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Effects of Multilevel and Multidomain Interventions on Glycemic Control Among Black Persons with Type 2 Diabetes in the U.S

A Systematic Review and Meta-Analysis

Datos Bibliográficos

ID19228337
AutoresFawsia Osman (University of Chicago), Cherry Jiang (University of Chicago), AMBER DECKARD (University of Chicago), Amber N Deckard, Erin M Staab (0000-0001-7326-8946, University of Chicago), Nikita C Thomas (University of Chicago), Wen Wan (0000-0002-1986-8446, University of Chicago), Monica E Peek (0000-0003-0434-7231, University of Chicago), Jason T Alexander (0000-0003-2159-0604, University of Chicago), Neda Laiteerapong (0000-0003-0124-4325, University of Chicago, autor de correspondencia)
Año2026
Fecha de publicación2026-06-04
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaJournal of Racial and Ethnic Health Disparities (JOURNAL)
Identificadores de la revistaISSN: 2196-8837 • E-ISSN: 2197-3792
EditorialSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s40615-026-03035-6
PMID42243353
OpenAlexW7163531887
IdiomaEN
Referencias citadas13

BACKGROUND: Type 2 diabetes (T2D) disproportionately affects Black individuals in the U.S., who have higher rates of complications and worse glycemic control. This systematic review and meta-analysis evaluated the effectiveness of non-pharmacological interventions on hemoglobin A1c (HbA1c) in this population. METHODS: We searched PubMed, Scopus, PsycInfo, and CINAHL for randomized controlled trials (RCTs) (1985-2019) enrolling ≥ 50% Black/African American adults with T2D or reporting race-specific HbA1c outcomes, with ≥ 3 months' follow-up. Interventions were classified by levels and domains of influence using the National Institute on Minority Health and Health Disparities framework. Risk of bias and evidence certainty were assessed using Cochrane and GRADE. A random-effects meta-analysis estimated the weighted mean difference (WMD) in HbA1c. RESULTS: Forty-six RCTs (7,864 participants) met criteria. Interventions significantly reduced HbA1c (WMD - 0.38%; 95% CI - 0.51 to - 0.25; I2=50%, τ2=0.08). Multi-domain interventions achieved the largest reductions (- 0.43%; 95% CI - 0.60 to - 0.25; I2=53%, τ2=0.08). Risk of bias was low, and strength of evidence was high. No interventions addressed community/societal levels or the physical/built environment. DISCUSSION: Interventions significantly improved glycemic control among Black adults with T2D. These findings underscore the importance of comprehensive, culturally tailored approaches to diabetes self-management support. Further research is needed on structural interventions to address disparities

CINAHL · Diabetes mellitus · Glycemic · MEDLINE · Meta-analysis · Psychological intervention · Randomized controlled trial · Type 2 diabetes · Diabetes Management and Education · Diabetes Management and Research · Diabetes, Cardiovascular Risks, and Lipoproteins

  • Social Determinants of Health and Diabetes

    Open Access•Felicia Hill-Briggs, Felicia Hill‐Briggs et al.•Diabetes Care•2021

  • GRADE guidelines

    Open Access•Gordon Guyatt, Gordon Guaytt et al.•Journal of Clinical Epidemiology•2011

  • Designing and Assessing Multilevel Interventions to Improve Minority Health and Reduce Health Disparities

    Tanya Agurs-Collins, Tanya Agurs‐Collins et al.•American Journal of Public Health•2019

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