Communication strategies in the prevention of type 2 diabetes and gestational diabetes in vulnerable groups: A scoping review

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Although evidence shows that vulnerable groups are affected disproportionally, these groups are difficult to reach in terms of preventive measures. Currently, there is no gold standard regarding communication strategies and/or public awareness campaigns. Methods We conducted a scoping review in September 2019. Two reviewers independently screened the results of the electronic literature search in several databases, including Medline, EMBASE, and PsycINFO. Extracted data were charted, categorized, and summarized. Results All of the included articles (n = 24) targeted T2DM; none targeted GDM. We identified the following five different vulnerable groups within the identified studies: migrants (n = 9), ethnic groups such as African Americans (n = 8), people with low socioeconomic status (n = 3), older people (n = 1) and people in need of care (n = 1). Three categories of communication strategies were identified as follows: adapted diabetes prevention programs (n = 21), community health workers (n = 5), and technical approaches (n = 9). Conclusion We found different approaches for preventive interventions for T2DM. Some of these approaches were already adapted to known barriers. Communication strategies should be adapted to barriers and facilitating factors to increase participation and motivation. Agroecology Type 2 diabetes mellitus prevention vulnerable groups communication strategies Figures Figure 1 Background The global prevalence of diabetes mellitus is nearly 9% [ 1 ], with 90% of patients having type 2 diabetes mellitus (T2DM). Additionally, the prevalence of gestational diabetes mellitus (GDM) is increasing with approximately 16% of all live births being affected by hyperglycemia [ 2 ]. Because of its health consequences, the global health-related costs are expected to nearly double from US $ 1.3 trillion in 2015 to $ 2.5 trillion by 2030, taking past trends into account [ 3 ]. This equals an increase in costs as a share of global gross domestic product from 1.8% in 2015 to a maximum of 2.2% in 2030 [ 3 ]. Many cases of T2DM/GDM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, and staying physically active [ 4 ]. Therefore, there is an increasing need to implement effective preventive policies and to promote healthy lifestyles. Ethnicity and/or lower socioeconomic status are important considerations in individuals affected by diabetes. For example, people in the lowest socioeconomic groups are 2.5 times as likely, and black and minority ethnic groups are up to six times as likely, to develop diabetes compared with the general population [ 5 ]. This could partly be attributed to lifestyle factors such as obesity, which more severely affect deprived communities and those living in vulnerable circumstances [ 6 ]. Yet, these vulnerable populations are difficult to reach in terms of preventive measures [ 6 ]. Numerous studies demonstrated that T2DM can be prevented or delayed by intensive lifestyle changes in individuals with prediabetes [ 7 ]. However, little is known regarding effective communication or awareness strategies for primary prevention of T2DM/GDM, in particular, regarding accessibility to those who are hardest to reach and most at risk. Identifying barriers and facilitators is necessary to increase the number of participants in preventive interventions that address vulnerable groups. Just as importantly, we must determine communication strategies to access participants, especially those in vulnerable groups. Therefore, we aimed to identify translations or modifications of existing programs or new communication strategies for vulnerable groups. Our target audiences are primary care providers (e.g., general practitioners, nutritionists, and midwives) as well as diabetologists and public health experts actively involved in diabetes prevention. The aim of this study was to systematically review the literature in order to identify and describe communication strategies for preventing T2DM/GDM in vulnerable groups. Methods This project was commissioned by the Federal Center for Health Education in Germany as part of the national education and communication strategy on diabetes mellitus. The project consists of two scoping reviews, one aimed to identify barriers and facilitating factors [ 8 ] and the other aimed to identify communication strategies for diabetes prevention in vulnerable groups. This report focuses on communication strategies. We used the same literature search for both scoping reviews. The methods were in accordance with those stated in a previously published protocol [ 9 ]. Deviations are outlined below. The scoping review was conducted following Arksey and O’Malley’s framework [ 10 ] and the Joanna Briggs Institute Reviewers’ Manual 2015 [ 11 ]. Furthermore, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist [ 12 ] was used. Since the International Prospective Register of Systematic Reviews (PROSPERO) does not register scoping reviews, this scoping review was not registered. Eligibility criteria Inclusion criteria vulnerable patients with, or at risk of, T2DM/GDM Studies presenting barriers and facilitating factors for implementing a preventive or health-promoting intervention (primary or secondary prevention) World Health Organization (WHO) mortality stratum A countries publication date no earlier than 2008 Exclusion criteria indigenous people, children, or people with mental disorders no full text available general prevention with no context of T2DM/GDM Studies including patients on oral antidiabetic or insulin medications Eligibility criteria are additionally shown in the PPC (Population, Concept, Context) mnemonic, which is presented in the protocol [ 9 ]. We included studies presenting communication strategies for the prevention of T2DM/GDM in vulnerable groups. Publications were restricted to studies published from January 2008 onward. No language restrictions were made. If necessary, full texts were translated. Furthermore, we included only those studies with a low mortality stratum (A) according to the WHO [ 13 ], thus ensuring that our findings would be applicable to western industrialized countries. We defined vulnerable groups using the definition of Lewis et al. [ 14 ], except we excluded indigenous people, children, and people with mental disorders. These exclusion criteria were added after the protocol was published. Because it was necessary to define and separate primary and secondary from tertiary prevention or therapy, we excluded studies with patients treated with any antidiabetic medication (e.g., metformin or insulin). Information sources The following electronic databases were searched: PubMed, EMBASE, PsycINFO, PSYNDEX, Social Science Citation Index, and CINAHL. Gray literature was searched in greylit.org and through the homepages of the WHO and international, healthcare, or public health departments (e.g., Department of Health and Social Care, UK; Agency for Healthcare Research and Quality; and the U.S. Preventive Services Task Force). We searched manually for additional studies by cross-checking the reference lists of all included studies. Search The search strategy was developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline [ 15 ]. For all databases, the initial search was conducted in May 2018, but the gray literature was searched in July 2018. An update of the initial database searches was conducted in September 2019. An update of the initial gray literature search was not performed because the initial search was very time-consuming and not worthwhile. The search strategy is presented as Supplement 1. Data management The search results were uploaded and managed using Microsoft Excel. A PRISMA flow diagram was used to summarize and visualize the study selection. Study selection Two reviewers independently screened titles and abstracts of the search results against the inclusion criteria. Subsequently, two reviewers independently screened full-text reports for potential eligibility. Any disagreement was resolved through discussion and consensus. The reasons for exclusion of full texts were documented. A list of included studies in addition to study characterization is shown in Table 2 and a list of excluded studies is provided as Supplements 2. Table 2 Study Characteristics of all included studies Study Study design Participants [n] Gender [m/f]n(%) Age[years] mean(%)//n(%)//Range Vulnerable group category Bender MS, Cooper BA, Flowers E, Ma R, Arai S. Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial. Contemporary Clinical Trials Communications. 2018;12:76–84 Intervention 67 32(48)/35(52) 41.7 Migrants Blanks SH, Treadwell H, Bazzell A, Graves W, Osaji O, Dean J, McLawhorn JT, Stroud JL: Community Engaged Lifestyle Modification Research: Engaging Diabetic and Prediabetic African American Women in Community-Based Interventions. J Obes 2016, 2016:3609289 Intervention 79 0(0)/79(100) 29 Ethnic group Bolin JN, Ory MG, Wilson AD, Salge L. Diabetes education kiosks in a latino community. The Diabetes educator. 2013;39(2):204 − 12. Mixed Methods Use: 5372 Exit-Survey: 179 55(30.8)/115(63.7) < 18 18 (9.9) 19–35 28 (15.4) 36–49 71 (39.0) 50–64 44 (24.2) 65 + 10 (5.5) n.r. 11 (6.5) Ethnic group Borelli MR, Riden HE, Bang H, Schenker MB. Protocol for a cluster randomized controlled trial to study the effectiveness of an obesity and diabetes intervention (PASOS) in an immigrant farmworker population. BMC Public Health. 2018;18(1):849. Protocol n.a. n.a. n.a. Migrants Castro-Rivas E, Boutin-Foster C, Milan M, Kanna B. "Es como uno bomba de tiempo [It's like a time bomb]": A qualitative analysis of perceptions of diabetes among first-degree relatives of latino patients with diabetes. Diabetes Spectrum. 2014;27(1):50 − 7. Focus groups 23 15(65)/8(35) 46.4 Migrants Chang MW, Nitzke S, Brown R, Resnicow K. A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale. BMC public health. 2014;14:280. RCT IG/CG 410/202 0(0)/612(100) 28.1 LSES Fischer HHF, I.P.; Pereira, R.I.; Furniss, A.L.; Rozwadowski, J.M.; Moore, S.L.; Durfee, M.J.; Raghunath, S.G.;Tsai, A.G;, and Edward P. Havranek1: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016, 39:1364–1370. RCT IG/CG 51/34 IG: 13(25.5)/38(74.5) CG: 6(17.6)/28(82.4) IG: 47.9 CG: 41.6 Migrants Fontil V, McDermott K, Tieu L, Rios C, Gibson E, Sweet CC, et al. Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team. Journal of diabetes research. 2016;2016:8472391. Feasibility Study 18 8(47.0)/10(53.0) 53.0 LSES Ford AF, Reddick K, Browne MC, Robins A, Thomas SB, Crouse Quinn S. Beyond the cathedral: building trust to engage the African American community in health promotion and disease prevention. Health promotion practice. 2009;10(4):485-9. Review n.a. n.a. n.a. Ethnic group Fukuoka Y, Vittinghoff E, Hooper J. A weight loss intervention using a commercial mobile application in Latino Americans-Adelgaza Trial. Translational Behavioral Medicine. 2018;8(5):714 − 23. Intervention 54 17(31.0)/37(69.0) 45.3 Migrants Gary-Webb TL, Walker EA, Realmuto L, Kamler A, Lukin J, Tyson W, et al. Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. American journal of men's health. 2018:1557988318758788. Focus groups 29 29(100)/0(0) n.r. LSES Gutierrez J, Devia C, Weiss L, Chantarat T, Ruddock C, Linnell J, et al. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program. The Diabetes educator. 2014;40(2):214 − 22. Intervention 183 21(11.7)/159(88.3) 18–44: 25(15.6) 45–64: 83(51.9) 65–74: 40(25.9) 75+: 12(7.5) Ethnic group Hall D, Lattie E, McCalla J, Saab P. Translation of the Diabetes Prevention Program to Ethnic Communities in the United States. Journal of Immigrant & Minority Health. 2016;18(2):479 − 89. Review n.a. n.a. n.a. Ethnic group Handley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, et al. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implementation science : IS. 2016;11(1):73. Focus groups 22 0(0)/22(100) 31.5 Migrants Harvey I, Schulz A, Israel B, Sand S, Myrie D, Lockett M, et al. The Healthy Connections project: a community-based participatory research project involving women at risk for diabetes and hypertension. Progress in community health partnerships : research, education, and action. 2009;3(4):287–300. Intervention 1428 164 (11.5)/ 1264 (88.5) 18–29: 93(10.0) 30–44: 223(24.0) 45–59: 287(31.0) 60+: 325(35.0) N.R. 500 Ethnic group Kato S, Ando M, Kondo T, Yoshida Y, Honda H, Maruyama S. Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study). Nagoya J Med Sci. 2018;80(2):175 − 82. Protocol n.a. n.a. n.a. Older people Kim SE, Castro Sweet CM, Gibson E, Madero EN, Rubino B, Morrison J, et al. Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemp Clin Trials Commun. 2018;10:161-8. Intervention 230 44(19.1)/186(80.9) 48 LSES Newton RL, Jr., Johnson WD, Larrivee S, Hendrick C, Harris M, Johannsen NM, et al. A Randomized Community-based Exercise Training Trial in African American Men: ARTIIS. Med Sci Sports Exerc. 2019. RCT IG/CG 54/49 103(100)/0(0) 51.8 Ethnic group Nicolaou M, Vlaar E, van Valkengoed I, Middelkoop B, Stronks K, Nierkens V. Development of a diabetes prevention program for Surinamese South Asians in the Netherlands. Health promotion international. 2014;29(4):680 − 91. Review n.a. n.a. n.a. Migrants Ruggiero LO, S; Choi, J.K: Community-Based Translation of the Diabetes Prevention Program’s Lifestyle Intervention in an Underserved Latino Population. The Diabetes EDUCATOR 2011, 37(4):564–672. Intervention 69 0(0)/69(100) 37.9 Migrants Siddiqui F, Koivula RW, Kurbasic A, Lindblad U, Nilsson PM, Bennet L. Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention. Am J Prev Med. 2018;55(2):187 − 96. RCT IG/CG 50/46 IG//CG 14 (43.7)/24(56.3)//18 (48.6)/28(51.4) IG/CG 50.2/47.1 Migrants Vincent D, McEwen MM, Hepworth JT, Stump CS. The effects of a community-based, culturally tailored diabetes prevention intervention for high-risk adults of Mexican descent. The Diabetes educator. 2014;40(2):202 − 13. RCT IG/CG 38/20 IG 9(23.7)/29(76.3) CG 4(20.0)/16(80.0) IG/CG 50.0/52.8 Ethnic group Walker EA, Weiss L, Gary-Webb TL, Realmuto L, Kamler A, Ravenell J, et al. Power Up for Health: Pilot study outcomes of a Diabetes Prevention Program for men from disadvantaged neighborhoods. American Journal of Men's Health. 2018;12(4):989 − 97. Intervention 29 29(100)/0(0) 49.9 LSES Whittemore R, Rosenberg A, Gilmore L, Withey M, Breault A. Implementation of a Diabetes Prevention Program in Public Housing Communities. Public Health Nursing. 