Cross-Cultural Perspectives on Metabolic Syndrome Management and Attitudes Toward Using Digital Health Tools in Two Distinct Populations: Protocol for a Qualitative Descriptive Study
Clinical Snapshot
PICO Framework
| P — Population | Adults with metabolic syndrome (meeting ≥3 of 5 diagnostic criteria) recruited from primary care settings in two international sites: University of Memphis (United States) and King Saud bin Abdulaziz University for Health Sciences (Saudi Arabia); 20–30 participants per site via purposive maximum variation sampling |
| I — Intervention | Semi-structured one-on-one interviews (approximately 60 minutes) exploring self-management behaviours, barriers and facilitators to MetS management, and attitudes toward digital health tools |
| C — Comparator | Cross-cultural comparison between a US cohort and a Saudi Arabian cohort — no control group; qualitative descriptive design without intervention arm |
| O — Outcomes | Primary: Themes describing multilevel barriers and facilitators to MetS self-management; Secondary: Participant attitudes toward digital health tools for chronic disease management; cross-cultural variation in social, dietary, and familial influences on self-management engagement |
Bottom Line
This is a published protocol for a qualitative descriptive study that has not yet collected data. The study aims to explore barriers and facilitators to metabolic syndrome self-management and attitudes toward digital health tools across two culturally distinct populations — one in the United States and one in Saudi Arabia. The methodology is appropriate and the research question is clinically relevant, particularly given the global burden of metabolic syndrome and the growing role of digital health in chronic disease management. However, critical methodological details are absent from the protocol: ethics approval is not confirmed, researcher reflexivity is unaddressed, no theoretical framework is stated, and rigour-enhancing strategies such as member checking and inter-rater reliability are not described. Clinicians and researchers should treat this as a promising but incomplete protocol. The study's value will ultimately depend on the quality of execution and reporting in the final publication. For Australian practitioners, the cross-cultural findings — once available — may offer useful insights for managing metabolic syndrome in CALD communities, where culturally sensitive approaches to digital health engagement remain underdeveloped.
Key Findings
Effect Size: Not applicable — qualitative study; no quantitative effect sizes will be generated
Primary Outcome: Protocol only — no results available. Anticipated primary output: thematic analysis of multilevel barriers and facilitators to MetS self-management across US and Saudi Arabian populations
Nnt Or Sensitivity: Not applicable — qualitative descriptive design; transferability and credibility of themes will be the relevant quality indicators rather than statistical measures
Clinical Application
The study design is feasible in principle, with semi-structured interviews being a low-resource, widely applicable data collection method. However, the multi-national coordination, dual IRB processes, and cross-cultural instrument adaptation represent logistical challenges that the protocol does not fully address. Enrollment is planned for August 2026, with no timeline to completion or publication stated. Metabolic syndrome is highly prevalent in Australia, affecting approximately 29–35% of adults, with disproportionate burden in culturally and linguistically diverse (CALD) communities including Arabic-speaking, South Asian, and Pacific Islander populations. The RACGP's Red Book and chronic disease management frameworks emphasise culturally appropriate care. Digital health tools — including MyHealth Record, telehealth platforms, and PBS-subsidised chronic disease management plans — are increasingly central to Australian primary care. Findings from this study, once available, could inform culturally tailored digital health interventions for CALD communities in Australia, particularly given the significant Saudi and broader Arab diaspora population. The TGA's Digital Health Strategy and the Australian Digital Health Agency's national roadmap would provide relevant policy context for translating findings into practice. Clinicians should note that dietary and familial factors identified in the Saudi cohort may have direct relevance to Arabic-speaking patients in Australian primary care. Adults with established metabolic syndrome in primary care settings, particularly those from culturally diverse backgrounds. Findings will be most directly applicable to US and Saudi Arabian populations but may have broader relevance to other Gulf Arab, Middle Eastern, and Western immigrant communities managing MetS.
Abstract
BACKGROUND: Metabolic syndrome (MetS) is defined by the presence of at least 3 out of 5 clinical risk factors, including abdominal obesity, elevated blood pressure, high fasting glucose, elevated triglycerides, and low high-density lipoprotein cholesterol. Individuals with MetS face significantly increased risks of cardiovascular disease, type 2 diabetes, and all-cause mortality. OBJECTIVE: This study aims to explore the multilevel factors influencing individuals' engagement in self-management of MetS. Specifically, it seeks to identify key barriers and facilitators to effective self-management and to assess participants' attitudes toward the use of digital health tools in supporting disease management. METHODS: This qualitative descriptive study will be conducted at 2 international sites: the University of Memphis (United States) and King Saud bin Abdulaziz University for Health Sciences (Saudi Arabia), in collaboration with local primary care clinics. Participants will be recruited using purposive sampling with a maximum variation strategy, aiming for 20 to 30 individuals per site who meet eligibility criteria. Data will be collected through semi-structured, 60-minute one-on-one interviews. An abductive thematic analysis approach (integrating both inductive and deductive reasoning) will be used to analyze the data with NVivo 15 software. RESULTS: This study will begin participant enrollment in August 2026. Thematic analysis will be used to examine barriers and facilitators to MetS self-management and participants' views on digital health tools across 2 international sites. CONCLUSIONS: Findings will offer culturally grounded insights into how social, dietary, and familial factors influence chronic disease management. This knowledge can inform the design of equitable, context-sensitive digital health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/91903.
References
- 1.Ali, A., Ogbuiyi-Chima, I., Faisal, M., Alwatban, N., Alhabas, M., El-Metwally, A. A., & Joshi, A. (2026). Cross-cultural perspectives on metabolic syndrome management and attitudes toward using digital health tools in two distinct populations: Protocol for a qualitative descriptive study. JMIR Research Protocols. https://doi.org/10.2196/91903
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