title: Culturally competent interventions in Type 2 diabetes mellitus management: an equity-oriented literature review.
abstract: OBJECTIVE
  Although, culturally competent (CC) interventions aim to reduce health inequalities for ethnic minorities, they have been criticized on the grounds that they increase prejudice and stereotyping. It remains unclear whether CC interventions really can reduce health inequalities among ethnic minorities. The purpose of this review is to assess whether CC interventions in the management of Type 2 diabetes mellitus (T2DM) match the recommendations to reduce health inequalities.
  
  
  METHODS
  We identified CC interventions relating to T2DM among ethnic minority patients in the literature published between 2005 and 2011. Data were analyzed according to an equity-oriented framework. Each study was given a score based on its congruence with the reduction of health inequalities amongst ethnic minorities.
  
  
  RESULTS
  We reviewed 137 papers and found 61 studies that met the inclusion criteria. Most interventions focused on the individual level and the modification of patients' health behavior. Very few addressed the sociopolitical level. A minority of the studies acknowledged the role of socioeconomic deprivation in ethnic health inequalities. Half of the studies contained no information about the socioeconomic status of the patients. The patients receiving the interventions were socioeconomically deprived. Only 10 studies compared ethnic minority groups to majority groups. Thirty-three studies had a very low average congruence score. The highest score of congruence was achieved by one study.
  
  
  CONCLUSIONS
  Overall, CC interventions addressing T2DM are not congruent with the reduction of ethnic health inequalities. The future of CC interventions may involve going one step further and going back to basic tenets of cultural competence: the integration of difference, whatever its source, into the delivery of fair health care for patients.
authors.affiliation: a Institute of Health and Society IRSS , Université catholique de Louvain , Brussels , Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Dauvrin
authors.forename: Vincent
authors.initials: V
authors.lastname: Lorant
mesh_terms: D054521:Cultural Competency; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D011287:Prejudice; D012959:Socioeconomic Factors; D013240:Stereotyping
keywords: Type 2 diabetes mellitus; cultural competence; equity; ethnic minorities; socioeconomic status; systematic review