Implementing Culturally Tailored Diabetes Prevention in Hispanic Communities: An Integrative Review Using the RE-AIM Framework

Rachell Nguyen, DNP, APRN¹ (View author affiliations)

Suggested citation for this article: Nguyen R. Implementing Culturally Tailored Diabetes Prevention in Hispanic Communities: An Integrative Review Using the RE-AIM Framework. Prev Chronic Dis 2026;23:260050. DOI: http://dx.doi.org/10.5888/pcd23.260050.

PEER REVIEWED

Abstract

Introduction

Hispanic adults in the US have disproportionately high rates of diabetes and face persistent barriers to accessing evidence-based prevention programs. Despite the demonstrated efficacy of culturally tailored diabetes prevention interventions, translation into routine community practice is markedly limited. This integrative review examined implementation processes, barriers, and facilitators of culturally tailored diabetes prevention interventions in Hispanic communities, using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to identify strategies that support population-level impact.

Methods

Comprehensive searches of 5 databases (PubMed, CINAHL, Web of Science, EMBASE, ScienceDirect) from 2005 through 2025 identified 69 sources; 37 (empirical studies, study protocols, and reviews) reporting implementation data were analyzed. Data extraction and synthesis aligned with the RE-AIM framework and used constant comparative methods. Quality appraisal used the Johns Hopkins Evidence-Based Practice tool. This review was not registered, consistent with integrative review methods.

Results

Implementation facilitators included cultural concordance, community health worker models, community-based delivery, and family-centered programming. Barriers included funding instability, workforce shortages, male underrepresentation, and limited maintenance data. Interventions achieved clinically meaningful weight loss (3.2 kg–5.8 kg), but real-world outcomes were smaller than those reported in efficacy trials. Community-based organizations were the primary adopters, although resource constraints were common. Only 18% of studies reported outcomes beyond 12 months, limiting the assessment of sustained impact.

Conclusion

Culturally tailored diabetes prevention interventions are effective and acceptable in Hispanic communities; however, implementation gaps in adoption, scaling ability, and sustainability limit population-level impact. Successful translation requires cultural concordance, community partnerships, flexible delivery models, and workforce development. Addressing structural barriers through policy support for community health worker integration, sustainable funding mechanisms, and health care–community partnerships is essential to achieving equitable diabetes prevention at scale.

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Introduction

Hispanic adults are the largest ethnic minority group in the US and have a disproportionately high prevalence of type 2 diabetes, nearly 50% higher than that of non-Hispanic White adults, with increased risk and earlier onset of complications, including retinopathy, nephropathy, and cardiovascular disease (1). Despite evidence supporting culturally tailored diabetes prevention interventions, translation into routine community practice is limited (2).

The persistent gap between “what works” in controlled research settings and “what gets implemented” in real-world practice is a barrier to reducing health disparities. Although the National Diabetes Prevention Program (NDPP) has demonstrated efficacy, data show that only 35.5% of participants complete core requirements, with even lower rates among Hispanic participants (3). Programs are limited in Hispanic communities, particularly in rural areas, along with retention challenges and cultural–linguistic barriers that undermine effectiveness (4,5).

Although African American and Asian American communities also have high diabetes risk and face culturally specific barriers to program implementation, each warranting dedicated investigation, the Hispanic population is uniquely underserved by existing NDPP infrastructure, with persistently lower enrollment and completion rates than other high-risk groups (3). The cultural, linguistic, and structural heterogeneity in Hispanic communities, including variation by country of origin, acculturation level, immigration status, and geographic distribution, requires a population-focused implementation science lens.

Implementation science provides frameworks for implementing, adapting, sustaining, and scaling evidence-based interventions across diverse real-world contexts (6). The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework explicitly addresses implementation dimensions that are overlooked in traditional efficacy research (7). RE-AIM examines 5 interconnected dimensions: reach (proportion and representativeness of participants), effectiveness (impact in real-world settings), adoption (organizational uptake), implementation (fidelity, adaptation, and delivery consistency), and maintenance (sustained effects and organizational continuation).

