Factors influencing the uptake of culturally tailored diabetes self-management education and support programmes among ethnic minority patients with type 2 diabetes: A systematic review.
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Abstract
Purpose: This systematic review aimed to evaluate the factors influencing the uptake of culturally-tailored Diabetes Self-Management Education and Support (DSMES) programmes among ethnic minority patients diagnosed with type 2 diabetes mellitus (T2DM).
Methods: A systematic review, following PRISMA guidelines, was conducted, including quantitative research studies published in peer-reviewed journals from January 2013 to January 2023. Studies were extracted via the following databases, AMED, MEDLINE, CINAHL, EMBASE, EMCARE, PSYCHINFO, Ovid Nursing, and grey literature. Studies were selected based on eligibility criteria including the evaluation of DSMES programmes tailored for ethnic minorities and involving adult participants with T2DM. The factors affecting the uptake of these programs were mapped against the three categories of the Andersen's Behavioural Model of Health Services Use: predisposing, enabling, and need factors. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) checklist, and a narrative synthesis was conducted to analyse the findings.
Results: Nine studies met the inclusion criteria, demonstrating that culturally-tailored DSMES programmes significantly improve uptake among ethnic minorities. Key factors influencing participation included demographic characteristics, diabetes knowledge, emotional support, and cultural beliefs. Barriers such as language proficiency, cost, and diabetes fatalism were identified, while enablers included the use of local champions and culturally specific strategies.
Conclusions: This systematic review highlights the effectiveness of culturally-tailored DSMES programmes in improving health outcomes among ethnic minority groups. It suggests that more research is needed to explore these barriers and develop strategies to enhance the uptake of DSMES programmes among underserved populations.
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