For African-Americans, the burden of diabetes, diabetes-related conditions, and mortality is significant. Diabetic self-management education is an intervention used to increase knowledge, skill, and self-efficacy with diabetes self-care. Efforts have been made to establish culturally-adapted diabetic self-management education programs to improve health outcomes for African-Americans. However, research is limited with assessing their effectiveness. This systematic review and meta-analysis intends to evaluate the impact of existing culturally-tailored diabetic self-management education interventions on hemoglobin A1c and health-related quality of life for African-American adults with type 2 diabetes. Twelve randomized control trials comparing the effect of culturally tailored group diabetic self-management education programs versus usual care were selected for review. Seven trials contained data suitable for meta-analysis. Social determinants of health, including institutional racism, and critical race theory was used to provide context for the analysis. Results determine that existing culturally tailored programs have no impact on hemoglobin A1c and health-related quality of life when compared to usual care for African-American adults with type 2 diabetes. As there are no standards with determining the necessary components of a culturally appropriate intervention, many programs varied and subjective. Furthermore, most programs do not address social determinants of health, and are not comprehensive enough according to concepts of the critical race theory framework. Hence, additional research is needed concerning this subject which has important implications for both public and population health as it relates to historical and cultural competency as well as advocacy.
Crittendon, Denine, "A Systematic Review and Meta-analysis on the Effects of Culturally Tailored Group Diabetic Self-Management Education Programs Versus Usual Care on Hemoglobin A1c(HbA1c) and Health-related Quality of Life (HrQol) for African-American Adults with Type 2 Diabetes" (2017). Master of Public Health Capstone Presentations. Presentation 223.