JMIR Publications

ABSTRACT

Background:

The prevalence of diabetes in the US is very high. and Chinese patients with diabetes are estimated to comprise 50% of the total cases. Rates of diabetes continue to rise amongst Chinese and Chinese American patients; however, research regarding effective diabetes interventions for this minority group is sparse.

Objective:

A systematic review was conducted to shine a light on a study design and interventions for future studies investigating efficacy of a family-based intervention to improve diabetes care in Chinese Americans.

Methods:

The systematic review was conducted from the summer of 2019 to the spring of 2023. PubMed, CINAHL, ScienceDirect, ProQuest, Google Scholar, Scopus and the Cochrane Central Register of Controlled Trials were the databases used for the search. Key search terms utilized were “diabetes type 2,” “Chinese patients,” “minority patients,” “interventions for diabetes,” “diabetes and family,” “culturally responsive interventions for diabetic patients,” “family education for diabetes,” and “diabetes in China.”

Results:

The initial search retrieved 2,335 articles. Ten articles met the selection criteria to examine efficacy of family-based interventions for Chinese American patients. The review showed that providing multiple sessions of education and counseling for both patients and family members is promising in improving diabetes care. Recruitment of 20-60 dyads of a patient and a family member can help to assess family dynamics in the process of diabetes care, such as food shopping and preparation, and of diabetes management to further evaluate efficacy of an intervention. Glycated hemoglobin (HbA1c) was the primary outcome used most often. Other secondary outcomes included knowledge and efficacy in diabetes management and self-care activities related to diabetes care.

Conclusions:

A family-based intervention is essential for optimizing diabetes care for Chinese Americans. Thus, recruitment of a dyad of a patient and a family is important to investigate efficacy of a family-based intervention in improving diabetes care in this population. Strategies for improving recruitment and retention of dyads were identified. In addition, technology can be used to promote the delivery of interventions to patients, which in turn increases efficacy. Implications: This review can help researchers investigate the efficacy of family-based interventions in promoting diabetes management by designing culturally appropriate study protocols and interventions. Clinical Trial: This is a review paper thus a trial registration is not required.