title: Use of culturally focused theoretical frameworks for adapting diabetes prevention programs: a qualitative review.
abstract: BACKGROUND
  Diabetes disproportionately affects underserved racial/ethnic groups in the United States. Diabetes prevention interventions positively influence health; however, further evaluation is necessary to determine what role culture plays in effective programming. We report on the status of research that examines cultural adaptations of diabetes prevention programs.
  
  
  METHODS
  We conducted database searches in March and April 2014. We included studies that were conducted in the United States and that focused on diabetes prevention among African Americans, American Indians/Alaska Natives, Asian Americans/Pacific Islanders, and Latinos.
  
  
  RESULTS
  A total of 58 studies were identified for review; 29 were excluded from evaluation. Few adaptations referenced or followed recommendations for cultural adaptation nor did they justify the content modifications by providing a rationale or evidence. Cultural elements unique to racial/ethnic populations were not assessed.
  
  
  CONCLUSIONS
  Future cultural adaptations should use recommended processes to ensure that culture's role in diabetes prevention-related behavioral changes contributes to research.
authors.affiliation: Washington University in St. Louis, Brown School, One Brookings Dr, CB 1196, St. Louis, MO, 63130. Email: vthompson22@wustl.edu.
authors.forename: Vetta L
authors.initials: VL
authors.lastname: Sanders Thompson
authors.affiliation: University of Minnesota College of Pharmacy, Minneapolis, Minnesota.
authors.forename: Michelle
authors.initials: M
authors.lastname: Johnson-Jennings
authors.affiliation: Washington University in St. Louis, Brown School, St. Louis, Missouri.
authors.forename: Ana A
authors.initials: AA
authors.lastname: Bauman
authors.affiliation: Washington University in St. Louis, Brown School, St. Louis, Missouri.
authors.forename: Enola
authors.initials: E
authors.lastname: Proctor
mesh_terms: D003431:Cross-Cultural Comparison; D065246:Culturally Competent Care; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000208:ethnology / Q000517:prevention & control*; D004059:Diffusion of Innovation; D005006:Ethnicity / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010865:Pilot Projects; D016730:Program Development; D036301:Qualitative Research; D016896:Treatment Outcome; D014481:United States