A Systematic Review of Diabetes Self-Care Interventions for Older, African American, or Latino Adults

PURPOSE: This study systematically identified and examined published self-care interventions designed to improve glycemic control or quality of life (QoL) among older, African American, or Latino adults. METHODS: Six electronic databases were searched. Eligible publications were those that described an intervention to change knowledge, beliefs, or behavior among adults with diabetes who were either older than 55 years, African American, or Latino, and that measured the outcomes of glycemic control or QoL. RESULTS: Twelve studies met the inclusion criteria, of which 8 were randomized controlled trials (RCTs). Of the 8 RCTs, improved glycemic control was reported in the intervention arm of 5 RCTs compared with the control arm. Of the 4 RCTs that examined QoL, improved QoL was reported in the intervention arm of 1 study. Characteristics of successful interventions included poor glycemic control at baseline (A1C>11%), cultural or age-tailoring the intervention, use of group counseling or support, and involvement of spouses and adult children. CONCLUSIONS: Large-scale clinical trials designed according to cultural and age criteria specific for older Latinos and African Americans with diabetes are needed to determine how best to address this growing public health problem.