2014;31(4):317 − 26. Mixed methods 67 13(19.4)/54(80.6) Diabetes prevention: 41.9 Standard care: 39.0 People in need of care LSES: low socioeconomic status; n.a.: not applicable; n.r.: not reported Data extraction A standardized extraction form was developed for this review. A pilot test of the data extraction form was conducted on a sample of five articles by the reviewers involved in the scoping review to assess its completeness and applicability. Based on the pilot testing, modifications to the standardized data extraction form were needed and undertaken to ensure the data necessary to address the research questions were obtained. Data were extracted by one reviewer and checked by another. Disagreements were resolved through discussion and consensus. Data items The preliminary data extraction categories were derived from our overarching research question. The following data were collected: Study characteristics (e.g., country, setting, publication date, number of participants, target disease, and study design/method) Patient characteristics (e.g., age, gender, and affiliation to vulnerable group) Inclusion/exclusion criteria Communication strategies Risk of bias As this was a scoping review, there was no risk of bias assessment. This is consistent with guidance on the conduct of scoping reviews [ 10 ]. Data synthesis We used Arksey and O’Malley’s methods [ 10 ] of reporting and provide a descriptive analysis of the extent, nature, and distribution of the studies included in the review as well as a narrative, thematic summary of the data collected. This was achieved by summarizing the literature according to the types of vulnerable groups, communication strategies, comparators, implementation factors, and outcomes identified. We aimed to map the research landscape in this area. This was facilitated by some form of visual representation of the data to map the extent, range, and nature of research in this area. Data were charted, categorized, and summarized. We reported quantitative (e.g., frequency) and qualitative results. Furthermore, we sought to explore similarities and differences, both within and between studies, to identify patterns and themes and to postulate explanations for findings. By doing so, we also considered the robustness of the included studies themselves by reporting on the overall strength of and confidence in the findings. If possible, we stratified our results by vulnerable groups. Data analysis Assignment of subjects into the two vulnerable groups migrants and ethnic group was made in context of their labeling within the studies. For example, Mexican Americans were assigned to ethnic group because we defined them as Americans with a Mexican background. If a group was labeled as Latinos/Latinas, we assigned them to the vulnerable group migrants. Categorization of the communication strategies was made in two steps. First, we tried to identify which communication strategies were used, and second, we tried to identify the main communication strategy focused on, if more than one strategy was used. Results In our initial search we identified 8584 articles and 121 through grey literature search apart from the manual search for additional studies by cross-checking. After removing all duplicates, we screened 7888 articles. In total 572 articles were assessed in full text for eligibility (see Fig. 1 ). Of these, 549 articles were excluded mostly because of absent of communication strategies (n = 271) or missing vulnerable groups (n = 152). A list of excluded full text studies is available as Supplement 2. Characteristics of included studies The study design of the identified studies (n = 24) ranged from interventional trials (randomized controlled trials (RCTs) (n = 5), protocols for RCTs (n = 2), and other study designs (n = 8)) to qualitative studies (focus group (n = 3) or mixed methods (n = 2)). Additionally, we identified three narrative reviews and one feasibility study. All identified studies focused on T2DM; none focused on GDM. Most studies were conducted in the United States (n = 15), one in the Netherlands, and one in Japan. We identified five different vulnerable groups within the identified studies: migrants (n = 9), ethnic groups such as African Americans (n = 8), people with a low socioeconomic status (n = 3), older people (n = 1), and people in need of care (n = 1). The identified communication strategies were stratified into the following three categories: adapted diabetes prevention programs (ADPPs), community health workers (CHWs), and technical approaches (TAs). Table 1 shows the allocations to each category in addition to descriptions of the communication strategies in Table 3 . All study characteristics are listed in Table 2 . However, some of the included studies used more than one strategy, for example, some kind of diabetes prevention program (DPP) and a TA [ 16 ], in which case we pointed out the study’s main focus. Table 1 Communication strategies of the included studies Study Methods/vulnerable group Communication strategy Category* Bender et al., 2018 Intervention/migrants Fit&Trim DPP-based intervention with mobile technology ADPP + TA Blanks et al., 2016 Intervention/ethnic group “I am Women” DPP (based on the National Diabetes Education Program) via CHW ADPP + CHW Bolin et al., 2013 Mixed methods/ethnic group Bilingual, computerized touchscreen diabetes education kiosk (Diosk) designed to provide “on-demand” education TA Borelli et al., 2018 Protocol/migrants Five-step lifestyle intervention in workplace environment with additional, voluntary activities ADPP Castro-Rivas et al., 2014 Focus groups /migrants Focus group was asked about possible interventions and strategies on how to prevent diabetes ADPP Chang et al., 2014. RCT/LSES Intervention with culturally tailored video lessons TA Fischer et al., 2016 RCT/migrants Bilingual text messages relating to nutrition, physical activity, and motivation ADPP + CHW + TA Fontil et al., 2016 Feasibility study/LSES Digital health diabetes prevention and management program ADPP + TA Ford et al., 2009 Review/ethnic group Review on health promotion and disease prevention in African American community ADPP Fukuoka et al., 2018 Intervention/migrants Weight loss intervention using a commercial mobile application ADPP + TA Gary-Webb et al., 2018 Focus groups/LSES Adaptation of the NDPP for men with a low socioeconomic status. ADPP Gutierrez et al., 2014 Intervention/ethnic group Fine, Fit, and Fabulous: faith-based DPP ADPP Hall et al., 2016 Review/ethnic group Culturally tailored DPP ADPP Handley et al., 2016 Focus groups/migrants Health literacy-tailored health IT tool delivering DPP content ADPP + TA Harvey et al., 2009 Intervention/ethnic group CHW preventive information through house parties CHW Kato et al., 2018 Protocol/older people Lifestyle intervention using Internet of Things TA Kim et al., 2018 Intervention/LSES Language-and-literacy adapted digital DPP ADPP + TA Newton et al., 2019. RCT/ethnic group Aerobic plus resistance training ADPP Nicolaou et al., 2014 Review/migrants The "DH!AAN" intervention consisted of culturally targeted lifestyle counseling using motivational interviewing targeting physical activity and diet, conducted by dieticians ADPP Ruggiero et al., 2011 Intervention/migrants Community-based translation of the DDP ADPP + CWH Siddiqui et al., 2018 RCT/migrants Adapted lifestyle intervention to increased physical activity and improved food habits ADPP Vincent et al., 2014 RCT/ethnic group Culturally tailored, community-based DPP for Spanish speaking adults of Mexican descent ADPP Walker et al., 2018 Intervention/LSES ADPP (based on NDPP) for men from disadvantaged, urban neighborhoods (Power Up for Health) ADPP Whittemore et al., 2014 Mixed methods/people in need of care ADPP in public housing communities. ADPP + CHW *The main focus of the study is shown in bold. ADPP: adapted Diabetes Prevention Program; CHW; community health worker; DPP: Diabetes Prevention Program; LSES: low socioeconomic status; NDPP: National Diabetes Prevention Program; TA: technical approach; RCT: randomized controlled trial. Table 3 Study description of all included studies Study Study description Bender MS, Cooper BA, Flowers E, Ma R, Arai S. Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial. Contemporary Clinical Trials Communications. 2018;12:76–84 * attended 5 in-person intervention office visits * tracked real-time steps by wearing a Fitbit Zip on their torso at least 10 h/day * logged daily food/drink intake and weekly home weights on a mobile app/diary * received weekly postings of discussion topics (related to weight loss, PA and healthy eating) on the study's private Facebook group site to reinforce healthy behaviors learned during in-person intervention sessions * prior to receiving the intervention, participants were trained on how to: 1) use the Fitbit Zip; download the mobile app/diary; and 2) access and join the private Facebook group. Participants' Fitbit data was monitored by research staff and uploaded in real-time to the study's online account and secure data servers. Participants experiencing technological problems received remote assistance via phone. Blanks SH, Treadwell H, Bazzell A, Graves W, Osaji O, Dean J, McLawhorn JT, Stroud JL: Community Engaged Lifestyle Modification Research: Engaging Diabetic and Prediabetic African American Women in Community-Based Interventions. J Obes 2016, 2016:3609289 The curriculum includes the following sessions: * Introduction to the healthy lifestyle program * nutrition and chronic disease * nutritional literacy/building nutritional competence * combating stress and emotional eating * strategies for health eating and exercise * partnering with your healthcare provider * celebrating your healthier family other resources and activities: * physical activity planning section * healthy eating recipe * separate youth focused curriculum which supplements the adult sessions * community Resource Guide * field trip/activity planner Bolin JN, Ory MG, Wilson AD, Salge L. Diabetes education kiosks in a latino community. The Diabetes educator. 2013;39(2):204 − 12. Bilingual Diosk Modules: * What Is Diabetes? * Are You at Risk for Diabetes? * Preventing Diabetes * High and Low Blood Sugar * Complications Related to Diabetes * Healthy Recipes * Medications and Daily Management * Meal Planning * Kids’ Corner * Signs and Symptoms of Diabetes * Exercise * Sick Days, Disasters, and Special Events Borelli MR, Riden HE, Bang H, Schenker MB. Protocol for a cluster randomized controlled trial to study the effectiveness of an obesity and diabetes intervention (PASOS) in an immigrant farmworker population. BMC Public Health. 2018;18(1):849. The five steps intervention * move * drink water * eat fruits and vegetables * measure (food portions and weight) * share (information learned and healthy habits). Examples of additionally voluntary activities: * cooking demonstrations * education on specific health topics * cultural celebrations with modified recipes * walking challenges, and Zumba dance sessions * use of the “Salud para su Corazon” curriculum ( bilingual program for promotors developed specifically for Latino communities) Castro-Rivas E, Boutin-Foster C, Milan M, Kanna B. "Es como uno bomba de tiempo [It's like a time bomb]": A qualitative analysis of perceptions of diabetes among first-degree relatives of latino patients with diabetes. Diabetes Spectrum. 2014;27(1):50 − 7. Proposal for intervention * as involving community stakeholders and community engagement. * Identifying culturally relevant media to deliver health messages is crucial * nontraditional venues such as schools, social clubs, and churches * modifying and enhancing the physical environment and investigating the excess density of unhealthy options must be addressed Chang MW, Nitzke S, Brown R, Resnicow K. A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale. BMC public health. 2014;14:280. IG: * program for 16 weeks * culturally tailored DVDs (~ 20 min., weekly from week 1–4, every second week from week 5–16) with 11 chapters for stress management, healthy nutrition, physical activity and group teleconferences) * additionally weekly peer support group teleconferences for group discussions about the video's content CG: * printed materials from standard reliable sources for stress management, healthy eating and physical activity and a DVD about food and home safety (~ 10 minutes) Fischer HHF, I.P.; Pereira, R.I.; Furniss, A.L.; Rozwadowski, J.M.; Moore, S.L.; Durfee, M.J.; Raghunath, S.G.;Tsai, A.G;, and Edward P. Havranek1: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016, 39:1364–1370. Intervention * 6 text messages per week (English or Spanish) relating to nutrition, physical activity, and motivation * once-weekly text message asking participants to report their most recent weight. * motivational interviewing with a community health worker * possibility to join the control groups DPP Fontil V, McDermott K, Tieu L, Rios C, Gibson E, Sweet CC, et al. Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team. Journal of diabetes research. 2016;2016:8472391. * previous examination of barriers via focus groups * IT support for the first use of the program, especially for people with low computer capabilities * informational event adapted to people with a low reading level * bilingual program (English/Spanish) * telephone interviews during the whole program to find out further barriers Ford AF, Reddick K, Browne MC, Robins A, Thomas SB, Crouse Quinn S. Beyond the cathedral: building trust to engage the African American community in health promotion and disease prevention. Health promotion practice. 2009;10(4):485-9. * possible interventions: Health-coaches, examination of genetic family history, smoking cessation, fitness-courses, yoga, dancing, nutrition counseling, prevention of depression, aerobics, management of chronic diseases Fukuoka Y, Vittinghoff E, Hooper J. A weight loss intervention using a commercial mobile application in Latino Americans-Adelgaza Trial. Translational Behavioral Medicine. 2018;8(5):714 − 23. * two brief in-person counseling sessions, daily use of Fitbit Zip (3-axis accelerometer) and Fitbit app, and social media (Facebook) * during the 8-week intervention period, participants were asked to log all food/drinks and calories every day and their weight into the Fitbit app, sync daily steps data that were stored in a Fitbit Zip with the Fitbit app, and interact on Facebook Gary-Webb TL, Walker EA, Realmuto L, Kamler A, Lukin J, Tyson W, et al. Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. American journal of men's health. 2018:1557988318758788. * provided incentive of 6-month parks membership and small incentives throughout to increase motivation, including t-shirts, water bottle, pedometer * provided $ 15 for completing baseline and follow-up surveys * coaches were role-models (Black and/or Latino, only men) for participants: either through modeling weight loss efforts or professional expertise in health education or fitness training * statistics on erectile dysfunction and diabetes incorporated in “quick facts” section * intervention sessions conducted within park and recreations sites that were accessible to participants’ neighborhood and had exercise resources that could help men adhere to physical activity component of the program * revised curriculum to incorporate photos, examples, and quotes that would appeal to men Gutierrez J, Devia C, Weiss L, Chantarat T, Ruddock C, Linnell J, et al. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program. The Diabetes educator. 2014;40(2):214 − 22. * FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles. *participants reported statistically significant improvements in knowledge and healthy behaviors from baseline. Statistically significant numbers reported that they ate less fast food and were less likely to overeat at follow-up *FFF demonstrates the potential of faith-based health interventions to address obesity and diabetes risk in high-need communities of color. Hall D, Lattie E, McCalla J, Saab P. Translation of the Diabetes Prevention Program to Ethnic Communities in the United States. Journal of Immigrant & Minority Health. 2016;18(2):479 − 89. Afro-Americans * Offered sessions in Baptist churches * Material for the Intervention was tailored to group discussions, some questions were complemented to evoke the discussion * Praying at the beginning of every session Latinos * bilingual personnel (trainers, diet assistants, educators) * Realization of the program took place in the environment of the Latino participants * Information materials were tailored to a low level of health literacy and focused on visualizations ("nutritional traffic light") Arab Americans * bilingual personnel (trainers, diet assistants, educators) * Offered pre-interventional education program * previous focus groups to identify relevant points for the adaption of the program (PA and educational sessions separated in gender, motivating men to participate in meal preparation, including religion) * every session starts with an Arab wisdom * cooking lessons are tailored to Arab food * groups (n = 10–12) instead of single sessions * bilingual information Handley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, et al. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implementation science : IS. 2016;11(1):73. Combination of a health literacy-tailored health IT tool for reaching ethnic minority patients with diabetes and DPP content 5 DPP topics in Spanish and English * physical Activity * nutrition * mental Health and Stress * weight Loss * glucose Screening Postpartum Harvey I, Schulz A, Israel B, Sand S, Myrie D, Lockett M, et al. The Healthy Connections project: a community-based participatory research project involving women at risk for diabetes and hypertension. Progress in community health partnerships : research, education, and action. 2009;3(4):287–300. *"Healthy Connections Advocates" provided screening through House Parties and shared health information and practical support with members of their social networks Kato S, Ando M, Kondo T, Yoshida Y, Honda H, Maruyama S. Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study). Nagoya J Med Sci. 2018;80(2):175 − 82. * devices loading Internet of things (activity meter, blood pressure (BP) monitor, body weight (BW) scale), Public health nurse guidance by phone, exercise movie * patients were provided with smartphones programmed with the study-specific application, Bluetooth-enabled activity trackers, Bluetooth-enabled BP monitors, and Bluetooth-enabled BW scales. The measurements recorded in the activity meters, BW scales, and sphygmomanometer will be automatically collected and stored via the Internet * a movie filming a model of optimal exercise will be weekly delivered. It will be changed to step-up/step-down depending on the amount of physical activity in the previous week * lifestyle guidance was provided by a public health nurse (call center) via a telephone call once a month, and concomitantly, each participant’s behavior modification stage was surveyed Kim SE, Castro Sweet CM, Gibson E, Madero EN, Rubino B, Morrison J, et al. Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemp Clin Trials Commun. 