Although previous reviews examined the effectiveness of culturally tailored diabetes prevention interventions (8), they offered limited guidance on implementation processes, organizational adoption patterns, strategies for balancing fidelity and adaptation, workforce constraints, and factors predicting sustainability.

Health care and public health workforces, including nurses, community health workers, and health educators, play a central role in translating evidence-based prevention into practice; however, implementation strategies that support their success are poorly characterized. This integrative review addresses these gaps by synthesizing implementation science evidence on culturally tailored diabetes prevention for Hispanic adults using the RE-AIM framework. This research sought to answer the following questions:

1. What implementation facilitators and barriers affect culturally tailored diabetes prevention interventions for Hispanic adults across RE-AIM domains?
2. What evidence-based strategies support the successful adoption, delivery, and sustainability of culturally tailored diabetes prevention in Hispanic communities?

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Methods

Design

This integrative review used Whittemore and Knafl’s (9) 5-stage methodology, allowing inclusion of diverse study designs to provide a comprehensive understanding of implementation phenomena. The framework guided data extraction and synthesis across 5 implementation domains. The review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting standards for systematic reviews.

Search strategy

Comprehensive searches were conducted in PubMed, CINAHL, Web of Science, EMBASE, and ScienceDirect from January 2005 through December 2025. Search strategies combined 4 concept domains: diabetes prevention and prediabetes; Hispanic, Latino, Latina, and Latinx populations; cultural adaptation and tailoring; and implementation science constructs (ie, implementation, dissemination, adoption, scalability, feasibility, acceptability, sustainability, barriers and facilitators, community-based participatory research [CBPR], and fidelity).

After removing irrelevant articles, 320 records were obtained; this decreased to 296 unique records after removing 24 duplicates (Figure). A full-text review of 296 articles identified 69 sources that met the initial inclusion criteria. Because only sources reporting implementation data relevant to at least 1 RE-AIM domain were retained for the main analysis, this number was reduced to 37 (1,2,4–6,8,10–40) and organized in Zotero reference manager. Consistent with integrative review methodology (9), the 37 sources include empirical studies, study protocols with implementation detail, and reviews; some contributed data to multiple domains and are therefore represented as separate analytic units.

Figure. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram for systematic literature search and study selection process. [A text description of this figure is available.]

All screening, data extraction, and quality appraisal were conducted by a single reviewer (R.N.) with expertise in diabetes management and implementation science, using standardized tools and procedures to minimize bias. Title and abstract screening were conducted systematically using predetermined inclusion criteria. Full-text review applied explicit decision rules documented in an extraction protocol. Detailed characteristics of all 37 included studies, including design, population, intervention type, cultural adaptation strategy, and key findings by RE-AIM domain, were tabulated.

Sample

Inclusion criteria were peer-reviewed sources that were published in English between 2005 and 2025, were conducted in the US, involved Hispanic/Latino adults (aged ≥18 y), addressed diabetes prevention interventions, reported cultural adaptation components, and reported data on 1 or more RE-AIM domains. Consistent with integrative review methodology, which permits synthesis of empirical and nonempirical literature (9), both primary sources (empirical studies) and secondary sources (study protocols, reviews, and program summaries) were eligible when they described implementation processes, barriers, or facilitators. Study designs included randomized controlled trials (RCTs), quasi-experimental studies, mixed-methods studies, qualitative studies, program evaluations, CBPR studies, and feasibility or pilot studies when reporting implementation outcomes. Early phase feasibility and proof-of-concept studies were retained when they reported implementation processes relevant to domains, despite limited outcome data.

Exclusion criteria were sources with no implementation content (including reviews, commentaries, and protocols that described only intervention efficacy), studies on pediatric populations, studies with no cultural adaptation, efficacy trials without implementation context, and non–peer-reviewed literature.

