Goswami, Aumeya;
Poole, Lydia;
Thorlu-Bangura, Zareen;
Khan, Nushrat;
Hanif, Wasim;
Khunti, Kamlesh;
Gill, Paramjit;
... Ramasawmy, Mel; + view all
(2023)
The use of digital health interventions for cardiometabolic diseases among South Asian and Black minority ethnic groups: A realist review.
Journal of Medical Internet Research
, 25
, Article e40630. 10.2196/40630.
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Abstract
Background: Digital health interventions, have become increasingly common for the prevention and management of cardiometabolic disease. However, there is limited evidence for suitability of these approaches in minority ethnic populations, who are at increased risk of these diseases. Objective: This study aims to investigate use of digital health interventions for cardiovascular disease and/or type 2 diabetes among minority ethnic populations in majority White, English-speaking countries; focussing on people who identify as South Asian, Black, and/or African-American. Methods: A realist methodology framework was followed. A literature search was conducted to develop context-mechanism-outcome configurations, including contexts that digital health interventions work in for the target minority ethnic groups, mechanisms that these contexts trigger, and resulting health outcomes. After systematic searches, qualitative analysis of included studies was conducted using deductive and inductive coding. Results: 15 studies of uptake of digital health interventions for cardiovascular disease and/or diabetes were identified, of which 13 focused on people from an African-American background. The review found evidence in support of the use of digital health interventions in minority ethnic populations when specific factors are considered in implementation and design, including: patient beliefs and health needs; education and literacy levels; material circumstances; culture, social networks and the wider community; and supporting healthcare systems. Conclusions: Our context-mechanism-outcome configurations provide a useful guide for the future development of DHIs targeted at South Asian and Black minority ethnic populations, with specific recommendations on improving cultural competency, and promoting accessibility and inclusivity of design.
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