title: Consideration of ethnicity in guidelines and systematic reviews promoting lifestyle interventions: a thematic analysis.
abstract: BACKGROUND
  There is a growing body of evidence supporting lifestyle interventions for the prevention of chronic disease. However, it is unclear to what extent these evidence-derived recommendations are applicable to ethnic minority populations. We sought to assess the degree of consideration of ethnicity in systematic reviews and guidelines for lifestyle interventions.
  
  
  METHODS
  Two reviewers systematically searched seven databases to identify systematic reviews (n = 111) and UK evidence-based guidelines (n = 15) on smoking cessation, increasing physical activity and promoting healthy diet, which were then scrutinized for ethnicity-related considerations. Evidence statements were independently extracted and thematically analysed.
  
  
  RESULTS
  Forty-one of 111 (37%) systematic reviews and 12 of 15 (80%) guidelines provided an evidence statement relating to ethnicity; however, these were often cursory and focused mainly on the need for better evidence. Five major themes emerged: (i) acknowledging the importance of diversity and how risk factors vary by ethnicity; (ii) noting evidence gaps in the effectiveness and cost-effectiveness of interventions for ethnic minorities; (iii) observing differential effects of interventions where these have been trialled with ethnic minority populations; (iv) suggesting adaptation of interventions for ethnic minority groups; (v) proposing improvements in research on interventions involving ethnic minority populations.
  
  
  CONCLUSIONS
  Despite increasing recognition of the challenges posed by ethnic health inequalities, there remains a lack of guidance on the extent to which generic recommendations are applicable to, and how best to promote lifestyle changes in, ethnic minority populations. These important evidence gaps need to be bridged and tools developed to ensure that equity and population context is appropriately considered within evidence syntheses.
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Emma M
authors.initials: EM
authors.lastname: Davidson
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Jing Jing
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Raj S
authors.initials: RS
authors.lastname: Bhopal
authors.affiliation: 2 Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: White
authors.affiliation: 3 Faculty of Health and Life Sciences, De Montfort University, Leicester, UK.
authors.forename: Mark R D
authors.initials: MR
authors.lastname: Johnson
authors.affiliation: 4 School of the Built Environment, Heriot-Watt University, Edinburgh, UK.
authors.forename: Gina
authors.initials: G
authors.lastname: Netto
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Smitha
authors.initials: S
authors.lastname: Kakde
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Umar
authors.initials: U
authors.lastname: Yousuf
authors.affiliation: 1 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK Aziz.sheikh@ed.ac.uk.
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D005006:Ethnicity; D017408:Guidelines as Topic; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D012196:Review Literature as Topic; D040242:Risk Reduction Behavior