Introduction

Indifference with the ethnoreligious needs of Muslim-minorities has led to a complex array of poorly understood barriers to health and social care (Hanrieder, 2017), affecting Muslims’ wellbeing (Patmisari et al., 2022). Mainstream indifference leads to marginalization and, consequently, low levels of health literacy (Hamiduzzaman et al., 2022; Shahin et al., 2021), inequitable access to community services and care (Ishaq et al., 2021; Samari, 2016), and poorer health outcomes (Shahin et al., 2021; Shlala & Jayaweera, 2016). Marginality is a key factor that hinders the confidence of Muslim-minorities in their access of mainstream health and social care. In our recent study of multicultural quality of life predictive effects of wellbeing among an Australian sample, feeling safe and having access to religiously appropriate resources was seen as crucial to the health of this Muslim community (Patmisari et al., 2022). Nonetheless, the health and social care of this community was equally impacted by the persistence of anti-Muslim sentiment and ethnoreligious misunderstanding across nations and time (Elkassem et al., 2018; McLaren & Patil, 2016; Patil & McLaren, 2019).

In countries where Muslims are minority, there may be few policies in health and social care settings, or motivation, to either tackle Islamophobia or to operationalize ethnoreligious components into care (Allen, 2021; Griera & Martínez-Ariño, 2016; Silva et al., 2018). For example, Bawadi et al. (2020) studied the experiences of Arab Muslim women in maternity hospitals in the UK and found discrimination and prejudice, emotional coldness from staff, and ideological conflicts towards the women during childbirth and aftercare. African Muslim women hospitalized in Spain likewise experienced religious discrimination when denied support to worship or pray during their confinement (Plaza del Pino et al., 2020). The absence of religious tailoring of policy and practice in these examples represents both disrespect and neglect in the wholistic care of Muslims, and denial of basic human rights. Abuelezam et al. (2018) noted in their review of USA health services that religious information was collected on intake, but the information was not used to inform the health, caring or decision-making with Muslims populations. Alternatively, McLaren et al. (2021) in their review of religiosity in health and wellbeing interventions with Muslim-minorities, showed that praying, fasting and meditating (dhikr) was important to Muslims receiving care. However, research interest in taking positive action towards accommodating Islamic beliefs in health and social care in the community settings of non-Muslim countries is relatively recent (i.e. Hamdiui et al., 2021; Ishaq et al., 2021; Saidun et al., 2019).

As a basis for generating baseline evidence in which to culturally tailor our own programme development and research with a local Muslim community in Australia, we undertook an integrative review of literature reporting health and social care outcomes with Muslim-minority communities. Our focus was on academic articles reporting research outcomes of interventions in Australia, Canada, UK, and USA. Since ‘interventions affect and are affected by both system and client characteristics producing desired outcomes’, the Quality of Health Outcomes Model (QHOM, Mitchell et al., 1998, p. 44) provided an analysis frame to deductively theme the dynamic interconnection between clients, systems, interventions, and outcomes across the studies reviewed.

We adopt the definition of religious tailoring by Worthington Jr et al. (2013) as interventions that accommodate one’s faith or tradition, spiritual practices, values, or beliefs. We note, however, that majority of literature on the provision of religiously accommodative interventions is with Christians. The current efficiency of religious tailoring or adaptations by service providers to ensure good health and social care outcomes with Muslim-minorities in Anglophone countries is not known. Adaptations are an important implementation strategy (Miller et al., 2020). Of interest here is the nature and scope of adaptations in association with outcomes reported.

Methods

An integrative review was chosen to capture the heterogeneity of research, e.g. quantitative, qualitative, and mixed methods. Our initial intention was to include articles reporting Mosque-based social care and welfare programmes in countries where Muslims were minority. When our initial scope returned too few results, we expanded the eligibility criteria to include both health and social care interventions with Muslim-minorities in community settings.

