Davidson, E. M., Krasuska, M., Jenum, A. K., Gill, J. M.R. , Beune, E., Stronks, K., van Valkengoed, I. G.M., Diaz, E. and Sheikh, A. (2021) Developing a realist informed framework for cultural adaptation of lifestyle interventions for the prevention of type 2 diabetes in South Asian populations in Europe. Diabetic Medicine, 38(11), e14584. (doi: 10.1111/dme.14584) (PMID:33838051)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
238983.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. 401kB |
Abstract
Aims: Selected lifestyle interventions proven effective for White-European populations have been culturally adapted for South Asian populations living in Europe, who are at higher risk of type 2 diabetes. However, a limited theoretical basis underpins how cultural adaptations are believed to augment intervention effectiveness. We undertook a realist review to synthesise existing literature on culturally adapted type 2 diabetes prevention interventions, to develop a framework that shows ‘how’ cultural adaptation works, for ‘whom’ and in ‘what contexts’. Methods: We followed the stepped methodological approach of realist review. Our work concluded a European-wide project (EuroDHYAN), and core studies were identified from the preceding EuroDHYAN reviews. Data were extracted, coded into themes and synthesised to create ‘Context–Mechanism–Outcome’ configurations and to generate a refined explanatory framework. Results: We identified eight core intervention papers. From this evidence, and supporting literature, we examined the ‘Team’ domain of cultural adaptation and identified a mechanism of shared cultural identity which we theorised as contributing to strong team-participant relationships. We also identified four key contexts which influenced intervention outcomes: ‘research setting’ and ‘heterogeneous populations’ (intrinsic to the intervention) and ‘broader environment’ and ‘socio-cultural stress’ (extrinsic barriers). Conclusions: This work instigates research into the mechanisms of cultural adaptation which, if pursued, will allow a more nuanced understanding of how to apply adaptations, and for whom. In practice we recommend greater consideration of heterogeneous and intersecting population characteristics; how intervention design can safeguard sustainability; and how the four key contexts identified influence how, and whether, these interventions work.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Gill, Professor Jason |
| Authors: | Davidson, E. M., Krasuska, M., Jenum, A. K., Gill, J. M.R., Beune, E., Stronks, K., van Valkengoed, I. G.M., Diaz, E., and Sheikh, A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Diabetic Medicine |
| Publisher: | Wiley |
| ISSN: | 0742-3071 |
| ISSN (Online): | 1464-5491 |
| Published Online: | 10 April 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published in Diabetic Medicine 38(11): e14584 |
| Publisher Policy: | Reproduced under a Creative Commons License |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information