title: Culturally Targeted Strategies for Diabetes Prevention in Minority Population.
abstract: Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention's key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).|VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler).
authors.forename: Pooja A
authors.initials: PA
authors.lastname: Lagisetty
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).
authors.forename: Shubadra
authors.initials: S
authors.lastname: Priyadarshini
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).
authors.forename: Stephanie
authors.initials: S
authors.lastname: Terrell
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).
authors.forename: Mary
authors.initials: M
authors.lastname: Hamati
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).
authors.forename: Jessica
authors.initials: J
authors.lastname: Landgraf
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
authors.affiliation: Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler).|VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler).
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D065246:Culturally Competent Care / Q000379:methods*; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control*; D005006:Ethnicity; D006801:Humans; D008913:Minority Groups; D011322:Primary Prevention / Q000379:methods*