2018;10:161-8. * digital intensive lifestyle intervention based on DPP that includes virtual group support, personalized health coaching, weekly lessons, and digital tracking tools *participants are placed into small virtual groups with peers * each group has a private online social network where they can discuss goals, challenges, progress, and provide social support to one another at any time, similar to a private chat board or discussion board. * users asynchronously complete weekly health education lessons each week. The lessons are available on the digital platform and can be accessed through internet or smartphone. * user communicates with their health coach and receives individualized counseling through private messaging on the platform; coaches also facilitate discussions on the group chat board * users track meals using digital online tracking tools, track weight loss and physical activity using a wireless weight scale and pedometer, and monitor their engagement and weight loss progress. Newton RL, Jr., Johnson WD, Larrivee S, Hendrick C, Harris M, Johannsen NM, et al. A Randomized Community-based Exercise Training Trial in African American Men: ARTIIS. Med Sci Sports Exerc. 2019. * exercise training intervention for 5 months consisting of 150 minutes of moderate intensity aerobic activity and two days of resistance training per week, consistent with the current federal physical activity guidelines Nicolaou M, Vlaar E, van Valkengoed I, Middelkoop B, Stronks K, Nierkens V. Development of a diabetes prevention program for Surinamese South Asians in the Netherlands. Health promotion international. 2014;29(4):680 − 91. * components of DH!AAN intervention focus on improving diet and physical activity, risk perception of the disease, social contexts regarding to support by family and friends, the generation of positive attitudes towards healthy versions of traditional behavior and food and the development of skills like cooking. * use of an information folder using a "Bollywood" theme: Photos of South Asian individuals, examples and tips on healthy eating using traditional foods, items on yoga, testimonials on healthy eating from a local man and stories about weight loss practices from Bollywood stars. * integration of basic and specific cultural elements (eating/cooking habits, influence of social environment) Ruggiero LO, S; Choi, J.K: Community-Based Translation of the Diabetes Prevention Program’s Lifestyle Intervention in an Underserved Latino Population. The Diabetes EDUCATOR 2011, 37(4):564–672. * regular community advisory board meetings, inclusion of community members as project staff and interventionists (i.e., CHWs), and hosting community forums * program was further tailored and enhanced for this Latino community by providing culturally specific information on diabetes risk and providing culturally relevant and language-appropriate program and supplemental educational material * implementation of the groups was designed to minimize the impact of barriers to participation, such as education and literacy levels, language, income, transportation, and lack of medical coverage * to address language and literacy barriers, the group sessions were conducted in Spanish, and all participant program materials were provided in Spanish * in addition to receiving program session materials, participants were provided with supplemental culturally appropriate educational materials (e.g., recipe book, National Diabetes Education Program materials), self-monitoring tools (e.g., personalized weight chart), a pedometer, a body weight scale, and measuring cups Siddiqui F, Koivula RW, Kurbasic A, Lindblad U, Nilsson PM, Bennet L. Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention. Am J Prev Med. 2018;55(2):187 − 96. * in addition to the verbal instructions by an Arabic-speaking nurse, participants were also provided with written instructions. Participants were instructed to wear the device continuously for a total of 10 complete days * the intervention was composed of seven group sessions, including one cooking class, and addressed self-empowerment, cultural and social barriers to lifestyle change, diet, and PA habits * health coaches organized and led the sessions, but participants were encouraged to actively participate in the discussions * participants were asked to identify barriers to being physically active and to develop an action plan for overcoming such obstacles. They were motivated to incorporate PA in daily life, such as walking or using stairs instead of riding a bus or taking the elevator * gender differences and cultural barriers to PA were discussed * participants received information on available PA centers, including a “women only” swimming hall, and gyms in the area * participants were offered financial assistance to buy shoes and clothing for PA or admission to a PA center Vincent D, McEwen MM, Hepworth JT, Stump CS. The effects of a community-based, culturally tailored diabetes prevention intervention for high-risk adults of Mexican descent. The Diabetes educator. 2014;40(2):202 − 13. IG Culturally tailored messages for promoting healthful eating and for increasing physical activity. Cultural tailoring included using an educational fotonovela (story with photographs and small dialogue bubbles), offering the intervention and all materials in Spanish and English, using culturally acceptable exercise strategies (e.g., walking, dancing), providing cooking demonstrations of low-fat traditional Mexican American foods, and facilitating group meal sharing. CG Educational sessions giving general information on health promotion and disease prevention. Walker EA, Weiss L, Gary-Webb TL, Realmuto L, Kamler A, Ravenell J, et al. Power Up for Health: Pilot study outcomes of a Diabetes Prevention Program for men from disadvantaged neighborhoods. American Journal of Men's Health. 2018;12(4):989 − 97. * curriculum adapted to better engage men from disadvantaged, urban neighborhoods. Modifications to the NDPP curriculum were made by the research team in an iterative manner under the guidance of an Advisory Panel of experts in men’s health promotion, male community leaders, and the Power Up for Health coaches * curriculum was facilitated by male lifestyle coaches who had received training as an NDPP coach and also trained in the delivery of the Power Up for Health curriculum * if participating men missed a session, however, by protocol the coaches proactively offered a telephone make-up of that session to each participant to be done after they received the session materials by email or by mail from study staff. These telephone make-up sessions were delivered as individual topic sessions (i.e., not multiple missed sessions grouped in one phone call) and independent of the in-person sessions Whittemore R, Rosenberg A, Gilmore L, Withey M, Breault A. Implementation of a Diabetes Prevention Program in Public Housing Communities. Public Health Nursing. 2014;31(4):317 − 26. * homecare nurses delivered an ADPP at public housing communities to adults at-risk for T2DM * DPP was adapted after focus groups with stakeholders and residents of the community ADPP: adapted Diabetes Prevention Program; BP: blood pressure; BW: body weight; CHW; community health worker; CG: control group; DPP: Diabetes Prevention Program; IG: intervention group; LSES: low socioeconomic status; NDPP: National Diabetes Prevention Program; PA: physical activity; TA: technical approach; RCT: randomized controlled trial. Adapted diabetes prevention programs We identified 21 studies that used any kind of ADPP (in 12 studies, it was the main focus [ 17 – 28 ]). Most studies adapted the DPP [ 29 ], which is a lifestyle intervention designed in 2002 by the DPP Research Group. It is based on a 16-session core curriculum with sessions such as Healthy Eating, Being Active, and Problem Solving. Other programs such as the National Diabetes Education Program (NDEP) [ 30 ] or the National Diabetes Prevention Program (NDPP) [ 31 ] were also used as a curriculum base for some of the included studies (e.g., NDEP [ 32 ] and NDPP [ 28 ]). The included studies (n = 21) targeted mostly migrants (n = 9) and ethnic groups (n = 6). Mostly, the adaptation of the DPPs was based on barriers or facilitating factors to participate in a preventive program, e.g., language barriers, economic factors, or religious/cultural background. Some studies (for example [ 18 , 21 , 27 ]) were adapted for cultural/religious backgrounds, including language adaptation. Other studies focused on community translation and financial aspects. One example of an ADPP is the study conducted by Nicolaou et al. [ 24 ]. They described a lifestyle intervention based on a DPP targeting Surinamese men and women from South Asia living in the Netherlands. The program was culturally adapted; e.g., they had dietitians who were familiar with Surinamese South Asian dietary habits and provided cooking classes to adjust traditional dishes. Furthermore, they provide family sessions in home settings to integrate family in achieving dietary goals. Additionally, they used role models from favorite Bollywood movies in an information folder with examples and tips on healthy eating using traditional foods, yoga, and stories about weight loss practices from Bollywood stars. Cultural adaptation was also achieved with respect to physical activity by recommending 30 minutes of daily yoga and Bollywood-like dancing using motivational interviewing [ 24 ]. Community health workers We identified five studies which used CHWs, three of which focused on CHWs [ 32 – 35 ]. Blanks et al. [ 32 ] and Harvey et al. [ 34 ] both used CHWs in African American settings for preventive interventions. In general, CHWs were trained in T2DM prevention and had the same ethnic and social background as the participants. Blanks et al. focused on prediabetic African American women. The aims was to increase participant knowledge related to the complex of nutrition, physical activity, and health literacy and therefore have a positive impact on increasing awareness of diabetes risks and improved access to healthcare [ 32 ]. Harvey et al. targeted African Americans and Latinos (88.5% women) at risk of diabetes and hypertension in house parties where health workers or health connections advocates provided screening and shared health information and practical support with members of their social networks [ 34 ]. Technological approaches Another communication strategy was an approach using any kind of technical device. Overall, nine studies focused on TA in combination with an ADPP [ 16 , 33 , 36 – 42 ], but two used a TA alone [ 36 , 37 ]. Fischer et al. [ 33 ] sent bilingual (English/Spanish) text messages relating to nutrition, physical activity, and motivation. The intervention group could additionally join the DPP classes. Handley et al. [ 40 ] also sent text messages and used weekly phone calls plus live, tailored call-back health coaching. The kiosk system used by Bolin et al. [ 36 ] is a bilingual (English/Spanish) diabetes education kiosk system (Diosk) that provides information on different topics such as what “diabetic” means, preventing diabetes, meal planning, and exercise. Kiosk systems use touch-screen displays at waist level. They were placed in low-income pharmacies, federal qualified healthcare centers, and community arts centers. The Diosks not only provide on-demand information to the user but also collect general user frequencies and the frequencies of the topics accessed. Fontil et al. [ 38 ] used a bilingual (English/Spanish) digital health program for low-income prediabetic participants. IT support for the first use of the program, especially for people with low computer capabilities as well as an informational event adapted to people with a low reading level were provided prior to the program use. Discussion We identified different communication strategies for the prevention of T2DM in vulnerable groups. All but two studies were conducted in the United States and therefore targeted mostly ethnic groups (African Americans) or migrants. Most communication strategies used TAs or adapted existing programs such as the DPP for language and cultural background. TAs differed most within the categories, because every identified study used a different approach (videos, SMS, kiosk systems, and digital health program). The other categories were more similar among the studies, but they may have, for example, adapted for different barriers for different vulnerable groups. It seems necessary to identify common barriers and facilitating factors in T2DM prevention to develop communication strategies for vulnerable groups. Some of the identified studies initially searched for barriers and facilitating factors or gained this information through focus groups. Therefore, some of the communication strategies had already been adapted to known barriers [ 26 , 36 ] such as language (e.g., adaptation to bilingualism) or cultural factors. The communication strategies often apply to just one vulnerable group, and there are just a few that overlap, such as low-income migrants. Especially, religious and cultural factors seem to require different approaches for each vulnerable group [ 43 ]. Furthermore, some approaches focused on only one gender [ 32 , 44 ]. Therefore, communication strategies should be tailored for one vulnerable group and/or gender and adapted to all known barriers. One important known facilitating factor is family and friends [ 45 ]. None of the identified studies adapted their approaches with respect to this factor. For example, it is conceivable to include family members in cooking or exercise classes. Most studies used more than one communication strategy; just a few used only one. There are no data on the effectiveness of one strategy compared with mixed strategies regarding the willingness to participate or the outcome itself. It might be necessary to use a mixed strategy to adapt a preventive program for some of the known barriers, for example, to use a combination of a CHW strategy (a female CHW) and an ADPP strategy (language and cultural adaptation for migrant women). Perhaps, it is required to analyze whether all approaches could be used for each vulnerable group. For example, TAs may need a special adaptation for older people. Limitations As mentioned before, this review is part of the national awareness and prevention strategy on diabetes in Germany conducted by the Federal Center for Health Education and the Federal Ministry of Health. For this reason, we had to limit the publication date of included studies because we had a narrow time frame for completing this scoping review. However, there might be too many differences in communication strategies arising from increasing digitization. Sometimes, it was difficult to assign groups to either ethnic group or migrants. Therefore, there may have been incorrect assignments to the vulnerable groups. Furthermore, although we stated the main focus regarding the communication strategy of each study, we could not know whether this was the intended focus of the studies. Conclusion We identified three different categories of communication strategies for prevention of T2DM in vulnerable groups. Communication strategies should be adapted to barriers and facilitating factors to increase participating and motivation. Furthermore, it seems necessary to address each vulnerable group separately. Abbreviations ADPP adapted Diabetes Prevention program CHW community health worker DPP Diabetes Prevention Program GDM gestational diabetes NDEP National Diabetes Education Program NDPP National Diabetes Prevention Program PPC Population, Concept, Context RCT randomized controlled trial T2DM type 2 diabetes mellitus TA technical approach WHO World Health Organization Declarations Ethics approval and consent to participate Not applicable Consent for publication Not applicable Availability of data and materials Not applicable Competing interests The authors declare that they have no competing interests. Funding This study was funded by the Federal Center for Health Education. The funder had no role in developing the scoping review. The findings and conclusions are those of the authors. 