Our systematic search followed PRISMA guidelines (Page et al., 2021), with Covidence (2015) used to facilitate the screening based on our inclusion and exclusion criteria. Studies were deductively coded and arranged into themes (Erlingsson & Brysiewicz, 2017). Included articles were evaluated for risk of bias using the mixed methods appraisal tool (MMAT) (Hong et al., 2018). The QHOM offered a framework to identify associations between religious tailoring of interventions and the health and social care outcomes of Muslim-minorities in non-Muslim countries.

We included studies reporting on Muslim-minorities, and sub-samples of Muslims. Originally returning 20 studies, one from Austria was excluded (Bader et al., 2006), enabling a discrete focus on Anglophone countries (Australia, Canada, UK, and USA). Peer-reviewed academic journals in English language reporting primary research were included in the current review. Review and opinion articles, conference papers and theses, and grey literature were excluded to prioritize academic rigour in the sample.

Search Strategy

A database search was completed in April 2021, followed by ancestry searching of reference lists and Google Scholar tracking of citing authors. There were five major databases in the electronic search: ProQuest, Scopus, Web of Science, PsycINFO, and Informit. Searches likely to capture articles on health, social and welfare interventions with Muslim-minorities included terminologies such as: ‘Muslim’, ‘Islam’, ‘Mosque’, ‘minority’, ‘health’, ‘wellbeing’, ‘community’, and specific types of interventions likely in community health and social care (Table S1, databases and search syntax). No date, country of author or publication country thresholds were applied to the search.

The initial search returned 936 items. Duplicates (n = 322) were removed, leaving 625 items for titles and abstract screening (completed by two authors). Full-text screening of 90 items resulted in 19 eligible articles, inclusive of three identified from citation tracking of included articles and excluded review studies. The Prisma Flow diagram provides a visual overview of the systematic search and inclusion/exclusion process (Fig. 1).

Fig. 1
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PRISMA flow diagram of articles included

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Quality assessments were completed using the MMAT tool by Hong et al. (2018), which considers clarity of research questions, rationale, study design, and strength of analysis (Table 1). All articles contained a well-defined research question and collected data appropriate to answer. Two of the four mixed-methods studies and three qualitative studies did not provide justification of research design. Three qualitative studies did not clearly articulate data collection processes and coherence between qualitative data sources, collection, analysis, and interpretation. Non-response bias, missing data and face validity in quantitative studies were provided as reason for non-participation, and risk of bias associated with survey instruments were generally not discussed.

Table 1 The quality appraisal for the selected studies using MMAT tool
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Synthesis and Analysis of Results

Study characteristics extracted from each article included authors, aims, population, interventions, measure/instruments, and reported intervention outcomes. The intention was to enable a broad overview of activities targeted at improving health and social care, patterns across the interventions, any ethnoreligious barriers that may have influenced participation by Muslim women and men, and intervention outcomes. Cross-checking and confirmation of information by the co-authors ensured trustworthiness in the review findings.

Data analysis of study interventions and outcomes used a combination of content and deductive analysis. Guided by methods established by Erlingsson and Brysiewicz (2017), extraction and analysis involved coding, developing categories and meanings, and condensed meaning units. Deductive thematic analysis guided by the QHOM framework enabled searching for three characteristics, or themes: the system, client, and intervention, to be considered in the context of a fourth theme: health and social care outcomes.

Findings

Nineteen articles were reviewed. They were published between 2002 and 2021. There were eight quantitative studies (2 RCT, 5 non-RCT, and 1 quantitative descriptive), eight qualitative and three mixed-method studies. Four studies (2 qualitative and 2 quantitative non-randomized) were written by the same lead author (Padela et al., 2018; Padela, Malik, Ally Syeda, et al., 2018; Padela, Malik, Vu, et al., 2018; Padela et al., 2019; Table 2).

