How cultural and social norms affect the uptake of diabetes prevention messages.

Asian couple

Diabetes has a higher prevalence among some ethnic groups, particularly people of South Asian origin.  This systematic review looked for  qualitative evidence on the implementation of community based lifestyle behaviour interventions to reduce the risk of diabetes in black and minority ethnic (BME) groups in the UK.

Clinical question:

In ethnic minority populations, what cultural barriers or facilitators exist that affect uptake of behaviour change to prevent diabetes?

The evidence:

The reviewers found 13 studies, which they describe as of good quality.  They conducted Thematic Analysis on the reports of these studies.

The key issues they highlighted were:

  • lack of understanding by health service providers of cultural and religious requirements
  • difficulties for users in accessing services
  • behaviour change was impeded by cultural and social norms, and by individual resistance to change
  • there are important differences between different age groups in how they approach diet and exercise.

Appraisal hints:

  • Did the reviewers get the original data from the studies or did they rely solely upon what was reported in the published articles?
  • How did they assess the quality of the studies they included in their analysis?
  • Specifically what sorts of intervention were looked at, and what outcomes were reported?
  • Does it make sense to combine the findings in this way?
  • Will your population experience the same issues?


Johnson M, Everson-Hock E, Jones R, Woods HB, Payne N, Goyder E.  What are the barriers to primary prevention of type 2 diabetes in black and minority ethnic groups in the UK? A qualitative evidence synthesis.  Diabetes Res Clin Pract. 2011 Aug;93(2):150-8.

See also:

The American Association of Diabetes Educators have just released some guidance on diabetes education for ethnic minority groups:  American Association of Diabetes Educators. Cultural Sensitivity and Diabetes Education.  The Diabetes Educator January/February 2012 38: 137-141.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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