Measurements

All studies meeting initial inclusion criteria were appraised by using the Johns Hopkins Evidence-Based Practice appraisal tool, which evaluates the level and quality of evidence. Of the 69 sources screened, 37 were retained and rated level I through level III, with high (A) or good (B) methodological quality; these 37 sources formed the basis for the results synthesis. Empirical studies were appraised on their design; protocols, reviews, and summaries were appraised as level III nonexperimental evidence on the basis of the implementation detail they provided. Lower-quality studies that provided unique contextual or implementation insights were retained but weighted accordingly in interpretation. Standardized forms captured study characteristics, population characteristics, intervention characteristics, cultural adaptation strategies, and implementation data for each domain. Many studies provided data relevant to multiple domains; the primary domain each study explicitly addressed was documented, while the results synthesis incorporated all relevant data across domains.

Analytic strategy

Data analysis used constant comparative methods and thematic synthesis. The initial analysis organized findings from the 37 sources by domain. Within each domain, iterative coding identified patterns and themes. Implementation barriers and facilitators were categorized by using multilevel socioecological frameworks. Given substantial heterogeneity, narrative synthesis rather than meta-analysis was used.

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Results

Study characteristics

Thirty-seven sources published from 2005 through 2025 informed the synthesis: 24 empirical studies (RCTs, quasi-experimental and pilot studies, and qualitative, observational, and mixed-methods studies), 6 study protocols with implementation detail, and 7 reviews or program summaries (Table 1). Sample sizes ranged from 21 to 143,000 participants, reflecting both intensive community-based feasibility studies and large-scale national program evaluations. Studies were geographically concentrated in regions with substantial Hispanic populations, particularly the Southwest (California, Texas, Arizona, New Mexico), with additional representation from Florida, Illinois, New York, and North Carolina. Approximately 44% of studies explicitly referenced implementation science frameworks or constructs. Methodological quality, assessed using the Johns Hopkins Evidence-Based Practice criteria, were rated either high or good (Table 2). All 37 studies contributed meaningfully to understanding the implementation of culturally tailored diabetes prevention across diverse Hispanic populations and settings.

Population characteristics

Mexican Americans were the most frequently represented subgroup across studies, followed by Puerto Ricans. Many studies reported participants as “Hispanic/Latino” without specifying their ethnic subgroup. Female participation averaged 78% (range, 65%–100%), with only 3 studies specifically studying men (25,30). Male participation ranged from 7% to 35% in mixed-sex studies, below population parity, despite Hispanic men experiencing comparable diabetes rates (1). Studies successfully reached high-risk populations: 64% enrolled low-income participants, 50% enrolled uninsured or Medicaid-insured participants, and 73% enrolled Spanish-speaking participants (22,29,38).

Table 3 provides a summary of facilitators, barriers, and notable outcomes across all 5 RE-AIM domains.

Reach: participation and representativeness

Of the studies, 18 provided data relevant to the reach outcomes. Among those reporting participation rates, enrollment ranged from 18% to 67% of eligible people, with a median of 43% (5,10,37). A large-scale NDPP implementation study encountered challenges: only 35.5% of enrolled participants completed the core requirements, with even lower completion rates among Hispanic participants (3). Rural Hispanic adults faced limited access due to fewer available sites, geographic distances, and transportation issues (10). A community-based program using intensive engagement strategies reported higher enrollment rates, ranging from 45% to 67%, despite serving smaller eligible populations (22).

Reach facilitators. Community-based recruitment through trusted venues (churches, community centers) proved most effective (75% of studies). Promotora-led recruitment leveraged community health workers’ shared cultural backgrounds and existing trust relationships (52% of studies), achieving higher enrollment than professional recruiters (22). CBPR approaches were commonly associated with improved cultural appropriateness (25% of studies). Culturally tailored recruitment materials featuring Spanish language, culturally relevant imagery, and messaging emphasizing family health resonated powerfully with Hispanic adults (68% of studies) (12). Family-based recruitment, leveraging familismo values and flexible, low-barrier approaches that accommodate work schedules and reduce administrative burden, improved participation (39% of studies) (13,15,33).

