RNSystematic ReviewJournal of advanced nursing2025

Cultural Influences, Experiences and Interventions Targeting Self-Management Behaviours for Prediabetes or Type 2 Diabetes in First-Generation Immigrants: A Scoping Review.

Min Zhang, Kirsten Coppell, Johnny Lo and 1 others

PMID 39569469

WHAT IT FOUND

Adult first-generation immigrants with prediabetes or type 2 diabetes reported language barriers, limited health literacy, cost, family roles and cultural beliefs shaping self-management.

Culturally tailored education, interpreters, family and peer support, and flexible scheduling were described as supports.

Key findings

01Adult first-generation immigrants with prediabetes or type 2 diabetes reported barriers including limited health literacy, language barriers, cost, cultural beliefs and limited access to services.

02Facilitators described by participants included daily routine, family and peer support, culturally specific education, language support and flexible scheduling.

03Twenty-four studies reported self-management interventions, but the review says intervention effectiveness is uncertain because evidence is inconsistent and mostly from feasibility or pre-post designs.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Only English-language studies were included, so useful evidence from other languages may be missing. Most studies used convenience or purposive sampling, so the results may not apply to all immigrant groups or regions. Research focused mainly on large immigrant groups in the US, such as Mexican, Chinese and Korean adults, while smaller groups, refugees, war migrants and stateless people were underrepresented. No included studies reported application of social determinants of health screening in this population. Study designs, outcomes and intervention components varied widely. This makes comparison and certainty about effects difficult. Intervention evidence came mostly from feasibility or pre-post studies, so it cannot show which component caused change. The search ended in February 2023, although a later search found three papers that did not change the review's conclusions.

The easy way to misread this

Do not read the review as evidence that culturally tailored diabetes programmes improve outcomes. The review included many different interventions. Most were feasibility or pre-post studies, and the authors say effectiveness is uncertain.

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