Tolentino Dante Anthony, Ali Samreen, Jang Seo Young, Kettaneh Celeste, Smith Judith E
National Clinician Scholars Program, University of Michigan, Ann Arbor, Michigan, USA.
School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
Health Equity. 2022 Sep 23;6(1):750-766. doi: 10.1089/heq.2021.0083. eCollection 2022.
Type 2 diabetes (T2D) is one of the leading causes of death among Asian Americans. Despite being a culturally diverse racial group with differences in history, language, religion, and values, Asian Americans are often viewed as a monolith. With the high prevalence rate of T2D, a careful examination of self-management interventions across Asian Americans is needed to develop effective and culturally sensitive interventions.
To describe existing literature by examining study characteristics, different intervention components, and outcome measures of various T2D interventions among Asian Americans.
Using Arksey and O'Malley's framework to ground this review, six online databases were used to identify studies.
A total of 18 publications were included. Thirteen studies were published after 2013, with 44% and 22% of these studies focused on Chinese Americans and Korean Americans. We found a lack of geographic diversity in the location of the studies. Majority of the participants were females. Most of the interventions were implemented in person. Licensed health care providers were the most common interventionists, with a number of studies using community health workers. Outcome measures focused on three key areas: physiological, psychosocial and behavioral, and program-related outcomes. Many of the studies measured changes in HbA1C, self-efficacy, distress, depression, and quality of life. Overall, we saw improvements in physiological measures in most of the studies. For example, majority of the studies showed a decline in the participants' HbA1C. Most studies showed an increase or improvement in healthy behaviors. Studies that measured efficacy, knowledge, attitude, motivation, quality of life, or general health showed improvement from baseline. All the studies that measured distress or depression showed a reduction of symptoms postintervention.
Overall, we found that culturally tailored interventions that focus on specific Asian American subpopulations saw an improvement in physiological, psychosocial, or behavioral measures. There were several gaps in the existing T2D self-management programs or interventions among Asian Americans studied in the United States. Based on our analysis, we recommend when designing or implementing self-management interventions among Asian Americans, considerations should be made for targeted recruitment for understudied Asian American subgroups, gender, and location.
2型糖尿病（T2D）是亚裔美国人主要死因之一。尽管亚裔美国人是一个文化多元的种族群体，在历史、语言、宗教和价值观方面存在差异，但他们常被视为一个整体。鉴于T2D的高患病率，需要仔细研究亚裔美国人的自我管理干预措施，以制定有效且具有文化敏感性的干预措施。
通过研究亚裔美国人中各种T2D干预措施的研究特征、不同干预组成部分和结果指标，描述现有文献。
采用阿克西和奥马利的框架进行本综述，使用六个在线数据库识别研究。
共纳入18篇出版物。13项研究于2013年后发表，其中44%和22%的研究分别聚焦于华裔美国人和韩裔美国人。我们发现研究地点缺乏地理多样性。大多数参与者为女性。大多数干预措施是亲自实施的。持牌医疗保健提供者是最常见的干预者，一些研究使用了社区卫生工作者。结果指标集中在三个关键领域：生理、心理社会和行为以及与项目相关的结果。许多研究测量了糖化血红蛋白（HbA1C）、自我效能感、痛苦、抑郁和生活质量的变化。总体而言，我们在大多数研究中看到了生理指标的改善。例如，大多数研究显示参与者的HbA1C有所下降。大多数研究显示健康行为有所增加或改善。测量效能、知识、态度、动机、生活质量或总体健康的研究显示，与基线相比有所改善。所有测量痛苦或抑郁的研究都显示干预后症状减轻。
总体而言，我们发现针对特定亚裔美国亚群体的文化定制干预措施在生理、心理社会或行为指标方面有所改善。在美国研究的亚裔美国人现有的T2D自我管理项目或干预措施存在若干差距。基于我们的分析，我们建议在为亚裔美国人设计或实施自我管理干预措施时，应考虑针对研究不足的亚裔美国亚群体、性别和地点进行有针对性的招募。
