Type 2 Diabetes Self-Management Interventions Among Asian Americans in the United States: A Scoping Review

Abstract

Introduction: 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. Objective: To describe existing literature by examining study characteristics, different intervention components, and outcome measures of various T2D interventions among Asian Americans. Methods: Using Arksey and O'Malley's framework to ground this review, six online databases were used to identify studies. Results: 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. Conclusion: 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.

Acceptability of community health worker and peer supported interventions for ethnic minorities with type 2 diabetes: a qualitative systematic review

“…The ability of CHWPs to deliver interventions in the native language of participants was key for some Latino, Navajo and Punjabi participants ( 50 , 61 , 62 ). This has been previously recognised as an important consideration in delivering self-management interventions in Latino ( 119 ) Black African and Caribbean ( 120 ), Asian ( 121 ) and a range of minority populations ( 122 , 123 ). However, providing content in a familiar language does not itself overcome issues of health literacy which is typically more predominant in minoritized populations ( 124 ).…”

Filipino Americans’ Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition

“…While FilAms have one of the highest rates of T2DM among Asian Americans ( Araneta, 2019 ; CDC, 2020 ), few studies have explored the experience of FilAms with T2DM ( Araneta, 2019 ; Bender et al, 2018 ; Fuller-Thomson et al, 2017 ; Tolentino et al, 2022 ). Historically, health has often been regarded through a colonial lens, suggesting their behaviors are non-compliant and inferior ( Dawson, 2018 ).…”