Khunti K, Camosso-Stefinovic J, Carey M, Davies M J, Stone M A
Department of Health Scienes, University of Leicester, University Hospital of Leicester NHS Trust, Leicester, UK.
Diabet Med. 2008 Aug;25(8):985-92. doi: 10.1111/j.1464-5491.2008.02512.x.
To conduct a systematic review to determine the scope of published assessments of educational initiatives for South Asians with Type 2 diabetes living in Western countries and to consider the effectiveness of reported interventions.
A range of electronic databases was searched using Medical Subject Headings (MeSH) and free text terms; papers published up to the end of 2007 were considered. Two researchers independently reviewed titles and abstracts and the full text of selected citations. Reference list review and consultation with experts in the field were used to check for completeness of the final sample of studies prior to data extraction.
Only nine studies, including five randomized controlled trials with a combined total of 1004 cases, met our inclusion criteria. The quality of reporting in some studies was limited, e.g. omission of detailed information about ethnicity. Selected studies included a range of group and one-to-one interventions with varied knowledge, psychological and biomedical outcome measures. The effectiveness of the interventions was also variable, and the low number and heterogeneity of the studies made identification of factors linked to effectiveness difficult and meta-analysis inappropriate. However, it appeared that improvements in knowledge levels may be easier to achieve than positive biomedical outcomes, and the need for tailored approaches was suggested.
Our findings confirm the difficulty of designing, assessing and achieving an impact through educational interventions for migrant South Asians with Type 2 diabetes and emphasize the need for good-quality studies in these high-risk populations.
进行一项系统综述，以确定针对生活在西方国家的南亚2型糖尿病患者所开展的教育举措的已发表评估范围，并考量所报告干预措施的有效性。
使用医学主题词（MeSH）和自由文本词检索一系列电子数据库；纳入截至2007年底发表的论文。两名研究人员独立审查标题、摘要及所选引文的全文。在数据提取之前，通过参考文献列表审查和与该领域专家咨询来检查最终研究样本的完整性。
仅有9项研究符合我们的纳入标准，其中包括5项随机对照试验，共计1004例病例。一些研究的报告质量有限，例如遗漏了有关种族的详细信息。所选研究包括一系列团体和一对一干预措施，采用了不同的知识、心理和生物医学结局测量方法。干预措施的有效性也各不相同，而且研究数量少且存在异质性，使得确定与有效性相关的因素变得困难，也不适合进行荟萃分析。然而，知识水平的提高似乎比积极的生物医学结局更容易实现，这表明需要采用量身定制的方法。
我们的研究结果证实了为患有2型糖尿病的南亚移民设计教育干预措施、评估其效果并实现其影响存在困难，并强调在这些高危人群中开展高质量研究的必要性。
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