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Supplementary Files Supplement3PRISMAScRChecklist.docx Supplement2ExcludedstudiesCOMEUPUpdate.docx Supplement1searchstrategyUpdate.docx Cite Share Download PDF Status: Published Journal Publication published 24 Nov, 2021 Read the published version in Systematic Reviews → Version 1 posted Editorial decision: Minor revision 04 Apr, 2021 Review # 2 received at journal 19 Jan, 2021 Reviewer # 2 agreed at journal 18 Jan, 2021 Review # 1 received at journal 13 Dec, 2020 Reviewer # 1 agreed at journal 28 Nov, 2020 Reviewers invited by journal 27 Nov, 2020 Editor assigned by journal 25 Aug, 2020 Editor invited by journal 24 Aug, 2020 Submission checks completed at journal 04 Aug, 2020 First submitted to journal 03 Aug, 2020 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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11:04:00","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-52836/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-52836/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13643-021-01846-8","type":"published","date":"2021-11-24T07:49:04+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":1827606,"identity":"9615c64e-deed-45a8-b5c7-f08e7f6807df","added_by":"auto","created_at":"2020-08-06 21:58:35","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":53277,"visible":true,"origin":"","legend":"Flowchart_search_strategy","description":"","filename":"Fig1.JPG","url":"https://assets-eu.researchsquare.com/files/rs-52836/v1/Fig1.JPG"},{"id":15853964,"identity":"dd249f0c-e670-4a8d-b9a0-f9cfdbd17b59","added_by":"auto","created_at":"2021-11-24 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\u003cp\u003eThe global prevalence of diabetes mellitus is nearly 9% [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], with 90% of patients having type 2 diabetes mellitus (T2DM). Additionally, the prevalence of gestational diabetes mellitus (GDM) is increasing with approximately 16% of all live births being affected by hyperglycemia [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Because of its health consequences, the global health-related costs are expected to nearly double from US \u003cspan\u003e$\u003c/span\u003e1.3 trillion in 2015 to \u003cspan\u003e$\u003c/span\u003e2.5 trillion by 2030, taking past trends into account [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This equals an increase in costs as a share of global gross domestic product from 1.8% in 2015 to a maximum of 2.2% in 2030 [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMany cases of T2DM/GDM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, and staying physically active [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Therefore, there is an increasing need to implement effective preventive policies and to promote healthy lifestyles.\u003c/p\u003e \u003cp\u003eEthnicity and/or lower socioeconomic status are important considerations in individuals affected by diabetes. For example, people in the lowest socioeconomic groups are 2.5 times as likely, and black and minority ethnic groups are up to six times as likely, to develop diabetes compared with the general population [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This could partly be attributed to lifestyle factors such as obesity, which more severely affect deprived communities and those living in vulnerable circumstances [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Yet, these vulnerable populations are difficult to reach in terms of preventive measures [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNumerous studies demonstrated that T2DM can be prevented or delayed by intensive lifestyle changes in individuals with prediabetes [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. However, little is known regarding effective communication or awareness strategies for primary prevention of T2DM/GDM, in particular, regarding accessibility to those who are hardest to reach and most at risk. Identifying barriers and facilitators is necessary to increase the number of participants in preventive interventions that address vulnerable groups. Just as importantly, we must determine communication strategies to access participants, especially those in vulnerable groups. Therefore, we aimed to identify translations or modifications of existing programs or new communication strategies for vulnerable groups. Our target audiences are primary care providers (e.g., general practitioners, nutritionists, and midwives) as well as diabetologists and public health experts actively involved in diabetes prevention. The aim of this study was to systematically review the literature in order to identify and describe communication strategies for preventing T2DM/GDM in vulnerable groups.\u003c/p\u003e "},{"header":"Methods","content":" \u003cp\u003eThis project was commissioned by the Federal Center for Health Education in Germany as part of the national education and communication strategy on diabetes mellitus. The project consists of two scoping reviews, one aimed to identify barriers and facilitating factors [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and the other aimed to identify communication strategies for diabetes prevention in vulnerable groups. This report focuses on communication strategies. We used the same literature search for both scoping reviews. The methods were in accordance with those stated in a previously published protocol [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Deviations are outlined below.\u003c/p\u003e \u003cp\u003eThe scoping review was conducted following Arksey and O\u0026rsquo;Malley\u0026rsquo;s framework [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] and the Joanna Briggs Institute Reviewers\u0026rsquo; Manual 2015 [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Furthermore, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] was used. Since the International Prospective Register of Systematic Reviews (PROSPERO) does not register scoping reviews, this scoping review was not registered.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eInclusion criteria\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003evulnerable patients with, or at risk of, T2DM/GDM\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStudies presenting barriers and facilitating factors for implementing a preventive or health-promoting intervention (primary or secondary prevention)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWorld Health Organization (WHO) mortality stratum A countries\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003epublication date no earlier than 2008\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eExclusion criteria\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eindigenous people, children, or people with mental disorders\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eno full text available\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003egeneral prevention with no context of T2DM/GDM\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStudies including patients on oral antidiabetic or insulin medications\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eEligibility criteria are additionally shown in the PPC (Population, Concept, Context) mnemonic, which is presented in the protocol [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. We included studies presenting communication strategies for the prevention of T2DM/GDM in vulnerable groups. Publications were restricted to studies published from January 2008 onward. No language restrictions were made. If necessary, full texts were translated. Furthermore, we included only those studies with a low mortality stratum (A) according to the WHO [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], thus ensuring that our findings would be applicable to western industrialized countries. We defined vulnerable groups using the definition of Lewis et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], except we excluded indigenous people, children, and people with mental disorders. These exclusion criteria were added after the protocol was published. Because it was necessary to define and separate primary and secondary from tertiary prevention or therapy, we excluded studies with patients treated with any antidiabetic medication (e.g., metformin or insulin).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInformation sources\u003c/h2\u003e \u003cp\u003eThe following electronic databases were searched: PubMed, EMBASE, PsycINFO, PSYNDEX, Social Science Citation Index, and CINAHL. Gray literature was searched in greylit.org and through the homepages of the WHO and international, healthcare, or public health departments (e.g., Department of Health and Social Care, UK; Agency for Healthcare Research and Quality; and the U.S. Preventive Services Task Force). We searched manually for additional studies by cross-checking the reference lists of all included studies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSearch\u003c/h2\u003e \u003cp\u003eThe search strategy was developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. For all databases, the initial search was conducted in May 2018, but the gray literature was searched in July 2018. An update of the initial database searches was conducted in September 2019. An update of the initial gray literature search was not performed because the initial search was very time-consuming and not worthwhile. The search strategy is presented as Supplement 1.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData management\u003c/h2\u003e \u003cp\u003eThe search results were uploaded and managed using Microsoft Excel. A PRISMA flow diagram was used to summarize and visualize the study selection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStudy selection\u003c/h2\u003e \u003cp\u003eTwo reviewers independently screened titles and abstracts of the search results against the inclusion criteria. Subsequently, two reviewers independently screened full-text reports for potential eligibility. Any disagreement was resolved through discussion and consensus. The reasons for exclusion of full texts were documented. A list of included studies in addition to study characterization is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e and a list of excluded studies is provided as Supplements 2.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy Characteristics of all included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudy design\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eParticipants [n]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGender [m/f]n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAge[years] mean(%)//n(%)//Range\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVulnerable group category\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBender MS, Cooper BA, Flowers E, Ma R, Arai S. Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial. Contemporary Clinical Trials Communications. 2018;12:76\u0026ndash;84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32(48)/35(52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlanks SH, Treadwell H, Bazzell A, Graves W, Osaji O, Dean J, McLawhorn JT, Stroud JL: Community Engaged Lifestyle Modification Research: Engaging Diabetic and Prediabetic African American Women in Community-Based Interventions. J Obes 2016, 2016:3609289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)/79(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBolin JN, Ory MG, Wilson AD, Salge L. Diabetes education kiosks in a latino community. The Diabetes educator. 2013;39(2):204\u0026thinsp;\u0026minus;\u0026thinsp;12.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed Methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUse: 5372\u003c/p\u003e \u003cp\u003eExit-Survey: 179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55(30.8)/115(63.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;18 18 (9.9)\u003c/p\u003e \u003cp\u003e19\u0026ndash;35 28 (15.4)\u003c/p\u003e \u003cp\u003e36\u0026ndash;49 71 (39.0)\u003c/p\u003e \u003cp\u003e50\u0026ndash;64 44 (24.2)\u003c/p\u003e \u003cp\u003e65\u0026thinsp;+\u0026thinsp;10 (5.5)\u003c/p\u003e \u003cp\u003en.r. 11 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorelli MR, Riden HE, Bang H, Schenker MB. Protocol for a cluster randomized controlled trial to study the effectiveness of an obesity and diabetes intervention (PASOS) in an immigrant farmworker population. BMC Public Health. 2018;18(1):849.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtocol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCastro-Rivas E, Boutin-Foster C, Milan M, Kanna B. \"Es como uno bomba de tiempo [It's like a time bomb]\": A qualitative analysis of perceptions of diabetes among first-degree relatives of latino patients with diabetes. Diabetes Spectrum. 2014;27(1):50\u0026thinsp;\u0026minus;\u0026thinsp;7.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15(65)/8(35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChang MW, Nitzke S, Brown R, Resnicow K. A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale. BMC public health. 2014;14:280.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIG/CG\u003c/p\u003e \u003cp\u003e410/202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)/612(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLSES\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFischer HHF, I.P.; Pereira, R.I.; Furniss, A.L.; Rozwadowski, J.M.; Moore, S.L.; Durfee, M.J.; Raghunath, S.G.;Tsai, A.G;, and Edward P. Havranek1: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016, 39:1364\u0026ndash;1370.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIG/CG \u003c/p\u003e \u003cp\u003e51/34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIG: 13(25.5)/38(74.5)\u003c/p\u003e \u003cp\u003eCG: 6(17.6)/28(82.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIG: 47.9\u003c/p\u003e \u003cp\u003eCG: 41.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFontil V, McDermott K, Tieu L, Rios C, Gibson E, Sweet CC, et al. Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team. Journal of diabetes research. 2016;2016:8472391.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeasibility Study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(47.0)/10(53.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLSES\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFord AF, Reddick K, Browne MC, Robins A, Thomas SB, Crouse Quinn S. Beyond the cathedral: building trust to engage the African American community in health promotion and disease prevention. Health promotion practice. 2009;10(4):485-9.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFukuoka Y, Vittinghoff E, Hooper J. A weight loss intervention using a commercial mobile application in Latino Americans-Adelgaza Trial. Translational Behavioral Medicine. 2018;8(5):714\u0026thinsp;\u0026minus;\u0026thinsp;23.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(31.0)/37(69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGary-Webb TL, Walker EA, Realmuto L, Kamler A, Lukin J, Tyson W, et al. Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. American journal of men's health. 2018:1557988318758788.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29(100)/0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.r.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLSES\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGutierrez J, Devia C, Weiss L, Chantarat T, Ruddock C, Linnell J, et al. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program. The Diabetes educator. 2014;40(2):214\u0026thinsp;\u0026minus;\u0026thinsp;22.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21(11.7)/159(88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18\u0026ndash;44: 25(15.6)\u003c/p\u003e \u003cp\u003e45\u0026ndash;64: 83(51.9)\u003c/p\u003e \u003cp\u003e65\u0026ndash;74: 40(25.9)\u003c/p\u003e \u003cp\u003e75+: 12(7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHall D, Lattie E, McCalla J, Saab P. Translation of the Diabetes Prevention Program to Ethnic Communities in the United States. Journal of Immigrant \u0026amp; Minority Health. 2016;18(2):479\u0026thinsp;\u0026minus;\u0026thinsp;89.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHandley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, et al. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implementation science : IS. 2016;11(1):73.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)/22(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHarvey I, Schulz A, Israel B, Sand S, Myrie D, Lockett M, et al. The Healthy Connections project: a community-based participatory research project involving women at risk for diabetes and hypertension. Progress in community health partnerships : research, education, and action. 2009;3(4):287\u0026ndash;300.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e164 (11.5)/ 1264 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18\u0026ndash;29: 93(10.0)\u003c/p\u003e \u003cp\u003e30\u0026ndash;44: 223(24.0)\u003c/p\u003e \u003cp\u003e45\u0026ndash;59: 287(31.0)\u003c/p\u003e \u003cp\u003e60+: 325(35.0)\u003c/p\u003e \u003cp\u003eN.R. 500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKato S, Ando M, Kondo T, Yoshida Y, Honda H, Maruyama S. Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study). Nagoya J Med Sci. 2018;80(2):175\u0026thinsp;\u0026minus;\u0026thinsp;82.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtocol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOlder people\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKim SE, Castro Sweet CM, Gibson E, Madero EN, Rubino B, Morrison J, et al. Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemp Clin Trials Commun. 2018;10:161-8.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44(19.1)/186(80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLSES\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNewton RL, Jr., Johnson WD, Larrivee S, Hendrick C, Harris M, Johannsen NM, et al. A Randomized Community-based Exercise Training Trial in African American Men: ARTIIS. Med Sci Sports Exerc. 