Health-Related Education for New Immigrants to Prevent Chronic Diseases: A Systematic Review.
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Cardiovascular diseases (CVD) and cancers are chronic, often preventable diseases that remain the leading causes of mortality and morbidity globally. Immigrants are at higher risk of developing CVD and cancers, therefore, and it is important to understand the effectiveness of health-related education targeted to this group to improve knowledge, attitudes, and behaviours related to chronic disease prevention. The objective of this systematic review is to examine the effectiveness of health-related education delivered to new immigrants to western countries at improving knowledge, attitudes, and health behaviours to prevent chronic disease. A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Literature was searched using Medline, Embase, Emcare, Global Health, and Google Scholar was used to identify grey literature. Each database was searched from its inception through April 16th, 2024. A narrative synthesis was completed. Appropriate validated tools were utilized to assess the methodological quality of each study. A comprehensive assessment of study quality was undertaken for all the studies using the QUaDS tool. A total of 11 studies were included in the review, which included quantitative, qualitative and mixed-method studies. The 11 studies included 1,212 participants with age range from 18-75 years of age. The studies included changes in knowledge, (deeper understanding of food and health, recipes to cook traditional foods with healthier recipes, diabetes prevention strategies), behaviours (an increase in weekly step count, reading food labels when doing grocery shopping, purchasing food based on nutritional quality, eliminating unhealthy foods, consumption of more fruits and vegetables, quitting smoking, and improved sleep behaviours). Several methodological limitations of the included studies were identified. This review highlights that the use of behaviour change theories can assist clinicians better understand behaviour change and at the same time inform the development of evidence-based interventions. Given the significant burden of chronic diseases in immigrant populations, it is imperative that health-related education programs are made available, and immigrant populations are informed and valued at each phase of the program. Tailored approaches, for example, story-telling, in-class instructions, healthy heart melas (community gatherings), video and pictorial illustrations have been found to be particularly effective.