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. 2023 Nov 20;7:e48746. doi: 10.2196/48746

Table 1.

Description of studies included in the systematic review.

Author(s), year Study purpose Study design and sample size Intervention Participants and inclusion criteria Recruitment Outcomes
Zhao et al, 2022 [7] To examine the effects of the patients’ and family members’ perceived family support on diabetes management Cross-sectional; 70 dyads N/Aa Chinese people in China

  1. DMb ≥6 months

  2. Aged 50-79 years

  3. HbA1cc between 7.0% and 10.0%

 Recruitment took place in 26 residential communities; no other details were provided. Patients’ perceived family support, such as actively helping patients adjust their lifestyles (healthy diet and regular exercise), was positively associated with diabetes management.
Feng et al, 2023 [6] To examine the effectiveness of a family-based intervention with WeChat RCTd with 2 groups; 225 dyads (intervention: 111; control: 111) 12-week interventions, including distribution of educational articles, quizzes, and more via WeChat (social media) to patients and family members of patients Chinese people in China

  1. Registered in 1 of the 2 community health service centers in the urban area in Jiading District

  2. Had been diagnosed with T2DMe by a doctor at least 6 months before study enrollment

  3. Aged 18 to 79 years

  4. HbA1c level ≥7%

  5. Had no plans to leave their place of residence in the following 12 months

  6. Had a family member who could use WeChat and lived with the patient or visited them at least once a week

 Recruited from family doctors in 2 community health centers; patients and family interviewed by the research team member HbA1c significantly decreased by 0.60% (P<.001); other secondary outcomes included decrease in nonsupportive behavior (P=.03) and improved scores for general diet (P<.001), specific diet (P<.001), exercise (P=.002), blood sugar testing (P=.02), foot care (P<.001), risk knowledge (P<.001), personal control (P<.001), worry (P=.02), optimism bias (P=.03), and supportive behaviors (P<.001).
Cai and Hu, 2016 [11] To examine the effects of a family-based self-management education intervention for adults Quasiexperimental design with 2 groups; 57 dyads (intervention: 29 dyads; control: 28 dyads) 7 educational sessions with patients and their family members Chinese people in China

  1. Self-reported diagnosis of T2DM

  2. >18 years old

  3. HbA1c >7.0%

 Recruited via flyers posted in health community centers and via referral from physicians Significant average 1% reduction in HbA1c (intervention group vs control group); significant reduction in average BMI (23.27, SD 2.13 for the intervention group vs 24.96, SD 3.07 for the control group; F=18.11; P<.001); significant increase in average diabetes knowledge (22.97, SD 2.03 for the intervention group vs 14.11, SD 4.57 for the control group; F=92.77; P<.001).
Shao et al, 2017 [10] To determine if better social support perceived or received by patients could reinforce self-efficacy, medical regimen, and glycemic control Cross-sectional study; n=532 N/A Chinese people in China

  1. Diagnosis of T2DM at least 1 year prior

  2. >18 years old

  3. No concurrent serious health conditions, such as advanced renal failure

  4. Chinese inhabitants of Guangzhou, China

  5. Able to complete a questionnaire

 Recruited from outpatients and inpatient units in 2 hospitals Social support was significantly associated with diabetes control. Social support was measured in 3 dimensions: (1) objective support (ie, visible support, such as social network), (2) subjective support (ie, an individual’s sense of being supported or understood by family), (3) support utilization (ie, the extent of accepting help and actively looking for support from family).
Chen et al, 2018 [4] To identify common factors affecting diabetes management Qualitative study using thematic analysis (TCA); n=229 Cross-sectional study (no intervention) Chinese people in China

