South Asian populations in the UK experience increased health risks related to long-term conditions, exacerbated by underdiagnosis, cultural differences in help-seeking behaviours, language barriers, low health literacy and a lack of culturally sensitive services. We know that group interventions that include education and rehabilitation, such as cardiac and pulmonary rehabilitation, are highly effective, but people from diverse communities often face barriers to access and engage with them. This review aims to synthesise evidence on the barriers and facilitators to education and rehabilitation interventions experienced by South Asian people living with long-term conditions.

A systematic review of qualitative studies using meta-ethnography as the analytical approach to synthesis was conducted, following Noblit and Hare’s approach, eMERGe Reporting Guidance for Meta-Ethnography, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic searches were performed across MEDLINE, PsycINFO, CINAHL, CENTRAL, EMBASE and Applied Social Sciences Index and Abstracts from database inception through March 2024 (updated April 2025).

MEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost platform), CENTRAL (Cochrane Library), EMBASE (Ovid), Applied Social Sciences Index and Abstracts (ProQuest platform) were searched from inception to March 2024 (updated April 2025).

We included qualitative research exploring the attitudes, views and experiences of South Asian adults (outside of South Asia) with diabetes, cardiovascular disease or chronic obstructive pulmonary disease (COPD) regarding group treatments for these conditions.

Two independent reviewers searched, screened and coded studies, while remaining authors peer-reviewed. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data extraction and synthesis followed eMERGe and PRISMA reporting guidance, with findings synthesised qualitatively.

Of 8348 identified citations, 17 studies met inclusion criteria, providing data from South Asian people living with cardiovascular disease and diabetes mellitus. No studies including people with COPD met the inclusion criteria. Synthesis revealed four overarching themes, each incorporating both barriers and facilitators: faith, culture, communication, and safe space and professional relationship.

Findings indicate that current group education and rehabilitation interventions are not fully inclusive of South Asian needs, often lacking cultural sensitivity, which impedes engagement. Special attention is required for South Asian women, who can face additional cultural and societal barriers. Addressing these challenges through culturally sensitive care, such as flexible intervention scheduling around religious practices, gender-sensitive adaptations and culturally tailored communication strategies, has potential to improve engagement in education and rehabilitation interventions, and therefore long-term condition outcomes.

CRD42024493644.

Alcohol is consumed by an estimated 137.4 million people in the USA 12 years of age and older and, as a result, is estimated to have caused about 140 thousand deaths among people 20 to 64 years of age each year from 2015 up to and including 2019.

The proposed review of the evidence on alcohol’s impact on health aims to produce conclusions to inform the Dietary Guidelines for Americans, 2026–2030. A multi-method approach will be utilised to formulate conclusions on (i) weekly (ie, average) thresholds to minimise long-term and short-term risks of morbidity and mortality, (ii) daily thresholds to minimise the short-term risk of injury or acute illness due to per occasion drinking, (iii) alcohol use among vulnerable populations (eg, pregnant women) and (iv) situations and circumstances that are hazardous for alcohol use. To inform expert decisions, this project will also include a systematic review of existing low-risk drinking guidelines, a systematic review of meta-analyses which examine alcohol’s impact on key attributable disease and mortality outcomes, and of estimates of the lifetime absolute risk of alcohol-attributable mortality and morbidity based on a person’s sex and average level of alcohol use. The systematic reviews were designed in accordance with the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The preliminary conclusions produced as a result of this project will undergo public consultation, and data from these consultations will be qualitatively analysed. The results of the public consultations will be used to further revise and refine the project’s conclusions.

The study was granted an ethics exemption as only secondary data sources and unidentifiable public consultation will be utilised. Systematic reviews are pre-registered with PROSPERO (registration numbers CRD42024584924 and CRD42024584948).

This project will establish a scientific consensus concerning alcohol’s impact on health. This consensus is imperative for informing the upcoming Dietary Guidelines for Americans, 2026–2030, and for better informing individuals about the health risks associated with alcohol use.