Implementing Culturally Tailored Diabetes Prevention in Hispanic Communities: An Integrative Review Using the RE-AIM Framework

Hispanic adults in the US have disproportionately high rates of diabetes and face persistent barriers to accessing evidence-based prevention programs. Despite the demonstrated efficacy of culturally tailored diabetes prevention interventions, translation into routine community practice is markedly limited. This integrative review examined implementation processes, barriers, and facilitators of culturally tailored diabetes prevention interventions in Hispanic communities, using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to identify strategies that support population-level impact.

Comprehensive searches of 5 databases (PubMed, CINAHL, Web of Science, EMBASE, ScienceDirect) from 2005 through 2025 identified 69 sources; 37 (empirical studies, study protocols, and reviews) reporting implementation data were analyzed. Data extraction and synthesis aligned with the RE-AIM framework and used constant comparative methods. Quality appraisal used the Johns Hopkins Evidence-Based Practice tool. This review was not registered, consistent with integrative review methods.

Implementation facilitators included cultural concordance, community health worker models, community-based delivery, and family-centered programming. Barriers included funding instability, workforce shortages, male underrepresentation, and limited maintenance data. Interventions achieved clinically meaningful weight loss (3.2 kg-5.8 kg), but real-world outcomes were smaller than those reported in efficacy trials. Community-based organizations were the primary adopters, although resource constraints were common. Only 18% of studies reported outcomes beyond 12 months, limiting the assessment of sustained impact.

Culturally tailored diabetes prevention interventions are effective and acceptable in Hispanic communities; however, implementation gaps in adoption, scaling ability, and sustainability limit population-level impact. Successful translation requires cultural concordance, community partnerships, flexible delivery models, and workforce development. Addressing structural barriers through policy support for community health worker integration, sustainable funding mechanisms, and health care-community partnerships is essential to achieving equitable diabetes prevention at scale.