Electronic Health Interventions for Type 2 Diabetes and Obesity in Hispanic or Latino Adults: A Systematic Review of English and Spanish Studies.

Abstract

The objective of this study was to synthesize English and Spanish literature to determine whether electronic health interventions (EHIs) such as telehealth, telemedicine, digital health, and mobile health (mHealth) improve A1C, blood glucose, BMI, and/or weight among Hispanic/Latino adults with type 2 diabetes or overweight/obesity in the Americas. Searches were conducted in June 2021 using the Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Health Literature, PubMed, and PsycInfo literature databases. Studies were identified that investigated the effect of an EHI on A1C, blood glucose, BMI, or weight in populations that were ≥12% Hispanic/Latino adults with type 2 diabetes or overweight/obesity, were conducted in the Americas, and were published in English or Spanish. Study quality was determined using the Quality Index Score. Data were extracted and synthesized, and themes were identified. Twenty-five studies met inclusion criteria, including 23 in English (from the United States) and two in Spanish (from Chile). A total of 22 investigated type 2 diabetes, and three investigated overweight/obesity. The studies encompassed 6,230 participants, including 3,413 Hispanic/Latino adults. Sixty-three percent of studies demonstrated significant improvements in A1C or blood glucose and 67% in weight. Thirteen studies offered an EHI in both English and Spanish, and six offered the intervention in either English or Spanish alone. All EHIs involving mHealth exclusively and most (90%) involving more than one electronic modality demonstrated a higher number of significant findings compared with those having only one EHI modality, especially telehealth (44.4%). EHIs lasting ≤12 months had more significant findings (72.7%) than those lasting >12 months (50%). Six studies had industry-related funding, with 83.3% of those demonstrating significant improvements in outcomes. EHIs improved A1C and weight in adults (n = 4,355), including 45.5% Hispanic/Latino adults. mHealth and EHIs using more than one electronic modality and those lasting ≤12 months were especially effective. However, overall study quality was modest. Future research should be conducted in Spanish-speaking countries in Latin America and should compare the effectiveness of different EHI modalities.