2019.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIG/CG\u003c/p\u003e \u003cp\u003e54/49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103(100)/0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNicolaou M, Vlaar E, van Valkengoed I, Middelkoop B, Stronks K, Nierkens V. Development of a diabetes prevention program for Surinamese South Asians in the Netherlands. Health promotion international. 2014;29(4):680\u0026thinsp;\u0026minus;\u0026thinsp;91.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en.a.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRuggiero LO, S; Choi, J.K: Community-Based Translation of the Diabetes Prevention Program\u0026rsquo;s Lifestyle Intervention in an Underserved Latino Population. The Diabetes EDUCATOR 2011, 37(4):564\u0026ndash;672.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)/69(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSiddiqui F, Koivula RW, Kurbasic A, Lindblad U, Nilsson PM, Bennet L. Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention. Am J Prev Med. 2018;55(2):187\u0026thinsp;\u0026minus;\u0026thinsp;96.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIG/CG\u003c/p\u003e \u003cp\u003e50/46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIG//CG\u003c/p\u003e \u003cp\u003e14 (43.7)/24(56.3)//18 (48.6)/28(51.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIG/CG\u003c/p\u003e \u003cp\u003e50.2/47.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMigrants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVincent D, McEwen MM, Hepworth JT, Stump CS. The effects of a community-based, culturally tailored diabetes prevention intervention for high-risk adults of Mexican descent. The Diabetes educator. 2014;40(2):202\u0026thinsp;\u0026minus;\u0026thinsp;13.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIG/CG\u003c/p\u003e \u003cp\u003e38/20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIG\u003c/p\u003e \u003cp\u003e9(23.7)/29(76.3)\u003c/p\u003e \u003cp\u003eCG\u003c/p\u003e \u003cp\u003e4(20.0)/16(80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIG/CG \u003c/p\u003e \u003cp\u003e50.0/52.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalker EA, Weiss L, Gary-Webb TL, Realmuto L, Kamler A, Ravenell J, et al. Power Up for Health: Pilot study outcomes of a Diabetes Prevention Program for men from disadvantaged neighborhoods. American Journal of Men's Health. 2018;12(4):989\u0026thinsp;\u0026minus;\u0026thinsp;97.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29(100)/0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLSES\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhittemore R, Rosenberg A, Gilmore L, Withey M, Breault A. Implementation of a Diabetes Prevention Program in Public Housing Communities. Public Health Nursing. 2014;31(4):317\u0026thinsp;\u0026minus;\u0026thinsp;26.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(19.4)/54(80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDiabetes prevention: 41.9\u003c/p\u003e \u003cp\u003eStandard care: 39.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople in need of care\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eLSES: low socioeconomic status; n.a.: not applicable; n.r.: not reported\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData extraction\u003c/h2\u003e \u003cp\u003eA standardized extraction form was developed for this review. A pilot test of the data extraction form was conducted on a sample of five articles by the reviewers involved in the scoping review to assess its completeness and applicability. Based on the pilot testing, modifications to the standardized data extraction form were needed and undertaken to ensure the data necessary to address the research questions were obtained. Data were extracted by one reviewer and checked by another. Disagreements were resolved through discussion and consensus.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData items\u003c/h2\u003e \u003cp\u003eThe preliminary data extraction categories were derived from our overarching research question. The following data were collected:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eStudy characteristics (e.g., country, setting, publication date, number of participants, target disease, and study design/method)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePatient characteristics (e.g., age, gender, and affiliation to vulnerable group)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eInclusion/exclusion criteria\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCommunication strategies\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eRisk of bias\u003c/h2\u003e \u003cp\u003eAs this was a scoping review, there was no risk of bias assessment. This is consistent with guidance on the conduct of scoping reviews [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData synthesis\u003c/h2\u003e \u003cp\u003eWe used Arksey and O\u0026rsquo;Malley\u0026rsquo;s methods [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] of reporting and provide a descriptive analysis of the extent, nature, and distribution of the studies included in the review as well as a narrative, thematic summary of the data collected. This was achieved by summarizing the literature according to the types of vulnerable groups, communication strategies, comparators, implementation factors, and outcomes identified. We aimed to map the research landscape in this area. This was facilitated by some form of visual representation of the data to map the extent, range, and nature of research in this area. Data were charted, categorized, and summarized. We reported quantitative (e.g., frequency) and qualitative results. Furthermore, we sought to explore similarities and differences, both within and between studies, to identify patterns and themes and to postulate explanations for findings. By doing so, we also considered the robustness of the included studies themselves by reporting on the overall strength of and confidence in the findings. If possible, we stratified our results by vulnerable groups.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eAssignment of subjects into the two vulnerable groups migrants and ethnic group was made in context of their labeling within the studies. For example, Mexican Americans were assigned to ethnic group because we defined them as Americans with a Mexican background. If a group was labeled as Latinos/Latinas, we assigned them to the vulnerable group migrants. Categorization of the communication strategies was made in two steps. First, we tried to identify which communication strategies were used, and second, we tried to identify the main communication strategy focused on, if more than one strategy was used.\u003c/p\u003e \u003c/div\u003e "},{"header":"Results","content":" \u003cp\u003eIn our initial search we identified 8584 articles and 121 through grey literature search apart from the manual search for additional studies by cross-checking. After removing all duplicates, we screened 7888 articles. In total 572 articles were assessed in full text for eligibility (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of these, 549 articles were excluded mostly because of absent of communication strategies (n\u0026thinsp;=\u0026thinsp;271) or missing vulnerable groups (n\u0026thinsp;=\u0026thinsp;152). A list of excluded full text studies is available as Supplement 2.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCharacteristics of included studies\u003c/h2\u003e \u003cp\u003eThe study design of the identified studies (n\u0026thinsp;=\u0026thinsp;24) ranged from interventional trials (randomized controlled trials (RCTs) (n\u0026thinsp;=\u0026thinsp;5), protocols for RCTs (n\u0026thinsp;=\u0026thinsp;2), and other study designs (n\u0026thinsp;=\u0026thinsp;8)) to qualitative studies (focus group (n\u0026thinsp;=\u0026thinsp;3) or mixed methods (n\u0026thinsp;=\u0026thinsp;2)). Additionally, we identified three narrative reviews and one feasibility study. All identified studies focused on T2DM; none focused on GDM. Most studies were conducted in the United States (n\u0026thinsp;=\u0026thinsp;15), one in the Netherlands, and one in Japan. We identified five different vulnerable groups within the identified studies: migrants (n\u0026thinsp;=\u0026thinsp;9), ethnic groups such as African Americans (n\u0026thinsp;=\u0026thinsp;8), people with a low socioeconomic status (n\u0026thinsp;=\u0026thinsp;3), older people (n\u0026thinsp;=\u0026thinsp;1), and people in need of care (n\u0026thinsp;=\u0026thinsp;1). The identified communication strategies were stratified into the following three categories: adapted diabetes prevention programs (ADPPs), community health workers (CHWs), and technical approaches (TAs). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the allocations to each category in addition to descriptions of the communication strategies in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. All study characteristics are listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e. However, some of the included studies used more than one strategy, for example, some kind of diabetes prevention program (DPP) and a TA [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], in which case we pointed out the study\u0026rsquo;s main focus.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCommunication strategies of the included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMethods/vulnerable group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCommunication strategy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCategory*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBender et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFit\u0026amp;Trim DPP-based intervention with mobile technology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlanks et al., 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I am Women\u0026rdquo; DPP (based on the National Diabetes Education Program) via CHW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eCHW\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBolin et al., 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed methods/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBilingual, computerized touchscreen diabetes education kiosk (Diosk) designed to provide \u0026ldquo;on-demand\u0026rdquo; education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorelli et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtocol/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFive-step lifestyle intervention in workplace environment with additional, voluntary activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCastro-Rivas et al., 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups /migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFocus group was asked about possible interventions and strategies on how to prevent diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChang et al., 2014.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT/LSES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention with culturally tailored video lessons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFischer et al., 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBilingual text messages relating to nutrition, physical activity, and motivation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;CHW\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFontil et al., 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeasibility study/LSES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDigital health diabetes prevention and management program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFord et al., 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReview on health promotion and disease prevention in African American community\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFukuoka et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWeight loss intervention using a commercial mobile application\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGary-Webb et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups/LSES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdaptation of the NDPP for men with a low socioeconomic status.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGutierrez et al., 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFine, Fit, and Fabulous: faith-based DPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHall et al., 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCulturally tailored DPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHandley et al., 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus groups/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealth literacy-tailored health IT tool delivering DPP content\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHarvey et al., 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCHW preventive information through house parties\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCHW\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKato et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtocol/older people\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLifestyle intervention using Internet of Things\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKim et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/LSES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLanguage-and-literacy adapted digital DPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eTA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNewton et al., 2019.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAerobic plus resistance training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNicolaou et al., 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReview/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe \"DH!AAN\" intervention consisted of culturally targeted lifestyle counseling using motivational interviewing targeting physical activity and diet, conducted by dieticians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRuggiero et al., 2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCommunity-based translation of the DDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u0026thinsp;+\u003c/b\u003e\u0026thinsp;CWH\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSiddiqui et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT/migrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdapted lifestyle intervention to increased physical activity and improved food habits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVincent et al., 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT/ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCulturally tailored, community-based DPP for Spanish speaking adults of Mexican descent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalker et al., 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention/LSES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eADPP (based on NDPP) for men from disadvantaged, urban neighborhoods (Power Up for Health)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eADPP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhittemore et al., 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed methods/people in need of care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eADPP in public housing communities.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADPP\u0026thinsp;+\u0026thinsp;\u003cb\u003eCHW\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*The main focus of the study is shown in bold.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eADPP: adapted Diabetes Prevention Program; CHW; community health worker; DPP: Diabetes Prevention Program; LSES: low socioeconomic status; NDPP: National Diabetes Prevention Program; TA: technical approach; RCT: randomized controlled trial.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy description of all included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudy description\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBender MS, Cooper BA, Flowers E, Ma R, Arai S. Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial. Contemporary Clinical Trials Communications. 2018;12:76\u0026ndash;84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* attended 5 in-person intervention office visits\u003c/p\u003e \u003cp\u003e* tracked real-time steps by wearing a Fitbit Zip on their torso at least 10\u0026nbsp;h/day\u003c/p\u003e \u003cp\u003e* logged daily food/drink intake and weekly home weights on a mobile app/diary\u003c/p\u003e \u003cp\u003e* received weekly postings of discussion topics (related to weight loss, PA and healthy eating) on the study's private Facebook group site to reinforce healthy behaviors learned during in-person intervention sessions\u003c/p\u003e \u003cp\u003e* prior to receiving the intervention, participants were trained on how to: 1) use the Fitbit Zip; download the mobile app/diary; and 2) access and join the private Facebook group. Participants' Fitbit data was monitored by research staff and uploaded in real-time to the study's online account and secure data servers. Participants experiencing technological problems received remote assistance via phone.