期刊
PUBLIC HEALTH NUTRITION
卷 25, 期 2, 页码 422-436出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1368980021003682
关键词
Cultural tailoring; Black population; Self-management; Type 2 diabetes; Prevention
资金
- National Institute for Health Research (NIHR) Applied Research Collaboration South London at King's College Hospital NHS Foundation Trust
This study evaluated the cultural tailoring methods used in T2D interventions for populations of Black African ancestry and found that these interventions were effective in improving measures of glycaemia. The interventions that aligned with the FiLLM framework in terms of location, facilitators, messaging, and language showed the greatest benefits in terms of HbA1c improvement.
Objective: To evaluate the cultural tailoring methods used in type 2 diabetes (T2D), prevention and management interventions for populations of Black African ancestry and to examine their effectiveness on measures of glycaemia. Design: Three databases were searched in October 2020; eligible studies used a randomised controlled trial (RCT) design to evaluate the effectiveness of culturally tailored lifestyle interventions compared with usual care for the prevention or management of T2D in adults of Black African ancestry. Cultural tailoring methods were evaluated using the Facilitator-Location-Language-Messaging (FiLLM) framework, whereby facilitator refers to delivery by individuals from the target community, language focuses on using native language or language appropriate to literacy levels, location refers to delivery in meaningful settings, and messaging is tailoring with relevant content and modes of delivery. Results: Sixteen RCT were identified, all from USA. The mean age of participants was 55 years, majority female. Six of fifteen RCT reported significant improvements in glycated haemoglobin (HbA1c) at 6 and 8 months; one, in prediabetes, reported significantly improved fasting plasma glucose. Diabetes knowledge improvement (5/7 studies) was associated with HbA1c improvement. The majority tailored to location (12/16), facilitators (11/16), messaging (9/16) and language (6/16) domains of FiLLM. Those with ethnically matched facilitators and those which tailored to more than one domain showed the greatest HbA1C benefits. Conclusion: This evidence supports the effectiveness of culturally tailored lifestyle interventions for T2D management in populations of Black African ancestry, with further RCT needed to evaluate interventions for T2D prevention and for communities outside of the USA.
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