Table 2 Overview of studies in QHOM
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System Characteristics

System characteristics include the country of origin of the studies, types of organizations, whether mosque- or community-based, and staffing for the interventions. Nine studies were conducted in USA, five in UK, four in Canada, and one in Australia. Half of the studies used mosque-based educational interventions, 25% were conducted in community centres, and the remaining used a variety of places (i.e. combination of: mosques and either community centres or schools; mosques, clinics, and community centres). One study from Australia (Tse, 2002) did not specify the setting used for delivery of a training for sixteen community workers. In addition, a wide range of skills and expertise was involved in designing, delivering educational programmes, and evaluating health and social care outcomes. The mixture of organizing groups, inclusive of health and non-health professionals, was in most studies reviewed. Some studies did not mention health workers or relevant stakeholder involvement in design, delivery, and evaluation stages of the interventions (Abdulwasi et al., 2018; King et al., 2017; Vu et al., 2018).

Health promotion programmes in this review were developed by delegates from several research teams, social service associations, community centres, and community mosques, focussing on Muslim-American women from various community groups (Padela et al., 2018; Padela, Malik, Vu, et al., 2018; Padela et al., 2019). In two studies, programmes were facilitated by local health professionals with a specific focus on the Bangladeshi community in New York City (Islam et al., 2012, 2018). Medical doctors and nurses led a programme targeted towards the local Syrian refugee community in Baltimore (Chaudhary et al., 2019). The target population of (Zoellner et al., 2018) consisted of Somali Muslim refugees in a large city in the USA. Muslim women’s views were studied to inform the delivery of effective health messaging in Chicago (Vu et al., 2018). Finally, one health promotion initiative looked at ways to increase physical activity amongst South Asian Muslim women in Ontario (Abdulwasi et al., 2018).

Focused on health promotion, students and parents from multiple primary and secondary schools and faith organizations for Christians, Muslims, Hindus in London, UK, were involved in physical activity facilitated by a professional dancer at the schools (Maynard et al., 2017). Banerjee et al. (2017) also reported on a physical activity intervention, which was carefully crafted for South Asian Muslim women in Canada and delivered by physiotherapists and kinesiologists, supervised by a nurse practitioner. In a low-income, public housing sector of Seattle, USA, interventions facilitated by bilingual local health care workers sought to increase physical activity amongst women (Marinescu et al., 2013). Religious teachers facilitated an intervention to raise awareness of second-hand smoke inhalation among Bangladeshi and Pakistani Muslims (King et al., 2017). General medical practitioners, general dental practitioners, and hospital doctors tailored health promotion for Gujarati Muslims in West Yorkshire, UK, on tobacco consumption and oral cancer (Siddique & Mitchell, 2013).

To ensure cultural homogeneity, programmes were frequently delivered by Muslim facilitators who were either the same gender, ethnicity or spoke the same language as participants. In the Australian study, ethnically diverse Muslim community workers were employed to deliver psychoeducation surrounding depression and postnatal depression to ethnically diverse Muslim women (Tse, 2002). Alternatively, Darko et al. (2020) brought together a mix of Muslim primary health care workers and trained them in delivering a culturally tailored diabetes management programmes to culturally diverse Muslim communities.

