Effectiveness of Multilevel and Multidomain Interventions to Improve Glycemic Control in U.S. Racial and Ethnic Minority Populations: A Systematic Review and Meta-analysis
Authors' conclusion
Multilevel and multidomain DSME interventions had a modest impact on HbA1c. Few DSME trials have targeted the community and society levels or physical environment domain. Future research is needed to evaluate the effects of these interventions on outcomes beyond HbA1c.
Study context
- Population
- U.S. adults with T2D from racial and ethnic minority populations; RCTs of diabetes self-management education (DSME) (PubMed, Scopus, CINAHL, PsycINFO, 1985–2019)106 RCTs
- Participants
- 27 / 54 / 70 / 45
- Comparison
- DSME interventions by level and domain
- Individual-behavioraln = 27
- Multileveln = 54
- Multidomainn = 70
- Multilevel and multidomainn = 45
- Outcome
- Change in percent hemoglobin A1c (HbA1c)
Methodological detailsAnalyses restricted to RCTs
- Analyses restricted to RCTs
Pooled result
As reported in the abstract
Change in HbA1c Individual-behavioral −0.34 (95% CI −0.46–-0.22) percentage points · Multilevel −0.40 (95% CI −0.51–-0.29) percentage points · Multidomain −0.39 (95% CI −0.49–-0.29) percentage points · Multilevel and multidomain −0.43 (95% CI −0.55–-0.31) percentage points
I2
Mmol/mol Individual-behavioral −3.7 [−5.0, −2.4] · Multilevel −4.4 [−5.6, −3.2] · Multidomain −4.3 [−5.4, −3.2] · Multilevel and multidomain −4.7 [−6.0, −3.4]
Original publication
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