Reach barriers. Low prediabetes awareness and fatalistic beliefs about diabetes undermined prevention messages (n =12 studies, 32%), with patients unaware of their prediabetes status or unfamiliar with available prevention options (17,41). Language and health literacy barriers persisted even with Spanish-language offerings, as technical verbiage intimidated prospective participants (n = 17, 46%). Work schedule conflicts affected low-income hourly workers without flexible schedules (n = 19, 51%) (39). Transportation and childcare barriers prevented attendance, especially in rural areas (n = 14, 38%). Immigration concerns deterred participation among undocumented immigrants and mixed-status families (n = 7, 19%). Diabetes-related stigma affected enrollment decisions (n = 9, 24%). Sex-specific barriers for Hispanic men included programs that men felt were designed for women, work inflexibility, discomfort with group settings, and cultural expectations of masculine self-sufficiency (n = 6, 16%). Digital access barriers limited the use of technology-delivered interventions among low-income participants (n = 8, 22%).

Effectiveness: real-world outcomes

Community-based interventions produced clinically meaningful weight loss averaging 3.2 kg to 5.8 kg, body mass index reductions of 1.1 kg/m² to 2.3 kg/m², reductions in waist circumference of 3.4 cm to 7.1 cm, and reductions in hemoglobin A_1C of 0.2 to 0.6 percentage points (26,40). These real-world effect sizes were smaller than those in the original Diabetes Prevention Program (DPP) efficacy trial but were clinically significant (34). Dietary and physical activity improvements were substantial (21), with participants reporting sustained adoption of healthier practices culturally adapted to Hispanic preferences, including remotely delivered plant-based culinary programs that demonstrated feasibility and cultural acceptability among Hispanic adults (19,42). Participant satisfaction ratings were high (85%–95%) (36).

Implementation context effects. A community-based setting achieved outcomes comparable to or exceeding clinical settings while achieving higher levels of engagement (26). A promotora-led intervention reached results comparable to professional-led interventions while improving cultural acceptability and cost-effectiveness (22). Per NDPP data, dose–response relationships underscored retention’s importance: participants completing 9 or more of 16 NDPP sessions achieved 2 to 3 times more weight loss than those attending fewer sessions (3). Interventions using multiple cultural adaptation strategies achieved superior outcomes compared with single-strategy adaptations (31,40).

Adoption: organizational settings and delivery personnel

Twenty-seven studies provided data on organizational adoption. Community-based organizations were the most common adopters, offering trusted venues and cultural concordance, although resource constraints were typical. Faith-based organizations (33%) successfully adopted programs by leveraging social networks and trusted religious leaders but faced challenges with volunteer-dependent delivery. Primary care clinics and federally qualified health centers (26%) integrated programs but faced capacity constraints and competing priorities (11,28). Workplace (7%) and educational settings (4%) showed promise but faced sustainability challenges,

Delivery personnel varied across studies: community health workers/promotoras (52%) brought shared cultural backgrounds and community trust but faced recruitment challenges and limited career pathways; professional health educators (26%) provided clinical expertise but with limited bilingual/bicultural availability; hybrid models (15%), which partnered promotoras with professionals, optimized cultural responsiveness and clinical quality.

Adoption facilitators. Mission alignment with health equity (33% of studies), existing community relationships (43%), leadership support (22%), bilingual/bicultural staff characteristics (26%), external technical assistance (19%), and funding availability (41%) facilitated organizational adoption.

Adoption barriers. Resource constraints, including limited staff capacity and inadequate funding (37%), lack of a bicultural workforce (27%), organizational readiness gaps (15%), competing priorities (19%), sustainability concerns about time-limited grants (26%), and adaptation-fidelity tensions related to Centers for Disease Control and Prevention recognition requirements (11%), impeded adoption.