Participant Characteristics

While samples were selected purposively, all studies reviewed had Muslim people as participants, predominantly adults. Population samples ranged from 8 to 2446 participants, the Muslim participants’ representation in the sample ranging from 16 to 100%. Health promotion programmes specifically designed for refugees were the focus of two studies (Chaudhary et al., 2019; Zoellner et al., 2018). Only one study (Maynard et al., 2017) used a mixed sample of Muslims and non-Muslims, including children aged 8 to 13 and their parents. The most commonly discussed issues were women's health, with nine studies focussed on women and specific programmes related to women’s general health and physical activities, breast cancer screening, and depression (Abdulwasi et al., 2018; Banerjee et al., 2017; Marinescu et al., 2013; Padela, Malik, Ally Syeda, et al., 2018; Padela, Malik, Vu, et al., 2018; Padela et al., 2019; Tse, 2002; Vu et al., 2018). Related to individual lifestyle behaviours, the second most common health issue was diabetes as reported in five studies (Darko et al., 2020; Grace et al., 2008; Islam et al., 2012, 2018; Padela, Malik, Vu, et al., 2018), followed by breast cancer screening and awareness (Padela, Malik, Ally Syeda, et al., 2018; Padela, Malik, Vu, et al., 2018; Padela et al., 2019). One study focused on lifestyle and obesity related illness in children (Maynard et al., 2017). Health promotion content specific to smoking and oral cancer was the focus of two studies (King et al., 2017; Siddique & Mitchell, 2013). Apart from women-specific depression and suicide prevention program, other mental health-related issues, such as addiction and PTSD were also deliberated (Chaudhary et al., 2019; Hassan et al., 2021; Zoellner et al., 2018). While most of these studies used samples of lay people and Imams as the target of interventions, three study samples also included health professionals or community workers (Darko et al., 2020; Grace et al., 2008; Tse, 2002).

Intervention Methods

Resonance between Islamic teachings, and health and social care messages were frequently cited in most of the studies reviewed. Four studies held central the inherent interconnection of religion and culture for Muslims (King et al., 2017; Vu et al., 2018). King et al. (2017) reported the need to situate programmes within an Islamic context, specifically consideration of Quran, Sunnah and Islamic jurisprudence when developing interventions with Muslims. Islam et al. (2012) identified Muslims as having a religious commitment to build healthy habits and look after themselves, hence integrated ethnoreligious values and norms in their psychoeducational design. Islamic components considered important to achieving effective outcomes included people and place, i.e. mosque-based interventions, Imam’s presence, use of the Quran, and Sunnah to implement their programmes in a cultural manner (Chaudhary et al., 2019; Padela et al., 2018; Vu et al., 2018). Opportunities to break for prayer or using religiously tailored messages were reported as key to contribute to the success of interventions (Marinescu et al., 2013; Padela et al., 2019).

Ethnoreligious adaptation of interventions originally designed for non-Muslim populations was an important consideration in the delivery of interventions, such as those delivered at community centres and mosques for a Bangladeshi community in a London borough (Grace et al., 2008). Content in the interventions was generally co-created and delivered by individuals perceived to have cultural alliance or competence. In doing so, two major concerns were addressed: (1) that programmes were reviewed, delivered by Imams, and delivered in Mosques; (2) information and capacity-building activities were complemented with the Quran and Sunnah informed messages (Grace et al., 2008; Hassan et al., 2021; Padela et al., 2019; Zoellner et al., 2018). The use of the Quran and prophetic stories, was repeatedly confirmed in studies like Hassan et al. (2021) and Zoellner et al. (2018). The content, sermon scripts, and health messages were reviewed by the Imams to ensure theological accuracy and validity of the content (Chaudhary et al., 2019). Intervention content for delivery in the broader community was often co-created with Muslim participants in focus group discussions, which aimed to ensure ethnoreligious acceptability (Abdulwasi et al., 2018; King et al., 2017; Padela et al., 2018). Muslim professionals, e.g. general dental practitioners, general medical practitioners, psychiatrists, and health workers, were employed to deliver interventions in schools and community centres (Banerjee et al., 2017; Darko et al., 2020; Islam et al., 2018; Siddique & Mitchell, 2013), whereas delivery of health and social care messages in mosques was done by Imams (King et al., 2017; Padela et al., 2019; Padela, Malik, Vu, et al., 2018). While Imam-led sermons or classes were found effective in promoting women’s health, Vu et al. (2018) argued that Imams should be trained with health-related knowledge and healthcare workers should have religio-cultural competency to ensure intervention effectiveness.