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlanks SH, Treadwell H, Bazzell A, Graves W, Osaji O, Dean J, McLawhorn JT, Stroud JL: Community Engaged Lifestyle Modification Research: Engaging Diabetic and Prediabetic African American Women in Community-Based Interventions. J Obes 2016, 2016:3609289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe curriculum includes the following sessions:\u003c/p\u003e \u003cp\u003e* Introduction to the healthy lifestyle program\u003c/p\u003e \u003cp\u003e* nutrition and chronic disease\u003c/p\u003e \u003cp\u003e* nutritional literacy/building nutritional competence\u003c/p\u003e \u003cp\u003e* combating stress and emotional eating\u003c/p\u003e \u003cp\u003e* strategies for health eating and exercise\u003c/p\u003e \u003cp\u003e* partnering with your healthcare provider\u003c/p\u003e \u003cp\u003e* celebrating your healthier family other resources and activities:\u003c/p\u003e \u003cp\u003e* physical activity planning section\u003c/p\u003e \u003cp\u003e* healthy eating recipe\u003c/p\u003e \u003cp\u003e* separate youth focused curriculum which supplements the adult sessions\u003c/p\u003e \u003cp\u003e* community Resource Guide\u003c/p\u003e \u003cp\u003e* field trip/activity planner\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBolin JN, Ory MG, Wilson AD, Salge L. Diabetes education kiosks in a latino community. The Diabetes educator. 2013;39(2):204\u0026thinsp;\u0026minus;\u0026thinsp;12.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBilingual Diosk Modules:\u003c/p\u003e \u003cp\u003e* What Is Diabetes?\u003c/p\u003e \u003cp\u003e* Are You at Risk for Diabetes?\u003c/p\u003e \u003cp\u003e* Preventing Diabetes\u003c/p\u003e \u003cp\u003e* High and Low Blood Sugar \u003c/p\u003e \u003cp\u003e* Complications Related to Diabetes \u003c/p\u003e \u003cp\u003e* Healthy Recipes \u003c/p\u003e \u003cp\u003e* Medications and Daily Management \u003c/p\u003e \u003cp\u003e* Meal Planning \u003c/p\u003e \u003cp\u003e* Kids\u0026rsquo; Corner \u003c/p\u003e \u003cp\u003e* Signs and Symptoms of Diabetes\u003c/p\u003e \u003cp\u003e* Exercise \u003c/p\u003e \u003cp\u003e* Sick Days, Disasters, and Special Events\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorelli MR, Riden HE, Bang H, Schenker MB. Protocol for a cluster randomized controlled trial to study the effectiveness of an obesity and diabetes intervention (PASOS) in an immigrant farmworker population. BMC Public Health. 2018;18(1):849.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe five steps intervention\u003c/p\u003e \u003cp\u003e* move\u003c/p\u003e \u003cp\u003e* drink water\u003c/p\u003e \u003cp\u003e* eat fruits and vegetables\u003c/p\u003e \u003cp\u003e* measure (food portions and weight)\u003c/p\u003e \u003cp\u003e* share (information learned and healthy habits).\u003c/p\u003e \u003cp\u003eExamples of additionally voluntary activities:\u003c/p\u003e \u003cp\u003e* cooking demonstrations\u003c/p\u003e \u003cp\u003e* education on specific health topics\u003c/p\u003e \u003cp\u003e* cultural celebrations with modified recipes\u003c/p\u003e \u003cp\u003e* walking challenges, and Zumba dance sessions\u003c/p\u003e \u003cp\u003e* use of the \u0026ldquo;Salud para su Corazon\u0026rdquo; curriculum ( bilingual program for promotors developed specifically for Latino communities)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCastro-Rivas E, Boutin-Foster C, Milan M, Kanna B. \"Es como uno bomba de tiempo [It's like a time bomb]\": A qualitative analysis of perceptions of diabetes among first-degree relatives of latino patients with diabetes. Diabetes Spectrum. 2014;27(1):50\u0026thinsp;\u0026minus;\u0026thinsp;7.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProposal for intervention \u003c/p\u003e \u003cp\u003e* as involving community stakeholders and community engagement.\u003c/p\u003e \u003cp\u003e* Identifying culturally relevant media\u003c/p\u003e \u003cp\u003eto deliver health messages is crucial\u003c/p\u003e \u003cp\u003e* nontraditional venues such as schools, social clubs, and churches\u003c/p\u003e \u003cp\u003e* modifying and enhancing the physical environment and investigating the excess density of unhealthy options must be addressed\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChang MW, Nitzke S, Brown R, Resnicow K. A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale. BMC public health. 2014;14:280.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIG:\u003c/p\u003e \u003cp\u003e* program for 16 weeks\u003c/p\u003e \u003cp\u003e* culturally tailored DVDs (~\u0026thinsp;20\u0026nbsp;min., weekly from week 1\u0026ndash;4, every second week from week 5\u0026ndash;16) with 11 chapters for stress management, healthy nutrition, physical activity and group teleconferences)\u003c/p\u003e \u003cp\u003e* additionally weekly peer support group teleconferences for group discussions about the video's content\u003c/p\u003e \u003cp\u003eCG:\u003c/p\u003e \u003cp\u003e* printed materials from standard reliable sources for stress management, healthy eating and physical activity and a DVD about food and home safety (~\u0026thinsp;10 minutes)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFischer HHF, I.P.; Pereira, R.I.; Furniss, A.L.; Rozwadowski, J.M.; Moore, S.L.; Durfee, M.J.; Raghunath, S.G.;Tsai, A.G;, and Edward P. Havranek1: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016, 39:1364\u0026ndash;1370.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003cp\u003e* 6 text messages per week (English or Spanish) relating to nutrition, physical activity, and motivation \u003c/p\u003e \u003cp\u003e* once-weekly text message asking participants to report their most recent weight. \u003c/p\u003e \u003cp\u003e* motivational interviewing with a community health worker\u003c/p\u003e \u003cp\u003e* possibility to join the control groups DPP\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFontil V, McDermott K, Tieu L, Rios C, Gibson E, Sweet CC, et al. Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team. Journal of diabetes research. 2016;2016:8472391.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* previous examination of barriers via focus groups\u003c/p\u003e \u003cp\u003e* IT support for the first use of the program, especially for people with low computer capabilities\u003c/p\u003e \u003cp\u003e* informational event adapted to people with a low reading level\u003c/p\u003e \u003cp\u003e* bilingual program (English/Spanish)\u003c/p\u003e \u003cp\u003e* telephone interviews during the whole program to find out further barriers\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFord AF, Reddick K, Browne MC, Robins A, Thomas SB, Crouse Quinn S. Beyond the cathedral: building trust to engage the African American community in health promotion and disease prevention. Health promotion practice. 2009;10(4):485-9.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* possible interventions: Health-coaches, examination of genetic family history, smoking cessation, fitness-courses, yoga, dancing, nutrition counseling, prevention of depression, aerobics, management of chronic diseases\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFukuoka Y, Vittinghoff E, Hooper J. A weight loss intervention using a commercial mobile application in Latino Americans-Adelgaza Trial. Translational Behavioral Medicine. 2018;8(5):714\u0026thinsp;\u0026minus;\u0026thinsp;23.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* two brief in-person counseling sessions, daily use of Fitbit Zip (3-axis accelerometer) and Fitbit app, and social media (Facebook)\u003c/p\u003e \u003cp\u003e* during the 8-week intervention period, participants were asked to log all food/drinks and calories every day and their weight into the Fitbit app, sync daily steps data that were stored in a Fitbit Zip with the Fitbit app, and interact on Facebook\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGary-Webb TL, Walker EA, Realmuto L, Kamler A, Lukin J, Tyson W, et al. Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. American journal of men's health. 2018:1557988318758788.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* provided incentive of 6-month parks membership and small incentives throughout to increase motivation, including t-shirts, water bottle, pedometer\u003c/p\u003e \u003cp\u003e* provided \u003cspan\u003e$\u003c/span\u003e15 for completing baseline and follow-up surveys\u003c/p\u003e \u003cp\u003e* coaches were role-models (Black and/or Latino, only men) for participants: either through modeling weight loss efforts or professional expertise in health education or fitness training\u003c/p\u003e \u003cp\u003e* statistics on erectile dysfunction and diabetes incorporated in \u0026ldquo;quick facts\u0026rdquo; section\u003c/p\u003e \u003cp\u003e* intervention sessions conducted within park and recreations sites that were accessible to participants\u0026rsquo; neighborhood and had exercise resources that could help men adhere to physical activity component of the program\u003c/p\u003e \u003cp\u003e* revised curriculum to incorporate photos, examples, and quotes that would appeal to men\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGutierrez J, Devia C, Weiss L, Chantarat T, Ruddock C, Linnell J, et al. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program. The Diabetes educator. 2014;40(2):214\u0026thinsp;\u0026minus;\u0026thinsp;22.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles.\u003c/p\u003e \u003cp\u003e*participants reported statistically significant improvements in knowledge and healthy behaviors from baseline. Statistically significant numbers reported that they ate less fast food and were less likely to overeat at follow-up\u003c/p\u003e \u003cp\u003e*FFF demonstrates the potential of faith-based health interventions to address obesity and diabetes risk in high-need communities of color.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHall D, Lattie E, McCalla J, Saab P. Translation of the Diabetes Prevention Program to Ethnic Communities in the United States. Journal of Immigrant \u0026amp; Minority Health. 2016;18(2):479\u0026thinsp;\u0026minus;\u0026thinsp;89.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfro-Americans\u003c/p\u003e \u003cp\u003e* Offered sessions in Baptist churches\u003c/p\u003e \u003cp\u003e* Material for the Intervention was tailored to group discussions, some questions were complemented to evoke the discussion\u003c/p\u003e \u003cp\u003e* Praying at the beginning of every session\u003c/p\u003e \u003cp\u003eLatinos\u003c/p\u003e \u003cp\u003e* bilingual personnel (trainers, diet assistants, educators)\u003c/p\u003e \u003cp\u003e* Realization of the program took place in the environment of the Latino participants\u003c/p\u003e \u003cp\u003e* Information materials were tailored to a low level of health literacy and focused on visualizations (\"nutritional traffic light\")\u003c/p\u003e \u003cp\u003eArab Americans\u003c/p\u003e \u003cp\u003e* bilingual personnel (trainers, diet assistants, educators)\u003c/p\u003e \u003cp\u003e* Offered pre-interventional education program\u003c/p\u003e \u003cp\u003e* previous focus groups to identify relevant points for the adaption of the program (PA and educational sessions separated in gender, motivating men to participate in meal preparation, including religion)\u003c/p\u003e \u003cp\u003e* every session starts with an Arab wisdom\u003c/p\u003e \u003cp\u003e* cooking lessons are tailored to Arab food\u003c/p\u003e \u003cp\u003e* groups (n\u0026thinsp;=\u0026thinsp;10\u0026ndash;12) instead of single sessions\u003c/p\u003e \u003cp\u003e* bilingual information\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHandley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, et al. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implementation science : IS. 2016;11(1):73.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCombination of a health literacy-tailored health IT tool for reaching ethnic minority patients with diabetes and DPP content\u003c/p\u003e \u003cp\u003e5 DPP topics in Spanish and English \u003c/p\u003e \u003cp\u003e* physical Activity\u003c/p\u003e \u003cp\u003e* nutrition\u003c/p\u003e \u003cp\u003e* mental Health and Stress\u003c/p\u003e \u003cp\u003e* weight Loss\u003c/p\u003e \u003cp\u003e* glucose Screening Postpartum\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHarvey I, Schulz A, Israel B, Sand S, Myrie D, Lockett M, et al. The Healthy Connections project: a community-based participatory research project involving women at risk for diabetes and hypertension. Progress in community health partnerships : research, education, and action. 2009;3(4):287\u0026ndash;300.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e*\"Healthy Connections Advocates\" provided screening through House Parties and shared health information and practical support with members of their social networks\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKato S, Ando M, Kondo T, Yoshida Y, Honda H, Maruyama S. Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study). Nagoya J Med Sci. 2018;80(2):175\u0026thinsp;\u0026minus;\u0026thinsp;82.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* devices loading Internet of things (activity meter, blood pressure (BP) monitor, body weight (BW) scale), Public health nurse guidance by phone, exercise movie \u003c/p\u003e \u003cp\u003e* patients were provided with smartphones programmed with the study-specific application, Bluetooth-enabled activity trackers, Bluetooth-enabled BP monitors, and Bluetooth-enabled BW scales. The measurements recorded in the activity meters, BW scales, and sphygmomanometer will be automatically collected and stored via the Internet\u003c/p\u003e \u003cp\u003e* a movie filming a model of optimal exercise will be weekly delivered. It will be changed to step-up/step-down depending on the amount of physical activity in the previous week\u003c/p\u003e \u003cp\u003e* lifestyle guidance was provided by a public health nurse (call center) via a telephone call once a month, and concomitantly, each participant\u0026rsquo;s behavior modification stage was surveyed\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKim SE, Castro Sweet CM, Gibson E, Madero EN, Rubino B, Morrison J, et al. Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemp Clin Trials Commun. 2018;10:161-8.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* digital intensive lifestyle intervention based on DPP that includes virtual group support, personalized health coaching, weekly lessons, and digital tracking tools\u003c/p\u003e \u003cp\u003e*participants are placed into small virtual groups with peers\u003c/p\u003e \u003cp\u003e* each group has a private online social network where they can discuss goals, challenges, progress, and provide social support to one another at any time, similar to a private chat board or discussion board.\u003c/p\u003e \u003cp\u003e* users asynchronously complete weekly health education lessons each week. The lessons are available on the digital platform and can be accessed through internet or smartphone. \u003c/p\u003e \u003cp\u003e* user communicates with their health coach and receives individualized counseling through private messaging on the platform; coaches also facilitate discussions on the group chat board\u003c/p\u003e \u003cp\u003e* users track meals using digital online tracking tools, track weight loss and physical activity using a wireless weight scale and pedometer, and monitor their engagement and weight loss progress.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNewton RL, Jr., Johnson WD, Larrivee S, Hendrick C, Harris M, Johannsen NM, et al. A Randomized Community-based Exercise Training Trial in African American Men: ARTIIS. Med Sci Sports Exerc. 2019.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* exercise training intervention for 5 months consisting of 150 minutes of moderate intensity aerobic activity and two days of resistance training per week, consistent with the current federal physical activity guidelines\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNicolaou M, Vlaar E, van Valkengoed I, Middelkoop B, Stronks K, Nierkens V. Development of a diabetes prevention program for Surinamese South Asians in the Netherlands. Health promotion international. 2014;29(4):680\u0026thinsp;\u0026minus;\u0026thinsp;91.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* components of DH!AAN intervention focus on improving diet and physical activity, risk perception of the disease, social contexts regarding to support by family and friends, the generation of positive attitudes towards healthy versions of traditional behavior and food and the development of skills like cooking.