Kanmiki Edmund Wedam, Fatima Yaqoot, Duong Thuy Linh, Von Senden Roslyn, Ushula Tolassa W, Mamun Abdullah A
Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia.
ARC Centre of Excellence for Children and Families Over the Life Course (Life Course Centre), The University of Queensland, Brisbane, Queensland, Australia.
Endocrinol Diabetes Metab. 2025 Jan;8(1):e70026. doi: 10.1002/edm2.70026.
Indigenous populations experience a disproportionately higher burden of early onset of type 2 diabetes mellitus (T2DM). To contribute towards addressing this health disparity, evidence-based culturally appropriate interventions are urgently needed. This systematic review examines interventions designed to improve the prevention and management of T2DM among Indigenous children and youth.
A comprehensive search of five electronic databases was carried out in February 2023 to identify relevant studies published in English. We included studies of all designs involving Indigenous children and youth under 25 years of age. An adapted version of the National Institute of Health (NIH) quality assessment tool for pre-post intervention studies was used for quality assessment. Due to the heterogeneity of methods used by reviewed publications, the convergent integrated approach developed by Joanna Briggs Institute (JBI) for mixed-method systematic reviews was employed in the analysis. Prospero registration ID: CRD42023423671.
The search identified 1127 publications, and 25 studies with a total of 4594 participants from four countries were eligible after screening. Notably, most (80%) originated from North America. Most interventions involved < 100 participants and lasted 6 months or less (58%). While knowledge and behaviours improved for most interventions, longer and culturally responsive interventions, often combining both community and school-based elements, demonstrated a greater effect on key anthropometrics and biomarkers associated with the risk of T2DM.
This review highlights the urgent need for more research to address T2DM among Indigenous youth. Future research should prioritise culturally appropriate, long-term interventions that engage communities and empower Indigenous youth to make healthy choices.
原住民群体在2型糖尿病（T2DM）早发方面承受着 disproportionately 更高的负担。为了有助于解决这一健康差距问题，迫切需要基于证据且符合文化背景的干预措施。本系统评价考察了旨在改善原住民儿童和青少年T2DM预防与管理的干预措施。
2023年2月对五个电子数据库进行了全面检索，以识别用英文发表的相关研究。我们纳入了所有涉及25岁以下原住民儿童和青少年的研究设计。采用美国国立卫生研究院（NIH）干预前后研究质量评估工具的改编版进行质量评估。由于所审查出版物使用方法的异质性，分析采用了乔安娜·布里格斯研究所（JBI）为混合方法系统评价开发的收敛性综合方法。Prospero注册编号：CRD42023423671。
检索到1127篇出版物，经过筛选，来自四个国家的25项研究、共4594名参与者符合条件。值得注意的是，大多数（80%）来自北美。大多数干预措施涉及不到100名参与者，且持续时间为6个月或更短（58%）。虽然大多数干预措施使知识和行为得到改善，但更长且具有文化适应性的干预措施，通常结合了社区和学校层面的元素，对与T2DM风险相关的关键人体测量指标和生物标志物产生了更大影响。
本评价强调迫切需要开展更多研究以解决原住民青少年中的T2DM问题。未来的研究应优先考虑符合文化背景的长期干预措施，这些措施要能让社区参与进来，并使原住民青少年有能力做出健康选择。
