abstract: 'Background Indigenous peoples in high income countries are

  disproportionately affected by Type 2 Diabetes. Socioeconomic

  disadvantages and inadequate access to appropriate healthcare are

  important contributors.

  Objectives This systematic review investigates effective designs of

  primary care management of Type 2 Diabetes for Indigenous adults in

  Australia, Canada, New Zealand, and the United States. Primary outcome

  was change in mean glycated haemoglobin. Secondary outcomes were

  diabetes-related hospital admission rates, treatment compliance, and

  change in weight or Body Mass Index.

  Methods Included studies were critically appraised using Joanna Briggs

  Institute appraisal checklists. A mixed-method systematic review was

  undertaken. Quantitative findings were compared by narrative synthesis,

  meta-aggregation of qualitative factors was performed.

  Results Seven studies were included. Three reported statistically

  significant reductions in means HbA1c following their intervention.

  Seven components of effective interventions were identified. These were:

  a need to reduce health system barriers to facilitate access to primary

  care (which the other six components work towards), an essential role

  for Indigenous community consultation in intervention planning and

  implementation, a need for primary care programs to account for and

  adapt to changes with time in barriers to primary care posed by the

  health system and community members, the key role of community-based

  health workers, Indigenous empowerment to facilitate community and

  self-management, benefit of short-intensive programs, and benefit of

  group-based programs.

  Conclusions This study synthesises a decade of data from communities

  with a high burden of Type 2 Diabetes and limited research regarding

  health system approaches to improve diabetes-related outcomes.

  Policymakers should consider applying the seven identified components of

  effective primary care interventions when designing primary care

  approaches to mitigate the impact of Type 2 Diabetes in Indigenous

  populations. More robust and culturally appropriate studies of Type 2

  Diabetes management in Indigenous groups are needed.

  Trail registration Registered with PROSPERO (02/04/2021:

  CRD42021240098).'
affiliation: 'Chopra, S (Corresponding Author), Princess Alexandra Hosp, Brisbane,
  Qld, Australia.

  Chopra, S (Corresponding Author), Univ Queensland, Brisbane, Qld, Australia.

  Chopra, Sahil, Princess Alexandra Hosp, Brisbane, Qld, Australia.

  Chopra, Sahil, Univ Queensland, Brisbane, Qld, Australia.

  Lahiff, Tahne Joseph, Royal Brisbane \& Womens Hosp, Brisbane, Qld, Australia.

  Franklin, Richard, James Cook Univ, Coll Publ Hlth Med \& Vet Sci, Townsville, Qld,
  Australia.

  Brown, Alex, Australian Natl Univ, Indigenous Genom, Nedlands, WA, Australia.

  Brown, Alex, Telethon Kids Inst, Nedlands, WA, Australia.

  Rasalam, Roy, Queensland Hlth, Publ Hlth Med, Townsville, Qld, Australia.'
article-number: e0276396
author: Chopra, Sahil and Lahiff, Tahne Joseph and Franklin, Richard and Brown, Alex
  and Rasalam, Roy
author-email: sahilchopra018@gmail.com
author_list:
- family: Chopra
  given: Sahil
- family: Lahiff
  given: Tahne Joseph
- family: Franklin
  given: Richard
- family: Brown
  given: Alex
- family: Rasalam
  given: Roy
da: '2023-09-28'
doi: 10.1371/journal.pone.0276396
files: []
issn: 1932-6203
journal: PLOS ONE
keywords-plus: HEALTH-CARE; AMERICAN-INDIANS; CHALLENGES; BARRIERS; CANADA; PEOPLE
language: English
month: NOV 10
number: '11'
number-of-cited-references: '55'
orcid-numbers: 'Rasalam, Roy/0000-0002-6822-7936

  Franklin, Richard Charles/0000-0003-1864-4552

  Brown, Alex/0000-0003-2112-3918

  Chopra, Sahil/0000-0002-7835-9131

  Lahiff, Tahne/0000-0003-4873-6802'
papis_id: 7ef9b78754c8965a3cf7047dc7863500
ref: Chopra2022effectiveprimary
researcherid-numbers: 'Rasalam, Roy/N-4558-2017

  Brown, Alex D/E-8614-2010

  Brown, Allison/JCO-5157-2023

  Franklin, Richard Charles/H-1731-2012

  '
tags:
- review
times-cited: '0'
title: 'Effective primary care management of type 2 diabetes for indigenous populations:
  A systematic review'
type: article
unique-id: WOS:000926098800023
usage-count-last-180-days: '4'
usage-count-since-2013: '5'
volume: '17'
web-of-science-categories: Multidisciplinary Sciences
year: '2022'