Grant Vivene, Litchfield Ian
Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
Front Clin Diabetes Healthc. 2024 May 21;5:1306199. doi: 10.3389/fcdhc.2024.1306199. eCollection 2024.
Ethnic minority groups in high income countries in North America, Europe, and elsewhere are disproportionately affected by T2DM with a higher risk of mortality and morbidity. The use of community health workers and peer supporters offer a way of ensuring the benefits of self-management support observed in the general population are shared by those in minoritized communities.
The major databases were searched for existing qualitative evidence of participants' experiences and perspectives of self-management support for type 2 diabetes delivered by community health workers and peer supporters (CHWPs) in ethnically minoritized populations. The data were analysed using Sekhon's Theoretical Framework of Acceptability.
The results are described within five domains of the framework of acceptability collapsed from seven for reasons of clarity and concision: described participants' satisfaction with CHWPs delivering the intervention including the open, trusting relationships that developed in contrast to those with clinical providers. In considering and , participants reflected on the impact of health, transport, and the responsibilities of work and childcare on their attendance, alongside a lack of resources necessary to maintain healthy diets and active lifestyles. In relation to participants appreciated the greater understanding of the specific cultural needs and challenges exhibited by CHWPs. The evidence related to indicated that participants responded positively to the practical and applied content, the range of teaching materials, and interactive practical sessions. Finally, in examining the impact of participants described how they changed a range of health-related behaviours, had more confidence in dealing with their condition and interacting with senior clinicians and benefitted from the social support of fellow participants and CHWPs.
Many of the same barriers around attendance and engagement with usual self-management support interventions delivered to general populations were observed, including lack of time and resource. However, the insight of CHWPs, their culturally-sensitive and specific strategies for self-management and their development of trusting relationships presented considerable advantages.
在北美、欧洲及其他地区的高收入国家，少数族裔群体受2型糖尿病的影响尤为严重，其死亡率和发病率风险更高。社区卫生工作者和同伴支持者的使用提供了一种方式，可确保少数族裔社区的人群也能享受到在普通人群中观察到的自我管理支持的益处。
检索主要数据库，以获取关于少数族裔人群中社区卫生工作者和同伴支持者（CHWPs）提供的2型糖尿病自我管理支持的参与者体验和观点的现有定性证据。使用塞洪的可接受性理论框架对数据进行分析。
结果在可接受性框架的五个领域内进行描述，为清晰简洁起见，从七个领域合并而来：描述了参与者对提供干预措施的CHWPs的满意度，包括与临床提供者相比所建立的开放、信任的关系。在考虑[此处可能缺失具体内容]和[此处可能缺失具体内容]时，参与者反思了健康、交通以及工作和育儿责任对其参与度的影响，同时缺乏维持健康饮食和积极生活方式所需的资源。关于[此处可能缺失具体内容]，参与者赞赏CHWPs对特定文化需求和挑战有更深入的理解。与[此处可能缺失具体内容]相关的证据表明，参与者对实用的应用内容、教材范围和互动实践课程反应积极。最后，在研究[此处可能缺失具体内容]的影响时，参与者描述了他们如何改变一系列与健康相关的行为，在应对自身病情以及与资深临床医生互动方面更有信心，并受益于同伴参与者和CHWPs的社会支持。
观察到许多与普通人群接受常规自我管理支持干预时相同的出勤和参与障碍，包括缺乏时间和资源。然而，CHWPs的洞察力、他们对自我管理的文化敏感且具体的策略以及他们建立的信任关系具有相当大的优势。