\u003c/p\u003e \u003cp\u003e* use of an information folder using a \"Bollywood\" theme: Photos of South Asian individuals, examples and tips on healthy eating using traditional foods, items on yoga, testimonials on healthy eating from a local man and stories about weight loss practices from Bollywood stars.\u003c/p\u003e \u003cp\u003e* integration of basic and specific cultural elements (eating/cooking habits, influence of social environment)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRuggiero LO, S; Choi, J.K: Community-Based Translation of the Diabetes Prevention Program\u0026rsquo;s Lifestyle Intervention in an Underserved Latino Population. The Diabetes EDUCATOR 2011, 37(4):564\u0026ndash;672.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* regular community advisory board meetings, inclusion of community members as project staff and interventionists (i.e., CHWs), and hosting community forums\u003c/p\u003e \u003cp\u003e* program was further tailored and enhanced for this Latino community by providing culturally specific information on diabetes risk and providing culturally relevant and language-appropriate program and supplemental educational material\u003c/p\u003e \u003cp\u003e* implementation of the groups was designed to minimize the impact of barriers to participation, such as education and literacy levels, language, income, transportation, and lack of medical coverage\u003c/p\u003e \u003cp\u003e* to address language and literacy barriers, the group sessions were conducted in Spanish, and all participant program materials were provided in Spanish\u003c/p\u003e \u003cp\u003e* in addition to receiving program session materials, participants were provided with supplemental culturally appropriate educational materials (e.g., recipe book, National Diabetes Education Program materials), self-monitoring tools (e.g., personalized weight chart), a pedometer, a body weight scale, and measuring cups\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSiddiqui F, Koivula RW, Kurbasic A, Lindblad U, Nilsson PM, Bennet L. Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention. Am J Prev Med. 2018;55(2):187\u0026thinsp;\u0026minus;\u0026thinsp;96.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* in addition to the verbal instructions by an Arabic-speaking nurse, participants were also provided with written instructions. Participants were instructed to wear the device continuously for a total of 10 complete days\u003c/p\u003e \u003cp\u003e* the intervention was composed of seven group sessions, including one cooking class, and addressed self-empowerment, cultural and social barriers to lifestyle change, diet, and PA habits\u003c/p\u003e \u003cp\u003e* health coaches organized and led the sessions, but participants were encouraged to actively participate in the discussions\u003c/p\u003e \u003cp\u003e* participants were asked to identify barriers to being physically active and to develop an action plan for overcoming such obstacles. They were motivated to incorporate PA in daily life, such as walking or using stairs instead of riding a bus or taking the elevator\u003c/p\u003e \u003cp\u003e* gender differences and cultural barriers to PA were discussed\u003c/p\u003e \u003cp\u003e* participants received information on available PA centers, including a \u0026ldquo;women only\u0026rdquo; swimming hall, and gyms in the area\u003c/p\u003e \u003cp\u003e* participants were offered financial assistance to buy shoes and clothing for PA or admission to a PA center\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVincent D, McEwen MM, Hepworth JT, Stump CS. The effects of a community-based, culturally tailored diabetes prevention intervention for high-risk adults of Mexican descent. The Diabetes educator. 2014;40(2):202\u0026thinsp;\u0026minus;\u0026thinsp;13.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIG\u003c/p\u003e \u003cp\u003eCulturally tailored messages for promoting healthful eating and for increasing physical activity. Cultural tailoring included using an educational fotonovela (story with photographs and small dialogue bubbles), offering the intervention and all materials in Spanish and English, using culturally acceptable exercise strategies (e.g., walking, dancing), providing cooking demonstrations of low-fat traditional Mexican American foods, and facilitating group meal sharing.\u003c/p\u003e \u003cp\u003eCG\u003c/p\u003e \u003cp\u003eEducational sessions giving general information on health promotion and disease prevention.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalker EA, Weiss L, Gary-Webb TL, Realmuto L, Kamler A, Ravenell J, et al. Power Up for Health: Pilot study outcomes of a Diabetes Prevention Program for men from disadvantaged neighborhoods. American Journal of Men's Health. 2018;12(4):989\u0026thinsp;\u0026minus;\u0026thinsp;97.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* curriculum adapted to better engage men from disadvantaged, urban neighborhoods. Modifications to the NDPP curriculum were made by the research team in an iterative manner under the guidance of an Advisory Panel of experts in men\u0026rsquo;s health promotion, male community leaders, and the Power Up for Health coaches\u003c/p\u003e \u003cp\u003e* curriculum was facilitated by male lifestyle coaches who had received training as an NDPP coach and also trained in the delivery of the Power Up for Health curriculum\u003c/p\u003e \u003cp\u003e* if participating men missed a session, however, by protocol the coaches proactively offered a telephone make-up of that session to each participant to be done after they received the session materials by email or by mail from study staff. These telephone make-up sessions were delivered as individual topic sessions (i.e., not multiple missed sessions grouped in one phone call) and independent of the in-person sessions\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhittemore R, Rosenberg A, Gilmore L, Withey M, Breault A. Implementation of a Diabetes Prevention Program in Public Housing Communities. Public Health Nursing. 2014;31(4):317\u0026thinsp;\u0026minus;\u0026thinsp;26.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e* homecare nurses delivered an ADPP at public housing communities to adults at-risk for T2DM\u003c/p\u003e \u003cp\u003e* DPP was adapted after focus groups with stakeholders and residents of the community\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eADPP: adapted Diabetes Prevention Program; BP: blood pressure; BW: body weight; CHW; community health worker; CG: control group; DPP: Diabetes Prevention Program; IG: intervention group; LSES: low socioeconomic status; NDPP: National Diabetes Prevention Program; PA: physical activity; TA: technical approach; RCT: randomized controlled trial.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eAdapted diabetes prevention programs\u003c/h2\u003e \u003cp\u003eWe identified 21 studies that used any kind of ADPP (in 12 studies, it was the main focus [\u003cspan additionalcitationids=\"CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]). Most studies adapted the DPP [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], which is a lifestyle intervention designed in 2002 by the DPP Research Group. It is based on a 16-session core curriculum with sessions such as Healthy Eating, Being Active, and Problem Solving. Other programs such as the National Diabetes Education Program (NDEP) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] or the National Diabetes Prevention Program (NDPP) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] were also used as a curriculum base for some of the included studies (e.g., NDEP [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] and NDPP [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]). The included studies (n\u0026thinsp;=\u0026thinsp;21) targeted mostly migrants (n\u0026thinsp;=\u0026thinsp;9) and ethnic groups (n\u0026thinsp;=\u0026thinsp;6). Mostly, the adaptation of the DPPs was based on barriers or facilitating factors to participate in a preventive program, e.g., language barriers, economic factors, or religious/cultural background. Some studies (for example [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]) were adapted for cultural/religious backgrounds, including language adaptation. Other studies focused on community translation and financial aspects.\u003c/p\u003e \u003cp\u003eOne example of an ADPP is the study conducted by Nicolaou et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. They described a lifestyle intervention based on a DPP targeting Surinamese men and women from South Asia living in the Netherlands. The program was culturally adapted; e.g., they had dietitians who were familiar with Surinamese South Asian dietary habits and provided cooking classes to adjust traditional dishes. Furthermore, they provide family sessions in home settings to integrate family in achieving dietary goals. Additionally, they used role models from favorite Bollywood movies in an information folder with examples and tips on healthy eating using traditional foods, yoga, and stories about weight loss practices from Bollywood stars. Cultural adaptation was also achieved with respect to physical activity by recommending 30 minutes of daily yoga and Bollywood-like dancing using motivational interviewing [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eCommunity health workers\u003c/h2\u003e \u003cp\u003eWe identified five studies which used CHWs, three of which focused on CHWs [\u003cspan additionalcitationids=\"CR33 CR34\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Blanks et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] and Harvey et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] both used CHWs in African American settings for preventive interventions. In general, CHWs were trained in T2DM prevention and had the same ethnic and social background as the participants. Blanks et al. focused on prediabetic African American women. The aims was to increase participant knowledge related to the complex of nutrition, physical activity, and health literacy and therefore have a positive impact on increasing awareness of diabetes risks and improved access to healthcare [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Harvey et al. targeted African Americans and Latinos (88.5% women) at risk of diabetes and hypertension in house parties where health workers or health connections advocates provided screening and shared health information and practical support with members of their social networks [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eTechnological approaches\u003c/h2\u003e \u003cp\u003eAnother communication strategy was an approach using any kind of technical device. Overall, nine studies focused on TA in combination with an ADPP [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan additionalcitationids=\"CR37 CR38 CR39 CR40 CR41\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], but two used a TA alone [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFischer et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] sent bilingual (English/Spanish) text messages relating to nutrition, physical activity, and motivation. The intervention group could additionally join the DPP classes. Handley et al. [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] also sent text messages and used weekly phone calls plus live, tailored call-back health coaching.\u003c/p\u003e \u003cp\u003eThe kiosk system used by Bolin et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] is a bilingual (English/Spanish) diabetes education kiosk system (Diosk) that provides information on different topics such as what \u0026ldquo;diabetic\u0026rdquo; means, preventing diabetes, meal planning, and exercise. Kiosk systems use touch-screen displays at waist level. They were placed in low-income pharmacies, federal qualified healthcare centers, and community arts centers. The Diosks not only provide on-demand information to the user but also collect general user frequencies and the frequencies of the topics accessed.\u003c/p\u003e \u003cp\u003eFontil et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] used a bilingual (English/Spanish) digital health program for low-income prediabetic participants. IT support for the first use of the program, especially for people with low computer capabilities as well as an informational event adapted to people with a low reading level were provided prior to the program use.\u003c/p\u003e \u003c/div\u003e "},{"header":"Discussion","content":" \u003cp\u003eWe identified different communication strategies for the prevention of T2DM in vulnerable groups. All but two studies were conducted in the United States and therefore targeted mostly ethnic groups (African Americans) or migrants. Most communication strategies used TAs or adapted existing programs such as the DPP for language and cultural background. TAs differed most within the categories, because every identified study used a different approach (videos, SMS, kiosk systems, and digital health program). The other categories were more similar among the studies, but they may have, for example, adapted for different barriers for different vulnerable groups.\u003c/p\u003e \u003cp\u003eIt seems necessary to identify common barriers and facilitating factors in T2DM prevention to develop communication strategies for vulnerable groups. Some of the identified studies initially searched for barriers and facilitating factors or gained this information through focus groups. Therefore, some of the communication strategies had already been adapted to known barriers [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] such as language (e.g., adaptation to bilingualism) or cultural factors.\u003c/p\u003e \u003cp\u003eThe communication strategies often apply to just one vulnerable group, and there are just a few that overlap, such as low-income migrants. Especially, religious and cultural factors seem to require different approaches for each vulnerable group [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Furthermore, some approaches focused on only one gender [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Therefore, communication strategies should be tailored for one vulnerable group and/or gender and adapted to all known barriers.\u003c/p\u003e \u003cp\u003eOne important known facilitating factor is family and friends [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. None of the identified studies adapted their approaches with respect to this factor. For example, it is conceivable to include family members in cooking or exercise classes.\u003c/p\u003e \u003cp\u003eMost studies used more than one communication strategy; just a few used only one. There are no data on the effectiveness of one strategy compared with mixed strategies regarding the willingness to participate or the outcome itself. It might be necessary to use a mixed strategy to adapt a preventive program for some of the known barriers, for example, to use a combination of a CHW strategy (a female CHW) and an ADPP strategy (language and cultural adaptation for migrant women). Perhaps, it is required to analyze whether all approaches could be used for each vulnerable group. For example, TAs may need a special adaptation for older people.\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eAs mentioned before, this review is part of the national awareness and prevention strategy on diabetes in Germany conducted by the Federal Center for Health Education and the Federal Ministry of Health. For this reason, we had to limit the publication date of included studies because we had a narrow time frame for completing this scoping review. However, there might be too many differences in communication strategies arising from increasing digitization. Sometimes, it was difficult to assign groups to either ethnic group or migrants. Therefore, there may have been incorrect assignments to the vulnerable groups. Furthermore, although we stated the main focus regarding the communication strategy of each study, we could not know whether this was the intended focus of the studies.\u003c/p\u003e \u003c/div\u003e "},{"header":"Conclusion","content":" \u003cp\u003eWe identified three different categories of communication strategies for prevention of T2DM in vulnerable groups. Communication strategies should be adapted to barriers and facilitating factors to increase participating and motivation. Furthermore, it seems necessary to address each vulnerable group separately.