understanding the relationship between interventions and resulting outcomes, particularly quality of life, will require attention to operational definitions and better conceptual models. There is an evidence base emerging about important characteristics of effective intervention programs. This evidence base can guide public health and clinical program planners to better understand and make prudent decisions about assessment, planning, implementation, and evaluation of interventions for people with complex chronic illnesses such as diabetes.
Magwood
Gayenell S
GS
The College of Nursing, Medical University of South Carolina, Charleston (GSM, JZ, CJ)
Zapka
Jane
J
The College of Nursing, Medical University of South Carolina, Charleston (GSM, JZ, CJ)|The Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston (JZ)
Jenkins
Carolyn
C
The College of Nursing, Medical University of South Carolina, Charleston (GSM, JZ, CJ)
D000328:Adult; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D006304:Health Status; D006801:Humans; D018579:Patient Selection; D011788:Quality of Life; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome