Culturally tailored interventions in adults with obesity: a protocol for a systematic review with meta-analysis and...

Obesity disproportionately affects ethnic minority populations due to structural inequalities, such as limited access to healthy food, inadequate healthcare and systemic racism. Universal weight management programmes often fail to meet the unique needs of ethnic minority populations. These universal interventions may lead to lower engagement and poorer health outcomes compared with those observed in non-minoritised ethnic groups. This systematic review will examine the impact of culturally tailored interventions to treat and manage obesity in adult ethnic minority populations on weight- and health-related outcomes (meta-analysis) and patient experience (qualitative evidence synthesis).

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. Interventions of interest will include standalone or multicomponent behavioural interventions with culturally tailored elements of design or delivery. These will be compared against standard weight management interventions or usual care in adults from ethnic minority populations living with obesity. The primary outcome is the mean percentage weight (kg) change between pre-post interventions. A search of databases (Ovid MEDLINE, Embase, APA PsycINFO, Scopus and Web of Science) was conducted in February 2025. Eligible studies include randomised controlled trials (RCTs), quasi-experimental (non-randomised trials, pre-post interventions) and qualitative research. Risk of bias will be assessed with the Cochrane Risk of Bias 2 tool and the Mixed Methods Appraisal Tool. Narrative synthesis will be performed according to the synthesis without meta-analysis guidelines. For eligible RCTs, a random-effects meta-analysis will calculate pooled effect sizes between pre-post intervention using standardised mean differences, with additional sensitivity and subgroup analyses. Qualitative evidence synthesis will be performed using semi-automated text analytics (unsupervised machine learning) and inductive thematic analysis.

Ethical approval is not required. Findings will be disseminated through peer-reviewed journal publications, conference presentations, professional organisations and patient and public networks.

CRD42025636750.