Implementation

Implementation success across studies was linked to cultural concordance and to predominantly bilingual/bicultural staff serving as trusted cultural brokers (22). One program delivered in trusted community settings reduced structural barriers and increased acceptability (35). CBPR approaches strengthened recruitment and supported adaptation without compromising core components (31). Flexibility accommodating work schedules, caregiving responsibilities, and transportation constraints improved attendance and retention (14).

Implementation barriers identified across studies included limited time-bound funding, which constrained staffing and continuity; bicultural personnel shortages, which impeded scalability; digital literacy gaps, which challenged remotely delivered interventions (18); and insufficient leadership buy-in, which complicated implementation in health care systems (2,24).

Maintenance

Maintenance was the least consistently examined domain, with only 1 analytical study (40) clearly treating it as a primary focus, although several others provided maintenance-related insights. Only 18% of studies reported outcomes beyond 12 months. Sustainability was closely linked to integration within existing health care infrastructures rather than to stand-alone, grant-funded initiatives (2). Programs integrated into primary care or community health organizations demonstrated greater continuity than those dependent on short-term external funding.

At the individual level, sustained behavior change was supported by family involvement, peer support, and ongoing group interaction (20,23). Institutional ownership, reimbursement mechanisms, and workforce stability facilitated organizational sustainability. Programs aligned with NDPP reimbursement pathways were more likely to persist (40). Few studies reported cost-effectiveness analyses or formal sustainability plans, limiting assessment of long-term feasibility (40).

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Discussion

This integrative review of 37 studies showed that culturally tailored diabetes prevention interventions for Hispanic adults are effective at reducing diabetes risk; however, their translation into sustained real-world practice is uneven. Applying the RE-AIM framework showed that, while reach and effectiveness are well documented, adoption, implementation, and maintenance lag, limiting population-level impact.

Interventions grounded in cultural concordance, community partnerships, and flexible delivery showed stronger implementation outcomes than clinic-based or technology-driven models alone (16,35). Promotora-led and family-centered approaches effectively fostered trust, relevance, and engagement, underscoring the importance of relational and culturally embedded strategies (43). However, persistent gaps, including male underrepresentation, workforce shortages, and sustainability limitations, underscore the need for intentional implementation planning that addresses structural barriers alongside intervention design.

The persistent gap between reach/effectiveness and the downstream domains of adoption, implementation, and maintenance reflects well-documented patterns in implementation science; interventions that demonstrate efficacy under controlled conditions frequently encounter structural, organizational, and resource barriers that impede real-world translation. Community-based organizations, while culturally aligned, frequently lack the infrastructure, reimbursement mechanisms, and workforce stability to sustain programming beyond initial grant periods, a phenomenon consistent with the implementation outcomes framework by Proctor et al, which identifies sustainability as the most distal and difficult-to-achieve implementation outcome (44).

Moreover, community partnerships improve implementation outcomes by reducing the structural distance between intervention design and the delivery context, facilitating real-time adaptation without compromising core components, a process that Glasgow et al describe as “fit” within the RE-AIM framework (7). Flexible delivery accommodates the lived realities of low-income, hourly-wage, and caregiving populations for whom rigid scheduling constitutes a participation barrier independent of intervention quality (2).

Promotora-led models are effective because promotoras serve as cultural and epistemological agents, people who share the participants’ language, cultural frameworks, and social contexts and who, therefore, communicate health information through culturally resonant meaning systems (22). Family-centered approaches leverage familismo, a core Hispanic cultural value emphasizing collective family identity and interdependence, thereby transforming behavior change from an individual responsibility into a shared family commitment, a reframing that reduces stigma and increases social accountability (44). The qualitative review by Sanders Thompson et al similarly identified culturally grounded theoretical frameworks as essential to intervention engagement and retention among Hispanic adults (43).

