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Effects of Multilevel and Multidomain Interventions on Glycemic Control in U.S. Hispanic Populations
Laura Bianco1, Sofía I Uranga2, Alexander W Rodriguez2
1Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL 60208, USA.
International Journal of Environmental Research and Public Health
|September 27, 2025
Summary
Non-pharmacological interventions modestly improved glycemic control in Hispanic adults with type 2 diabetes. Multi-level, multi-domain approaches showed promise, but further research into social and environmental factors is needed.
Area of Science:
- Public Health
- Diabetes Management
- Health Disparities
Background:
- Hispanic populations in the U.S. experience high rates of type 2 diabetes and its complications.
- Addressing health disparities requires interventions targeting multiple levels and domains.
- Evidence on effective approaches for glycemic control in this population is limited.
Purpose of the Study:
- To systematically review the effects of non-pharmacological interventions on glycemic control (HbA1c) among Hispanic individuals with diabetes.
- To analyze intervention effectiveness by level and domain.
- To identify research gaps in diabetes care for Hispanic populations.
Main Methods:
- Systematic review of randomized trials (1985-2019) from major databases (PubMed, Scopus, PsycInfo, CINAHL).
- Inclusion criteria focused on HbA1c outcomes in Hispanic populations.
- Random-effects meta-analyses and GRADE framework for evidence quality assessment were utilized.
Main Results:
- Forty-eight trials involving 9185 participants were included.
- Overall, non-pharmacological interventions reduced HbA1c by -0.32% (moderate strength of evidence).
- Multi-level, multi-domain interventions showed a greater reduction of -0.41% (moderate strength of evidence).
Conclusions:
- Non-pharmacological interventions offer a modest benefit for glycemic control in Hispanic adults with type 2 diabetes.
- Multi-level, multi-domain interventions are a promising strategy.
- Further research is needed on interventions addressing community, societal, and environmental factors.
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