Table 3.

Summary Characteristics of quantitative studies

First Author, Pub.Year.	Study Settings/ population/ duration/sample size	Study’s Aim	Study design/ tools used	Findings
Jansà,* et al., 2009	10 primary healthcare centers in Barcelona, Catalonia, Spain	To determine the profile of Moroccans with type 2 diabetes mellitus (T2DM), to provide diabetes education strategies.	cross-sectional study 70 questions covering: social demographic profile (11 questions); clinical data (16 questions); daily living with diabetes (attributions, knowledge about diabetes and quality-of-life, 25 questions); sociocultural factors 14 questions); appointment compliance and use of alternative medicine (4 questions)	• Interviews were conducted with forty patients, having an average age of 50 ± 15 years, with 73% being females. The predominant languages spoken were Arabic (58%) and Berber (42%). A majority of patients (90%) resided with their families, and 67% had spent more than five years in Catalonia. A significant percentage of patients (53%) were unable to read or write, 11% were on insulin therapy, 12% were administered oral medications, and 60% possessed capillary blood glucose meters. 1- It was reported by 66% of the patients that they had difficulties adhering to their dietary guidelines, while 44% found it challenging to maintain their medication schedules. 2- In terms of self-reported causes of Type 2 Diabetes Mellitus (T2DM), views on potential cures for diabetes, adherence to medication and appointments, and the use of alternative medicine: 60% of patients experienced language barriers. Furthermore, 63% of patients indicated that their impediments were related to observing Ramadan, and 86% participated in the Feast of the Lamb. 3- Among the patients, 11% were taking oral medications and 12% were on insulin, in contrast to the native population where these figures were higher, at 70.2% and 21.4% respectively. Additionally, 24% turned to alternative treatments, often herbal remedies.
Alzubaidi et al., 2015	Diabetes outpatient clinics at three major hospitals, ten general medical practices, and five community support groups.	To compare illness and treatment perceptions between ASB and ENG people with T2D. Also, exploring the decision-making processes and associated barriers and enablers that determine access and use of healthcare services in ASB and ENG patients with diabetes in Australia	A cross-sectional study used 12 validated tools measuring: diabetes-related distress, functional health literacy, treatment decision making, patients’ satisfaction with healthcare decisions, self-efficacy, and adherence to traditional values and attitudes (acculturation levels)	A high percentage of Arabic-speaking individuals (84%) exhibited low functional health literacy. Moreover, non-adherence to medication was seen in 88.3% of ASBs. A suboptimal level of blood sugar control and blood pressure was observed in 58.8% of ASBs, with HbA1c exceeding 7% (> 53 mmol/mol) and 13.85% having a blood pressure higher than 140/90mmHg. Additionally, Oral Hypoglycemic Agents (OHAs) were prescribed to 91.5% of the individuals. Compared to English-speaking participants, those who speak Arabic were significantly less compliant with all components of diabetes self-care, including dietary practices (P < 0.01; 95% confidence interval (CI) = − 1.17, − 0.84), physical activity (P = < 0.001, 95% CI = − 1.14, − 0.61), blood glucose testing (P < 0.001), and foot care (P < 0.001). Negative perceptions about diabetes among ASBs showed a strong and significant correlation with worse adherence to recommendations for diet, exercise, blood glucose testing, and foot care. Personal identity perceptions were significantly related to poor adherence to exercise, blood glucose testing, foot care, and dietary habits (Spearman’s rank correlation coefficients – 0.503; – 0.481– 0.228, – 0.494; respectively; P values < 0.001). 4- ASBs were less inclined to acknowledge the necessity for diabetes medications compared to English-speaking participants (P < 0.001, 95% CI = 0.93, 0.68). They also demonstrated heightened concerns regarding the usage and effects of diabetes medications (mean ± SD, 2.60 ± 0.86).
Alzubaidi et al., 2017	Diabetes outpatient clinics at three major hospitals, ten general medical practices, and five community support groups.	To examine and compare the patient–pharmacist relationship, medication underuse and adherence levels among Arabic speaking and Caucasian English-speaking patients with type 2 diabetes.	A cross-sectional study used 12 validated tools measuring: diabetes-related distress, functional health literacy, treatment decision making, patients’ satisfaction with healthcare decisions, self-efficacy, and adherence to traditional values and attitudes (acculturation levels)	Arabic-speaking individuals (ASBs) have been reported to have a lower compliance rate with pharmacist recommendations when compared to English-speaking individuals (ESBs), with 32% and 61.9% compliance rates respectively. ASBs were less prone to engage in conversations about their prescribed treatments with community pharmacists compared to ESBs, with the rates being 36% and 29% respectively. 3- Individuals holding a high school degree were almost twice as likely to seek a pharmacist’s advice concerning treatment or health issues, compared to those without a high school degree.
