Talia Isaacs|Daniel Hunt|Danielle Ward|Leila Rooshenas|Louisa Edwards
The Inclusion of Ethnic Minority Patients and the Role of Language in Telehealth Trials for Type 2 Diabetes: A Systematic Review
University of Bristol|University of Nottingham|University of Bristol|University of Bristol|University of Bristol
type 2 diabetes serious pervasive metabolic condition disproportionately affects ethnic minority patients telehealth interventions facilitate type 2 diabetes monitoring prevent secondary complications however trials designed test effectiveness telehealth interventions may underrecruit exclude ethnic minority patients language potential barrier recruitment underrepresentation minorities trials limits external validity findings key patient demographicthis systematic review examines 1 research reporting practices prevalence ethnic minority patients included telehealth randomized controlled trials rcts targeting type 2 diabetes trial characteristics associated recruiting high proportion minority patients 2 proportion included rcts report using english language proficiency patient screening criterion sotelehealth rcts published refereed journals targeting type 2 diabetes primary condition adults western majority englishspeaking countries included ethnically targeted rcts excluded main review included post hoc subgroup analysis abstract fulltext screening risk bias assessment data extraction independently conducted two reviewersof 3358 records identified search 79 articles comprising 58 rcts included nearly twothirds rcts 3858 reported ethnic composition participants median proportion 235 patients range 0977 fourteen studies 24 included least 30 minority patients usbased predominantly recruited urban areas described target population underserved financially deprived uninsured eight 14 studies 57 offered intervention materials language english employed bilingual staff half identified rcts 2958 included language proficiency participantscreening criterion language proficiency operationalized using nonstandardized measures eg sufficient verbal fluency three studies providing reasons excluding patients language groundsthere considerable variability across studies inclusion ethnic minority patients rcts higher participation rates countries legislation mandate inclusion eg united states without legislation eg united kingdom less 25 rcts recruited sizeable proportion ethnic minorities raises concerns external validity lack objective measures common procedures assessing language proficiency across trials implies languagerelated eligibility decisions often based trial recruiters impressionistic judgments could subject bias variability inconsistent reporting ethnicity socioeconomic factors descriptions research participants could specifically emphasized trial reporting guidelines promote best practiceprospero international prospective register systematic reviews crd42015024899 httpwwwcrdyorkacukprosperodisplayrecordaspidcrd42015024899 archived webcite httpwwwwebcitationorg6kqmi2bdf