Psychosocial interventions for diabetes distress in culturally diverse populations: a systematic scoping review

Diabetes distress, arising from the relentless demands of diabetes management, is notably higher in culturally diverse groups. Psychosocial interventions may reduce diabetes distress through cultural tailoring that addresses beliefs and language barriers. This scoping review aimed to map the availability, key features and impact of psychosocial interventions addressing diabetes distress in culturally diverse groups.

This scoping review followed the Arksey and O'Malley framework.

Five databases (PubMed, PsycINFO, Cochrane Library, CINAHL and Web of Science) were searched for peer-reviewed publications (2013-2024).

The included studies involved participants from culturally diverse groups who were diagnosed with diabetes and engaged in psychosocial interventions. Our search did not restrict diabetes type, but all included studies enrolled adults with type 2 diabetes. Studies in English, with no restrictions on study design and geographical location were included. The review excluded studies focusing on caregivers of patients with diabetes, healthcare providers, Native and Indigenous groups, and lifestyle interventions focused on physiological outcomes.

Study characteristics, participant demographics, intervention features and outcomes (including participant satisfaction and attrition) were extracted and synthesised thematically by intervention type. Findings are presented narratively.

The review included 13 studies. All psychosocial interventions included diabetes education alongside psychosocial strategies, with most being short-term (four months or less) and delivered in person. Small to moderate reductions in diabetes distress were observed in all but three studies. Empowerment-based interventions produced short-term reductions; longer interventions showed more gradual change. These interventions also improved knowledge of diabetes management, self-efficacy, self-management behaviours and social support. In contrast, peer-led interventions showed limited effectiveness in improving psychosocial outcomes. Mixed evidence was found for the value of family-based interventions.

This review recommends the integration of psychosocial interventions into healthcare plans and highlights several gaps in the evidence base, including limited cultural adaptations beyond linguistic modifications, and a limited focus on South Asian and Middle Eastern populations. Future research should consider multi-site RCTs, longitudinal designs and refinement of intervention designs to improve accessibility, cultural relevance, and sustainability over time.