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Consideration of ethnicity in guidelines and systematic reviews promoting lifestyle interventions: a thematic analysis

Lookup NU author(s): Professor Raj Bhopal CBE, Professor Martin White


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Background: There is a growing body of evidence supporting lifestyle interventions for the prevention of chronic disease. However, it is unclear to what extent these evidence-derived recommendations are applicable to ethnic minority populations. We sought to assess the degree of consideration of ethnicity in systematic reviews and guidelines for lifestyle interventions. Methods: Two reviewers systematically searched seven databases to identify systematic reviews (n = 111) and UK evidence-based guidelines (n = 15) on smoking cessation, increasing physical activity and promoting healthy diet, which were then scrutinized for ethnicity-related considerations. Evidence statements were independently extracted and thematically analysed. Results: Forty-one of 111 (37%) systematic reviews and 12 of 15 (80%) guidelines provided an evidence statement relating to ethnicity; however, these were often cursory and focused mainly on the need for better evidence. Five major themes emerged: (i) acknowledging the importance of diversity and how risk factors vary by ethnicity; (ii) noting evidence gaps in the effectiveness and cost-effectiveness of interventions for ethnic minorities; (iii) observing differential effects of interventions where these have been trialled with ethnic minority populations; (iv) suggesting adaptation of interventions for ethnic minority groups; (v) proposing improvements in research on interventions involving ethnic minority populations. Conclusions: Despite increasing recognition of the challenges posed by ethnic health inequalities, there remains a lack of guidance on the extent to which generic recommendations are applicable to, and how best to promote lifestyle changes in, ethnic minority populations. These important evidence gaps need to be bridged and tools developed to ensure that equity and population context is appropriately considered within evidence syntheses.

Publication metadata

Author(s): Davidson EM, Liu JJ, Bhopal RS, White M, Johnson MRD, Netto G, Kakde S, Yousuf U, Sheikh A

Publication type: Article

Publication status: Published

Journal: European Journal of Public Health

Year: 2014

Volume: 24

Issue: 3

Pages: 508-513

Print publication date: 26/07/2013

ISSN (print): 1101-1262

ISSN (electronic): 1464-360X

Publisher: Oxford University Press


DOI: 10.1093/eurpub/ckt093


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Funder referenceFunder name
Cancer Research UK
Centre for Translational Research in Public Health
British Heart Foundation
Economic and Social Research Council
Medical Research Council
National Institute for Health Research under the UK Clinical Research Collaboration
NHS Health Scotland
07/63/03National Institute for Health Research Health Technology Assessment Programme (HTA programme)