Effectiveness of culturally adapted lifestyle intervention package on blood pressure: A systematic review.
Culturally adapted lifestyle interventions can be effective for lowering blood pressure, especially when they include dietary, physical, and behavioral components tailored to the community.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This systematic review evaluated the effectiveness of culturally adapted lifestyle intervention packages on blood pressure in diverse populations. A total of 21,990 participants aged 18-95 years were included across 32 studies. Most interventions reported significant reductions in blood pressure, particularly those that were multi-component and culturally tailored.
Abstract
<h4>Objectives</h4>This systematic review aimed to identify culturally adapted lifestyle intervention packages and evaluate their effectiveness in reducing blood pressure across diverse populations. The focus was on interventions incorporating dietary, physical activity, and behavioral components within culturally relevant contexts.<h4>Study design</h4>Systematic review of literature.<h4>Methods</h4>A comprehensive systematic review search was conducted across PubMed, CINAHL, Scopus, Embase, and the Cochrane Library from March 5 to 11, 2024, covering studies published from 1995 to 2024, per the registered PROSPERO protocol. Search strategies targeted three key concepts: blood pressure, cultural adaptation, and lifestyle interventions, with cultural adaptation defined as any change made to the intervention's content, delivery, or materials to take into account the language, dietary patterns, social or societal norms, or community structures of the target group. Reference lists of included articles and relevant reviews were manually screened and explored. All studies were assessed using predefined inclusion and exclusion criteria to ensure methodological rigor and relevance.<h4>Results</h4>Thirty-two studies involving 21,990 participants aged 18-95 years were included. Sample sizes ranged from 19 to 10,741, with most studies enrolling both sexes. Most interventions reported significant reductions in systolic and/or diastolic blood pressure. Multi-component interventions combining dietary modification, physical activity, and behavioral education were consistently effective. Culturally tailored programs, particularly group-based interventions with longer duration and follow-up, showed sustained improvements; certainty of evidence, assessed using GRADE, was moderate for dietary interventions but very low for behavioral/educational and exercise-based interventions, reflecting variation between studies and the predominance of data from high-income countries.<h4>Conclusions</h4>Culturally adapted lifestyle interventions are effective, feasible, and sustainable strategies for lowering blood pressure. Multi-component approaches that integrate dietary, physical, and behavioral elements, particularly when culturally contextualized and community-based, offer practical, non-pharmacological options for hypertension management across diverse populations.
Background
This systematic review addresses the effectiveness of culturally adapted lifestyle interventions for blood pressure management, an important public health issue given the global prevalence of hypertension. Prior research has shown that lifestyle modifications can impact blood pressure, but the effectiveness of these interventions may vary across different cultural contexts. This study is significant as it synthesizes evidence from multiple studies to understand how cultural adaptation influences the success of lifestyle interventions.
Methods
The study utilized a systematic review design, searching databases including PubMed, CINAHL, Scopus, Embase, and the Cochrane Library for studies published from 1995 to 2024. Inclusion criteria were applied to ensure methodological rigor, and the review followed a registered protocol. The primary outcome measure was the reduction in blood pressure, while secondary outcomes included the effectiveness of various intervention components.
Results
Thirty-two studies were included, with a total of 21,990 participants. Most interventions reported significant reductions in systolic and/or diastolic blood pressure, although specific numeric findings were not detailed in the abstract. Multi-component interventions were consistently effective, particularly those that were culturally tailored and community-based.
Interpretation
The findings suggest that culturally adapted lifestyle interventions can be effective in managing blood pressure, aligning with previous literature that emphasizes the importance of cultural relevance in health interventions. However, the effect sizes for some interventions may not be clinically significant, particularly given the very low certainty of evidence for behavioral and exercise-based interventions. Limitations such as variability in study quality and predominance of data from high-income countries may confound the conclusions drawn.
Key findings
- 32 studies included, n=21,990 participants aged 18-95 years.
- Sample sizes ranged from 19 to 10,741 participants.
- Most interventions reported significant reductions in systolic and/or diastolic blood pressure.
- Culturally tailored programs showed sustained improvements, particularly in group-based interventions with longer duration.
Limitations
- Moderate certainty of evidence for dietary interventions.
- Very low certainty for behavioral/educational and exercise-based interventions.
- Predominance of data from high-income countries.
- Variability in study quality and sample sizes.