Implications for public health practice

Translating evidence-based diabetes prevention into sustainable community practice requires strategic implementation that addresses multilevel barriers (27). Community-based organizations demonstrated strong cultural alignment and trust but faced resource constraints that threatened continuity. Health care and public health workforces are well positioned to operationalize culturally tailored prevention strategies through partnerships with trusted community organizations, including faith-based settings (45), flexible delivery models that reduce structural barriers to participation, and the integration of cultural humility and language concordance into service delivery.

Addressing upstream factors, including stigma, gender norms, health literacy, and social determinants, is essential to improving reach and engagement. Persistent underrepresentation of Hispanic men across studies underscores the need for targeted outreach, including workplace-based programs, male-specific messaging, and interventions that address cultural expectations of masculine self-sufficiency. Rural communities face compounded access barriers related to geographic distance, transportation, and limited program availability, necessitating deliberate strategies such as telehealth adaptation, mobile delivery, and regional coordination.

The success of promotora-led models underscores the value of leveraging community health workers’ shared cultural backgrounds, existing trust relationships, and community embeddedness. However, workforce development must address recruitment challenges, limited career pathways, and the need for ongoing training and support. Hybrid models that pair community health workers with professional health educators optimize both cultural responsiveness and clinical quality while expanding workforce capacity.

Implications for policy and systems

Sustainable diabetes prevention requires structural support that extends beyond time-limited grant funding. Policy priorities include reimbursement for community health workers and promotoras, investment in bicultural workforce development, and incentives for health care–community partnerships (1,2). Without policy alignment, culturally tailored interventions risk remaining fragmented, short-term, and grant-dependent rather than embedded in health care and public health systems.

Integration into existing health care infrastructures demonstrated greater continuity than stand-alone initiatives. Programs aligned with NDPP reimbursement pathways were more likely to persist (40). Policy support for prevention services, workforce development, and health care–community integration is essential to achieving equitable access and sustained impact. Policies that address social determinants of health, which include immigration concerns, transportation barriers, childcare access, and inflexible work schedules, can reduce structural barriers that limit participation among populations at high risk of poor health outcomes.

Implications for the workforce

Implementation success depends on a culturally concordant, well-trained, and sustainably employed workforce. Findings from studies underline the need to equip public health and health care professionals with competencies in cultural adaptation, community-based participatory approaches, and implementation science frameworks. Educational programs should emphasize partnership development, health equity advocacy, and systems thinking to address multilevel barriers to diabetes prevention.

Public health workers, particularly those in community and public health settings, play essential roles in bridging evidence, culture, and community context. Their population-focused lens helps identify groups requiring targeted outreach, and their competencies in cultural humility, trust-building, and addressing social determinants position them to lead implementation efforts. However, successful workforce development extends beyond individual competencies to include career pathways for community health workers, continuing education and technical assistance, and organizational support for implementation fidelity and adaptation (2).

Integrating RE-AIM and similar implementation frameworks into workforce development strengthens the capacity to translate evidence-based interventions into equitable, sustainable community practice. Workforce planning must address bilingual/bicultural personnel shortages, which have emerged as a persistent implementation barrier to scalability and adoption across diverse settings (24).

Recommendations for future research

Research priorities that emerged from the synthesis of 37 studies include comparative implementation trials that identify which strategies work best in specific contexts (45), long-term maintenance studies extending beyond 12 months, cost-effectiveness analyses to inform sustainability decisions, tailored strategies to engage Hispanic men and underrepresented subgroups, and hybrid effectiveness–implementation designs that advance equitable, scalable prevention (27,40).

Inconsistent reporting of implementation outcomes, predominantly in the adoption and maintenance domains, limits evidence synthesis and cross-study comparisons. Future research should systematically measure and report RE-AIM outcomes using standardized metrics to strengthen the evidence base for implementation decision-making. Research examining workforce contributions to diabetes prevention implementation would inform workforce planning and educational preparation.

Limitations

Although comprehensive, the review had several limitations. These articles were limited to English-language studies conducted in the US, potentially excluding relevant international perspectives. The variability in study designs, intervention components, and outcome reporting across the 37 studies limited direct comparisons. Implementation outcomes were inconsistently reported, particularly in the adoption and maintenance domains, with only 2 studies examining maintenance beyond 12 months. The inclusion of study protocols and reviews alongside empirical studies broadened the implementation evidence but means that not all sources contributed outcome data; effectiveness findings are drawn from the empirical studies only.