  1. Patients with T2DM

  2. >18 years old

  3. Permanent residents of Tianjin, China

 Referred by physicians Major factors (themes) related to family support for diabetes management included a higher level of family support to promote diabetes management and more social integration (eg, patients felt less lonely and more willing to optimize their diabetes control).
Hu et al, 2014 [12] To test the efficacy of a family-based, culturally tailored intervention (8 weeks) for Hispanics with T2DM and their families Quasiexperimental long-term study; 92 dyads (51 in the intervention group; 41 in the control group) 8-week educational sessions taught in Spanish to patients and their family members Hispanic Americans

  1. Hispanic patients with T2DM and their family members

  2. Community-dwelling

  3. Self-identification as Hispanic

  4. Aged 18 years or older

  5. Self-identification as having a medical diagnosis of T2DM

  6. An adult family member willing to participate in the study

Inclusion criteria for family members:

  1. Residence in the same household as the participant with diabetes

  2. Aged 18 years or older

 Recruited from community clinics, physician offices, and churches Mean HbA1c significantly decreased by 1%, BMI significantly decreased (mean difference=–0.25 kg/m2; P=.02), and diabetes knowledge significantly improved (mean difference=5.89; P<.001).
McEwen et al, 2017 [9] To investigate the effects of a family-based self-management support intervention (12 weeks) for T2DM RCT with 2 groups; 157 dyads (83 dyads in the intervention group; 74 dyads in the control group) Participants randomly assigned to an intervention Mexican Americans

  1. Mexican American patient

  2. Diagnosed with T2DM at least 1 year prior

  3. 35-74 years old

  4. Spoke and read Spanish or English

  5. HbA1c ≥8.0%

  6. Had not participated in a diabetes education program in the prior year

  7. Able to walk at least 1 mile (determined by self-report)

  8. Access to and ability to talk on the telephone

  9. Had 1 adult family member willing to participate

 Recruited via outreach activities to various communities by the research team HbA1c did not change significantly over time, but other outcomes, including diabetes management activities and diabetes self-efficacy, were improved.
Yue et al, 2018 [5] To explore factors affecting patients with diabetes and develop family-based interventions Qualitative descriptive approach; 20 participants Qualitative data collection through interviews (no intervention) Chinese people in China

  1. HbA1c target <7%

  2. T2DM diagnosis

  3. >18 years old

  4. Living in the target community

 Referred by a community health care nurse to the research team Six major themes or patient concerns were identified through data analysis that included family experiences about starvation (starvation experience in early life led to overeating, which was associated with poor diabetes management), seeking family harmony in eating, and family financial burden.
Chesla et al, 2009 [3] To describe cultural and family challenges with illness management Qualitative, interpretive, comparative study; 20 dyads Qualitative data collection through interviews (no intervention) Chinese Americans

  1. T2DM for at least 1 year

  2. Aged 35-75 years

  3. Married for a minimum of 1 year

  4. Self-identified as Chinese American or Chinese having immigrated to the United States from mainland China or Hong Kong

  5. Spouse agreed to participate

 Recruitment from community clinics, community service organizations, and public notices The results showed that Chinese families were involved in diabetes management activities, such as food preparation.
Song et al, 2012 [13] Determine primary sources of social support for Korean Americans with T2DM and examine the effect of unmet needs in diabetes management Baseline data from an RCT; 83 patients with DM Survey/cross-sectional data from an RCT (no intervention) Korean Americans

  1. Self-identified as Korean American

  2. Aged ≥30 years

  3. Uncontrolled diabetes (HbA1c ≥7.5% within the past 6 months)

  4. Resided in the Baltimore, WA area

  5. Able to give written consent to participate in the study

 Recruitment via social media, Korean churches, and grocery stores The primary source of social support was their spouse (family support) for both genders; social support (mainly family support) was significantly associated with diabetes management. Diabetes management was measured by self-care activities, including diet, exercise, blood glucose testing, foot care, and medication adherence.

aN/A: not applicable.

bDM: diabetes mellitus.

cHbA1c: glycated hemoglobin.

dRCT: randomized controlled trial.

eT2DM: type 2 diabetes mellitus.