\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"2\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADPP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eadapted Diabetes Prevention program\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCHW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecommunity health worker\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes Prevention Program\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egestational diabetes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNDEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNational Diabetes Education Program\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNDPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNational Diabetes Prevention Program\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePopulation, Concept, Context\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erandomized controlled trial\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT2DM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etype 2 diabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etechnical approach\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Federal Center for Health Education. The funder had no role in developing the scoping review. The findings and conclusions are those of the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJB, CG, and DP conceived and drafted the scoping review. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eOgurtsova KdRFJ, Huang Y, Linnenkamp U, Guariguata L, Cho NH, Cavan D, Shaw JE, Makaroff LE. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40\u0026ndash;50.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eInternational Association of Diabetes and Pregnancy Study Groups Consensus. 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BMC Public Health. 2018;18(849):1\u0026ndash;11.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eCastro-Rivas EB-F, Milan C, Kanna M. B;: \u0026ldquo;Es como uno bomba de tiempo [It\u0026rsquo;s like a time bomb]\u0026rdquo;: A Qualitative Analysis of Perceptions of Diabetes Among First-Degree Relatives of Latino Patients With Diabetes. Diabetes Spectrum. 2014;27(1):50\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFord AF, Reddick KB, Robins MC, Thomas A, Quinn SB. S.C.;: Beyond the Cathedral: Building Trust to Engage the African American Community in Health Promotion and Disease Prevention. Health Promotion Practice. 2009;10(4):485\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGary-Webb TLW, Realmuto LA, Kamler L, Lukin A, Tyson J, Carrasquillo W, Weiss O. 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J Immigr Minor Health. 2016;18(2):479\u0026ndash;89.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eNewton RLJ, Larrivee WD, Hendrick S, Harris C, Johannsen M, Swift NM, Hsia DL, Church DS, T.S.: A Randomized Community-based Exercise Training Trial in African American Men: ARTIIS. \u003cem\u003eMedicine \u0026amp; Science in Sports \u0026amp; Exercise\u003c/em\u003e 2019, N.R.(N.R.):1\u0026ndash;44.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eNicolaou MV, van Valkengoed E, Middelkoop I, Stronks B, Nierkens K. V;: Development of a diabetes prevention program for Surinamese South Asians in the Netherlands. Health Promotion International. 2013;29(4):680\u0026ndash;91.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eRuggiero LO, Choi S. J.K.;: Community-Based Translation of the Diabetes Prevention Program\u0026rsquo;s Lifestyle Intervention in an Underserved Latino Population. The Diabetes EDUCATOR. 2011;37(4):564\u0026ndash;672.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSiddiqui FK, Kurbasic RW, Lindblad A, Nilsson U, Bennet PM. L.;: Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention. Am J Prev Med. 2018;55(2):187\u0026ndash;96.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eVincent DM, Hepworth MM, Stump JT. CS;: The Effects of a Community-Based, Culturally Tailored Diabetes Prevention Intervention for High-Risk Adults of Mexican Descent. The Diabetes EDUCATOR. 2014;40(2):202\u0026ndash;13.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWalker EAW, Gary-Webb L, Realmuto TL, Kamler L, Ravenell A, Tejeda J, Lukin C, Schechter J. C.B.: Power Up for Health: Pilot Study Outcomes of a Diabetes Prevention Program for Men from Disadvantaged Neighborhoods. American Journal of Men\u0026rsquo;s Health. 2018;12(4):989\u0026ndash;97.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGroup TDPPDR. The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care. 2002;25(12):2165\u0026ndash;71.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eNational Diabetes Education Program. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.niddk.nih.gov/health-information/communication-programs/ndep/about-national-diabetes-education-program\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePrevention CfDCa. National Diabetes Prevention Program. In.; 2019.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBlanks SH, Treadwell H, Bazzell A, Graves W, Osaji O, Dean J, McLawhorn JT, Stroud JL. Community Engaged Lifestyle Modification Research: Engaging Diabetic and Prediabetic African American Women in Community-Based Interventions. J Obes. 2016;2016:3609289.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFischer HHF, Pereira IP, Furniss RI, Rozwadowski AL, Moore JM, Durfee SL, Raghunath MJ, Tsai SG. A.G;, and Edward P. Havranek1: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care. 2016;39:1364\u0026ndash;70.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHarvey IS, Israel A, Sand B, Myrie S, Lockett D, Weir M, Hill S. Y: The Healthy Connections Project: A Community-Based Participatory Research Project Involving Women at Risk for Diabetes and Hypertension. Progress in Community Health Partnerships: Research Education Action. 2009;3(4):287\u0026ndash;300.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWhittemore RR, Gilmore A, Withey L, Breault M. A;: Implementation of a Diabetes Prevention Program in Public Housing Communities. Public Health Nurs. 2013;31(4):317\u0026ndash;26.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBolin JNO, Wilson MG, Salge AD. L;: Diabetes Education Kiosks in a Latino Community. The Diabetes EDUCATOR. 2013;39(2):204\u0026ndash;12.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eChang M-WB, Nitzke R. S;: Results and lessons learned from a prevention of weight gain program for low-income overweight and obese young mothers: Mothers In Motion. BMC Public Health. 2017;17(182):1\u0026ndash;12.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFontil V, McDermott K, Tieu L, Rios C, Gibson E, Sweet CC, Payne M, Lyles CR: Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team. \u003cem\u003eJ Diabetes Res\u003c/em\u003e 2016, 2016:8472391.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFukuoka YV, Hooper E. J.;: A weight loss intervention using a commercial mobile application in Latino Americans\u0026mdash;Adelgaza Trial. Translational Behavioral Medicine. 2018;8(5):714\u0026ndash;23.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHandley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, Martinez D, Ko J, Sausjord I, Rios C. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implement Sci. 2016;11(1):73.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eKato SA, Kondo M, Yoshida T, Honda Y, Maruyama H. S.;: Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study). Nagoya J Med Sci. 2018;80(2):175\u0026ndash;82.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eKima SECS, Gibsonb CM, Maderob E, Rubinoc EN, Morrisonc B, Rosend J, Imberge D, Cousineaua W. M.R.;: Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemporary Clinical Trials Communications. 2018;10:161\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eIslam NST, Mukherji D, Tanner R, Ghosh M, Alam K, Haq G, Rey M, Trinh-Shevrin MJ. C.: Understanding Barriers to and Facilitators of Diabetes Control and Prevention in the New York City Bangladeshi Community: A Mixed-Methods Approach. Research Practice. 2012;102(3):486\u0026ndash;90.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGary-Webb TL, Walker EA, Realmuto L, Kamler A, Lukin J, Tyson W, Carrasquillo O, Weiss L. Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. Am J Mens Health. 2018;12(4):998\u0026ndash;1006.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHempler NFN, Ewers S, Willaing B. B.;: Dietary education must fit into everyday life: a qualitative study of people with a Pakistani background and type 2 diabetes. Patient Preference Adherence. 2015;9:347\u0026ndash;54.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Type 2 diabetes mellitus, prevention, vulnerable groups, communication strategies","lastPublishedDoi":"10.21203/rs.3.rs-52836/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-52836/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe global prevalence of diabetes is nearly 9%, with an upward trend in type 2 diabetes mellitus (T2DM) and gestational diabetes (GDM). Although evidence shows that vulnerable groups are affected disproportionally, these groups are difficult to reach in terms of preventive measures. Currently, there is no gold standard regarding communication strategies and/or public awareness campaigns.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a scoping review in September 2019. Two reviewers independently screened the results of the electronic literature search in several databases, including Medline, EMBASE, and PsycINFO. Extracted data were charted, categorized, and summarized.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAll of the included articles (n\u0026thinsp;=\u0026thinsp;24) targeted T2DM; none targeted GDM. We identified the following five different vulnerable groups within the identified studies: migrants (n\u0026thinsp;=\u0026thinsp;9), ethnic groups such as African Americans (n\u0026thinsp;=\u0026thinsp;8), people with low socioeconomic status (n\u0026thinsp;=\u0026thinsp;3), older people (n\u0026thinsp;=\u0026thinsp;1) and people in need of care (n\u0026thinsp;=\u0026thinsp;1). Three categories of communication strategies were identified as follows: adapted diabetes prevention programs (n\u0026thinsp;=\u0026thinsp;21), community health workers (n\u0026thinsp;=\u0026thinsp;5), and technical approaches (n\u0026thinsp;=\u0026thinsp;9).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWe found different approaches for preventive interventions for T2DM. Some of these approaches were already adapted to known barriers. Communication strategies should be adapted to barriers and facilitating factors to increase participation and motivation.\u003c/p\u003e","manuscriptTitle":"Communication strategies in the prevention of type 2 diabetes and gestational diabetes in vulnerable groups: A scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-08-06 21:58:35","doi":"10.21203/rs.3.rs-52836/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2021-04-05T00:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-01-20T00:00:00+00:00","index":2,"fulltext":"Recommendation: Minor Revision\nForm responses:\n---\n\nComments to Author:\n---\nThe authors conducted a scoping review in September 2019. Two reviewers independently\nscreened the results of the electronic literature search in several databases, including\nMedline, EMBASE, and PsycINFO. Extracted data were charted, categorized, and\nsummarized.\nAll of the included articles (n=24) targeted T2DM; none targeted GDM. We identified\nthe following five different vulnerable groups within the identified studies: migrants\n(n=9), ethnic groups such as African Americans (n=8), people with low socioeconomic\nstatus (n=3), older people (n=1) and people in need of care (n=1). Three categories of\ncommunication strategies were identified as follows: adapted diabetes prevention\nprograms (n=21), community health workers (n=5), and technical approaches (n=9).\nThe authors found different approaches for preventive interventions for T2DM. Some of these\napproaches were already adapted to known barriers. Communication strategies should\nbe adapted to barriers and facilitating factors to increase participation and motivation.\n\nInclude in article\n1 - Compare and contrast your study with others in the most relevant world literature, particularly the recent literature.\n2 - What new information is sufficient to modify existing clinical practice?\n3 - What are the conclusions and implications for current practice, and particularly for future research that may have a significant impact on clinical decisions?\n4 - What does this study add to the literature?\n5 - At the end of the Discussion, under the subheading \"Limitations,\" review the limitations of your study.\n6 - At the end of the limitations, under the subheading \" Future directions\".\n7 - Conclusion\nTake special care to draw your conclusions only from your results and verify that your conclusions are firmly supported by your data\n8- References\nUpdate\n* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons after the final decision on the manuscript has been made. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Level of interest: **An article of importance in its field that should be highlighted to relevant networks**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **None**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: **\nI agree to the open peer review policy of the journal**\n* Were you mentored through this peer review?: **No**\n"},{"type":"reviewerAgreed","content":"","date":"2021-01-19T00:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-12-14T00:00:00+00:00","index":1,"fulltext":"Recommendation: Minor Revision\nForm responses:\n---\n\nComments to Author:\n---\nI am reviewing this submission in the context of search methods and scoping review methods and reporting. Overall I found the review well-written; the team references and appears to have followed methods and reporting standards specific to scoping reviews. While the topic is broad and the studies identified quite heterogeneous, this is appropriate for a scoping review study design and the writing teams presents a good overview of available literature since 2008. The search is well-reported in the supplementary materials with the exception of providing the database platforms searched. Search strategies were peer reviewed, which is always a plus and it shows in the final search strategies. I have a few minor notes and questions for the team to consider below, but I don't see any of them as having a large effect on the validity of the review.\n\nLine 111: why 2008 front end limit? (recognized in line 310-311; would be helpful to provide justification upfront where date limit is reported)\nLine 104: justification for excluding indigenous populations? Seems like a potentially important group at high risk.\nLine 122-123: Please report database platforms (ex., Ebscohost)\nLine 123: why Social Science Citation Index, but not Science Citation Index?\nLine 134: The search is now over a year old. An update would be great, but understand that it is time-consuming and may not be practical with publication schedule.\n**Very much appreciate PRESS on search strategies!**\n\nSearch strategy review:\n* Diabetic, prediabetic terms missing; relevant literature likely caught through indexing\n* Missing several derivatives, like refugee, as well as specific minority groups (may be difficult to identify all, but would be nice to see more represented. Most likely caught by MeSH indexing)\n* Might consider moving Patient Education terms to last search concept block (communication topics), but terms in both blocks were likely broad enough that the likelihood of missing something relevant is fairly low (especially paired with reference tracking). Likely not worth rerunning/rescreening citations!\n* Appreciate strategies for all databases! Syntax tells me which platforms searchers used, but please list (ex., Ebscohost)\n* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons after the final decision on the manuscript has been made. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Level of interest: **An article whose findings are important to those with closely related research interests**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: **\nI agree to the open peer review policy of the journal**\n* Were you mentored through this peer review?: **No**\n"},{"type":"reviewerAgreed","content":"","date":"2020-11-29T00:00:00+00:00","index":1,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-11-28T00:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-08-25T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-08-24T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-08-04T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2020-08-03T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c2ddccdd-38b5-4147-864d-5518d757cab5","owner":[],"postedDate":"August 6th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":251508,"name":"Agroecology"}],"tags":[],"updatedAt":"2021-11-24T07:49:04+00:00","versionOfRecord":{"articleIdentity":"rs-52836","link":"https://doi.org/10.1186/s13643-021-01846-8","journal":{"identity":"systematic-reviews","isVorOnly":false,"title":"Systematic Reviews"},"publishedOn":"2021-11-24 07:49:04","publishedOnDateReadable":"November 24th, 2021"},"versionCreatedAt":"2020-08-06 21:58:35","video":"","vorDoi":"10.1186/s13643-021-01846-8","vorDoiUrl":"https://doi.org/10.1186/s13643-021-01846-8","workflowStages":[]},"version":"v1","identity":"rs-52836","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-52836","identity":"rs-52836","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}