Despite an equity focus, some studies may have excluded structurally marginalized people, including people who are undocumented or those with unstable housing. Persistent male underrepresentation limits generalizability to Hispanic men. Furthermore, quality appraisal and data extraction were conducted by a single reviewer, which is a methodological limitation. Although standardized Johns Hopkins Evidence-Based Practice criteria were applied consistently and the reviewer has expertise in diabetes and implementation science, the absence of a second independent appraiser increases the risk of bias and limits the confirmability of quality ratings. Future reviews should incorporate dual reviewers and inter-rater reliability calculations to strengthen methodological rigor.

Conclusion

This integrative review demonstrates that culturally tailored diabetes prevention interventions for Hispanic adults are effective, acceptable, and culturally resonant. Yet, their real-world impact is limited by implementation and sustainability challenges. The application of the RE-AIM framework to analyze 37 primary research studies indicated gaps beyond effectiveness, particularly in adoption, implementation, and maintenance, which hinders equitable benefits at the population level.

Evidence from studies supports cultural concordance, community-based delivery, promotora models, and family-centered approaches as foundational to successful diabetes prevention in Hispanic populations. However, persistent barriers that include workforce limitations, funding instability, male underrepresentation, and limited maintenance data highlight the need for intentional implementation planning and sustainability-focused research.

Advancing equitable diabetes prevention requires coordinated efforts across practice, education, research, and policy to ensure that interventions are culturally tailored, accessible, scalable, and sustainable. Addressing structural inequities through workforce development, sustainable funding mechanisms, and health care–community partnerships is essential to translating evidence into population-level impact.

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Acknowledgments

The author thanks the PhD faculty at Texas Woman’s University for their mentorship in nursing scholarship, as well as the colleagues and mentors who provided guidance and support during the development of this integrative review.

The author declares no potential conflicts of interest with respect to the research, authorship, and publication of this article. The author received no external financial support for the research, authorship, or publication of this article. This research received no specific grant from any funding agency in the public, commercial, or nonprofit sectors. No copyrighted material, surveys, instruments, or tools were used in the research described in this article. This integrative review analyzed published literature and did not involve human participants. Ethical approval was not required. Data extraction forms and analysis materials are available from the corresponding author upon reasonable request.

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Author Information

Corresponding Author: Rachell Nguyen, DNP, APRN, Texas Woman’s University College of Nursing, 6700 Fannin St, Houston, TX 77030 (rnguyen8@twu.edu).

Author Affiliations: ¹Texas Woman’s University College of Nursing, Houston, Texas.

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Tables

Abbreviations: DPP, diabetes prevention program; JHNEBP, Johns Hopkins Evidence-Based Practice; NA, not applicable; NDPP, National Diabetes Prevention Program; RCT, randomized controlled trial; RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance.
^a This table summarizes the methodological quality appraisal of the 37 sources (empirical studies, study protocols, and reviews) included in the integrative review, using the JHNEBP appraisal tool.
^b Level I, experimental/RCT; Level II, quasi-experimental; Level III, nonexperimental, qualitative, mixed methods.
^c A indicates high quality, B indicates good quality, and C indicates low quality.

Abbreviations: CBPR, community-based participatory research; DPP, diabetes prevention program; NDPP, National Diabetes Prevention Program; RCT, randomized controlled trial; RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance.

Abbreviations: BMI, body mass index; CBPR, community-based participatory research; CDC, Centers for Disease Control and Prevention; CHW, community health worker; FQHC, federally qualified health center; HbA_1c, hemoglobin A_1c; NDPP, National Diabetes Prevention Program; RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance.
^a Percentages are calculated on all 37 included sources; some sources contributed data to more than 1 domain.

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