Berlie, et al., 2007	Cross sectional, population-based study conducted in Arab Americans during the years 2000 and 2001, In Dearborn, Michigan	To evaluate the quality of care among Arabic-speaking living with diabetes in United states. Also, comparing the results with other ethnic groups.	Cross sectional, population-based study conducted in Arab Americans during the years 2000 and 2001, assess the quality of care received by Arab American patients, Quality indicators (QI) such as the distribution of HbA1c, LDL, SBP and DBP were used to gauge the level of care received by the study patients. On the other hand, accountability measures were used to compare the quality of care in the Arab American population to that of the United States population	Over the past year, Arab Americans with diabetes reported visiting their physician once, with 75% of them stating they had four or more appointments. Merely 30% of the respondents achieved the American Diabetes Association (ADA) recommended HbA1c target of less than 7%. An average of 1.1 + 0.3 blood glucose tests per day and 4.6 + 3.8 tests per week were reported by 74% of participants. 66% of participants indicated that they had received diabetes education. Nutritional guidance was received by 93% of respondents, with 89% stating they adhered to the provided instructions. Strenuous exercise was partaken in by only 15% of Arab Americans, with a mere 5% engaging in non-strenuous physical activities. 70% of participants had an HbA1c of 7% or higher, and 25% had an HbA1c of 10% or higher. A greater proportion of female participants, 78%, had an HbA1c of 7% or higher, compared to 57% of males. A higher rate of non-completion of high school was noted among Arab Americans compared to other ethnic groups (41.5% NHANES vs. 27.1% BRFSS vs. 81.6% Arab American). Poor glycemic control, defined as HbA1c exceeding 9.5%, was comparable between Arab American females and the national female sample (21.9% vs. 20.3%), while Arab American males were more prone to poor glycemic control than the national male sample (33.3% vs. 16.1%). Arab American patients who hadn’t completed high school displayed higher rates of poor glycemic control compared to the national sample without a high school degree (30.0% vs. 16.1%). In the Arab American population, having diabetes for 15 years or more was associated with higher rates of poor glycemic control compared to the national sample (40.0% vs. 14.5%) . The likelihood of perceiving regular exercise as a crucial part of diabetes self-management was 70% lower for unemployed individuals compared to those who were employed [(Unemployed OR = 0.30, P = 0.046; 95% CI = 0.093–0.980)]. A significant relationship was observed between receiving instructions in Arabic and the outcome of food selection [OR = 6.66, P = 0.014; 95% CI = 1.48–30.03)]. A strong correlation was found between receiving instructions in Arabic and maintaining a healthy lifestyle [OR = 43.98, P = 0.003; 95% CI = 3.75-515.24)]. A considerable link was noted between family encouragement and engagement in discussions with clinicians regarding care [OR = 71.35, P = 0.003; 95% CI = 4.28-1189.06)]. There was a significant correlation between family understanding of food choices and participation in regular exercise [OR = 2.41, P = 0.03; 95% CI = 1.09–5.35)]. Participants voiced their concerns about dialogues with health-care providers and expressed a wish for doctors to provide more information and assistance regarding diabetes management. Participants also stressed the need to concentrate on the younger generations and educate them about a healthy lifestyle to foster a healthier community.
El Masri, 2020	To assess perceptions of diabetes self-management behaviors among ASBs with diabetes living in the US.	community pharmacies located in Michigan	For Quantitative analysis - Measure of central tendency were used to describe the sample - Pearson Chi-square tests were used to determine associations between perceptions of DSM behaviors and practices. - Logistic regression was also used to control for demographic factors and to obtain odds ratios between covariates and outcomes associated with perceived importance of DSM. behaviors. For Qualitative analysis: - data-driven inductive approach was used to establish codes and common themes.	Homemakers were 82% less likely to perceive regular exercise as an important DSM behavior. [(homemakers: OR = 0.187, P = 0.006; 95% CI = 056-0.620), The likelihood of perceiving regular exercise as a crucial part of diabetes self-management was 70% lower for unemployed individuals compared to those who were employed [(Unemployed OR = 0.30, P = 0.046; 95% CI = 0.093–0.980)]. A significant relationship was observed between receiving instructions in Arabic and the outcome of food selection [OR = 6.66, P = 0.014; 95% CI = 1.48–30.03)]. A strong correlation was found between receiving instructions in Arabic and maintaining a healthy lifestyle [OR = 43.98, P = 0.003; 95% CI = 3.75-515.24)]. A considerable link was noted between family encouragement and engagement in discussions with clinicians regarding care [OR = 71.35, P = 0.003; 95% CI = 4.28-1189.06)]. There was a significant correlation between family understanding of food choices and participation in regular exercise [OR = 2.41, P = 0.03; 95% CI = 1.09–5.35)]. Participants voiced their concerns about dialogues with health-care providers and expressed a wish for doctors to provide more information and assistance regarding diabetes management. Participants also stressed the need to concentrate on the younger generations and educate them about a healthy lifestyle to foster a healthier community.