Ali Muhanad Ahmed, Ali Fatema Mahad, Gerstle David, Zehra Aimen, Fazli Ghazal S
Department of Geography, Geometrics, and Environment, University of Toronto Mississauga, Mississauga, Ontario, Canada
Novo Nordisk Network for Healthy Population, University of Toronto Mississauga, Mississauga, Ontario, Canada.
BMJ Open. 2025 Jun 23;15(6):e090787. doi: 10.1136/bmjopen-2024-090787.
Type 2 diabetes is a growing public health concern, and it continues to disproportionately impact priority populations. Although earlier and more frequent screening of diabetes promotes early detection to prevent adverse outcomes, this is a significant barrier for priority populations due to inequities that hinder access to critical preventive screening in primary care settings. The purpose of this scoping review is to better understand the design and implementation of screening and early detection of type 2 diabetes in community settings for priority populations to reduce missed or delayed diagnoses and future potential adverse outcomes.
This scoping review will adopt the methodological framework of Arksey and O'Malley and be enhanced using Levac recommendations. A search strategy was designed using insights from experienced librarians through the Peer Review for Electronic Search Strategies to conduct a comprehensive search using the following databases: Medline, Embase, PsycINFO, Web of Science, Scopus, CINAHL and Google. The search will capture studies focused on community-based diabetes screening using point-of-care testing and deployed in community settings serving priority populations with undiagnosed diabetes. Studies will be excluded if priority populations were not a focus, individuals living with diabetes, the intervention is not implemented in a community setting and did not use point-of-care screening. Two authors will independently review and screen the articles (title, abstract and full-text), while a team-based approach will be applied to chart the data. A thematic analysis will be used to identify emerging themes and subthemes according to barriers and enablers of implementing an equitable community-based diabetes screening intervention.
The findings from this review will inform future diabetes screening interventions in community settings to enable an equity-informed approach in the design, planning and implementation of such strategies. Equally important, it will inform a larger project, in which the team plans to implement a community-based diabetes screening programme in Ontario, Canada.
2型糖尿病日益成为公共卫生问题，且持续对重点人群造成不成比例的影响。尽管更早且更频繁地筛查糖尿病有助于早期发现以预防不良后果，但由于存在不平等现象，阻碍了在初级保健机构获得关键的预防性筛查，这对重点人群来说是一个重大障碍。本范围综述的目的是更好地了解社区环境中针对重点人群的2型糖尿病筛查与早期检测的设计与实施情况，以减少漏诊或延迟诊断以及未来可能出现的不良后果。
本范围综述将采用阿克西和奥马利的方法框架，并根据莱瓦克的建议进行完善。利用经验丰富的图书馆员通过电子检索策略同行评审获得的见解设计了检索策略，使用以下数据库进行全面检索：医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、心理学文摘数据库（PsycINFO）、科学引文索引数据库（Web of Science）、斯高帕斯数据库（Scopus）、护理学与健康领域数据库（CINAHL）和谷歌。检索将获取专注于使用即时检验进行基于社区的糖尿病筛查并部署在为未确诊糖尿病的重点人群服务的社区环境中的研究。如果重点人群不是研究重点、研究对象为糖尿病患者、干预措施未在社区环境中实施且未使用即时检验筛查，则将研究排除。两名作者将独立审查和筛选文章（标题、摘要和全文），同时将采用基于团队的方法来梳理数据。将使用主题分析根据实施公平的基于社区的糖尿病筛查干预措施的障碍和促成因素来识别新出现的主题和子主题。
本综述的结果将为社区环境中未来的糖尿病筛查干预措施提供信息，以便在设计、规划和实施此类策略时采用基于公平性的方法。同样重要的是，它将为一个更大的项目提供信息，在该项目中，该团队计划在加拿大安大略省实施一项基于社区的糖尿病筛查计划。
