Mobile health interventions tailored to immigrant populations with diabetes: an integrative review

Immigrant populations face numerous barriers to accessing evidence-based diabetes interventions. Mobile health (mHealth) interventions are increasingly being used to support individuals in managing diabetes. This review aims to synthesize the available evidence on mHealth interventions specifically designed for immigrant populations with diabetes.

An integrative review was conducted following Whittemore and Knafl's methodology. Studies from the inception of PubMed, Web of Science, Cochrane Library, CINAHL Ultimate, Embase, and APA PsycInfo up to July 2024 were searched. The Mixed Methods Appraisal Tool was used to assess the quality of the included studies. A constant comparison strategy was employed for data analysis.

A total of seven studies met the inclusion criteria for this review, including five randomized controlled trials (RCTs: two fully powered RCTs and three pilot RCTs) and two pre-post single-arm pilot studies. All studies were conducted in the United States. The mHealth interventions were tailored to Korean, Chinese, Marshallese, Latinx, and South Asian immigrants. The sample sizes varied from 17 to 250. Evidence from the included studies is primarily limited by statistical power due to their pilot designs and small sample sizes. Despite this limitation, all studies demonstrated high feasibility and acceptability of mHealth interventions for diabetes management among these immigrant groups. Participants also reported high levels of satisfaction with mHealth interventions. The included studies consistently reported significant improvements in a range of health, psychosocial, and behavioral outcomes within the intervention groups, including hemoglobin A1C levels, body weight, blood glucose, total cholesterol, triglycerides, low-/high-density lipoprotein levels, and blood pressure; and self-efficacy, mental health status, diabetes knowledge, and quality of life; as well as physical activity, self-management, and dietary behaviors. However, when compared to control groups, the reported effectiveness of mHealth interventions on these outcomes was inconsistent.

This review demonstrates the feasibility and acceptability of mHealth interventions for diabetes management among within immigrant populations. The findings suggest that these interventions may serve as a viable strategy to improve health, psychosocial, and behavioral outcomes. Future RCTs with larger sample sizes are needed to provide more robust evidence of the effectiveness of mHealth interventions. Importantly, this review highlights the scarcity of mHealth-related studies focused on immigrant populations with diabetes and calls for more research to examine how to best support this underserved group.