Behavioral interventions to improve glycemic control in African Americans with type 2 diabetes: a systematic review

The use of behavioral interventions has been shown to improve glycemic control, however, the effectiveness of different behavioral interventions in one of the most high risk populations, African Americans, remains unclear. Our systematic review identified and examined findings of published behavioral interventions targeted at African Americans to improve glycemic control. The goal of our study was to distinguish which interventions were effective and identify areas for future research.

Medline, PsychInfo, and CINAHL were searched for articles published from January 2000 through January 2012 using a reproducible strategy. Study eligibility criteria included interventions aimed at changing behavior in adult African Americans with type 2 diabetes and measured glycemic control.

Ten studies met the inclusion criteria, of which five showed a statistically significant change in HbA1c in the intervention group when compared to the control group. Summary information and characteristics of the reviewed studies are provided.

Characteristics of successful interventions included using problem solving with the patient, culturally tailoring the intervention, and using a nurse educator. Limitations include the limited number of intervention studies available using glycemic control as the outcome measure. Clinical trials are needed to determine how best to tailor interventions to this largely underserved population and studies should describe details of cultural tailoring to provide information for future programs.