COMMUNITY-BASED EDUCATIONAL INTERVENTIONS FOR TYPE-II DIABETES PREVENTION: A SYSTEMATIC REVIEW AND METAANALYSES

Abstract

Background: We assessed community-based educational interventions towards primary prevention of type-II diabetes (T2D), but with a focus on theoretical framework and community factors. Methods:A comprehensive search for eligible studies was carried out on PubMed, EMBASE, ProQuest, CINAHL nursing & allied health source, Cochrane Library, Google scholar, conference proceedings, and reference lists. Data was extracted by using JBI standardized data extraction tool. The primary outcome variables were fasting blood glucose (FBG), haemoglobin A1c (HbAlc), mean body weight, mean body mass index (BMI), waist circumference (WC), systolic/diastolic blood pressure (s/d BP). Results: Based on the process of searching the electronic database, articles were published from 2000 to 2019. A total of 5178 articles were screened after removal of duplicate articles, of which 72 completed the full evaluation phase. A total of 19 studies entered this systematic review. The results of this study showed that the most studies have been done in high and middle income countries and this indicateed the importance of a community based approach in different societies. Researchers in these nineteen articles cited three indicators of FBG, HBA1c, and BMI as primary outcomes, with approximately 63% of studies reporting the FBG index succeeding in reducing the average of 5.3%. Among the reports of various indicators as secondary outcomes, 52% cited waist circumference in these studies, which on average succeeded in reducing this index by 3.7%. Of the eight studies related to theory and behavior change models, social cognition theory has received the most attention. Conclusion: The results of this systematic review showed that using a communitybased approach to prevent or delay type 2 diabetes has been effective. Theories and models of behavior change also have a dual effect on how to better educate and influence educational interventions. This systematic review has shown that the application of a community-based participatory approach has had successful effectsin addition to underdeveloped countries in developing and developed countries. It is concluded that decision-makers in future studies should consider how community involvement is a key factor in case-based studies.