Systematic Review of Type 2 Diabetes Interventions in Native Americans: An Emphasis on Reported Limitations, Funding Sources, and Community Involvement

Abstract

Specific Aims: This study assessed the extent to which American Indians were involved in the research process (i.e. design, implementation, analysis, and dissemination) in relationship to funding sources and reported limitations in research interventions that addressed diabetes, as well as research method or design. Methods: Systematic searches of The Cochrane Library, PubMed, CINAHL, International Pharmaceutical Abstracts (IPA), Web of Science, ERIC, and PsychINFO identified studies focused on type 2 diabetes in American Indians published between October 5, 2010 and April 30, 2012. Studies selected for inclusion were those that were interventional or programmatic in nature, used a comparison group for statistical analysis and reported patient level or patient related outcomes. Data were extracted and analyzed for study characteristics, reported limitations, funding sources, and extent to which the community was involved in the research process. Main Results: A total of 6 studies were included. There was no difference between American Indian involvement in the research process with respect to funding sources and reported limitations (p = 0.17 and p = 0.23, respectively). The majority of studies were conducted in a clinic setting (33.3%) on tribal/sovereign land (66.7%). Study design was evenly split between randomized controlled trials and observational studies (50% for both). The most frequently reported intervention was combination/multimodal (50%). Conclusion: American Indian involvement in the research process was not impacted by either funding sources or reported limitations.