Studies also focused on session structure, duration, and flexibility for Muslims, with some variation across them. Information sermons lasted for 30–45 min (Padela et al., 2018) and short programmes ranged from two to six sessions of two to four hours duration (Padela, Malik, Vu, et al., 2018; Zoellner et al., 2018). The longer programmes involved between five to 15 weekly interventions (Chaudhary et al., 2019; Hassan et al., 2021; Tse, 2002). Flexibility for participation was considered in two interventions, evident in the conscious consideration of pray times and gender-specific approaches (Marinescu et al., 2013; Zoellner et al., 2018).

Programme Outcomes

Three themes emerged including acceptance of the interventions, improved health and social care literacy, and changes in beliefs and behaviours for achieving health and wellbeing. Ten articles had specific focus on Muslim women’s participation, and associations between socio-cultural variables and intervention acceptance (Abdulwasi et al., 2018; Banerjee et al., 2017; Marinescu et al., 2013; Padela et al., 2018; Padela et al., 2019; Padela, Malik, Vu, et al., 2018; Tse, 2002; Vu et al., 2018). In considering religion as a key socio-cultural variable, acceptance was evidenced in two ways: completion rates and feeling culturally safe.

The study by Maynard et al. (2017) on healthy lifestyles required 24-h diet recalls and self-efficacy questionnaires and generated completion rates ranging from 89 to 100%. Padela et al. (2018) established that health and social care-based sermons were desired by 67% of participants and that the actual sermons were perceived as religiously acceptable by 72%. Banerjee et al. (2017) reported the average number of exercise classes attended by the participants was 20 out of 28, while the average number of women attending each session was 13/28. In terms of feeling culturally safe, one programme on Islamic trauma healing administered a client satisfaction survey (Zoellner et al., 2018). All respondents indicated “excellent” in response to integration of religious beliefs and cultural practices into interventions (poor = 1/excellent = 4; M = 4.00, SD = 0.00). Findings from mixed-methods and qualitative studies confirmed the acceptance of religious tailoring of health promotion messages in Islamic sermons (Abdulwasi et al., 2018; King et al., 2017; Marinescu et al., 2013). It is important to note that there were no significant differences in acceptability when comparing sermon or sermon-giver, by gender or race/ethnicity.

Both Muslim women and men reported increased awareness of health and social protective mechanisms when religious and socio-cultural elements were embedded in the interventions (Islam et al., 2012; Siddique & Mitchell, 2013). Siddique and Mitchell (2013), for example, showed that religious tailoring of health promotion improved health literacy postvention; evidenced by improved identification of oral cancer risk factors compared with baseline (difference 0.40, 95% CI 0.23 to 0.57, p =  < 0.001). Substantial improvements in participants’ health and social wellbeing were shown in quantitative and qualitative studies when religious references from the Quran and Sunnah were included and delivered by Imams, both in self-reported knowledge (Chaudhary et al., 2019; Hassan et al., 2021) and in observed application of new knowledge in self-care (Padela, Malik, Vu, et al., 2018; Tse, 2002; Vu et al., 2018). In terms of health and social care, religious tailored interventions also reduced detrimental health beliefs and adverse behaviours. For example, one study noted a significant decrease in agreement with the belief, ‘Breast Cancer Screening is not important because Allah decides who will get cancer’ (− 0.40, p = 0.03) (Padela et al., 2019). The use of religious messages to counter such health beliefs, such as this, was perceived across the studies as critical to change.

Religious beliefs shaped many of the Muslim participants’ beliefs and behaviours, with most studies confirming that religious tailoring improved the impact of interventions. Increased and sustained willingness to engage with health and social care following interventions, compared to baseline, were reported in two studies (Hassan et al., 2021; Padela, Malik, Ally Syeda, et al., 2018). Other studies noted changes associated with religious tailoring that included increases in readiness, self-efficacy, and refraining from engaging in adverse behaviours in the presence of children (Banerjee et al., 2017; King et al., 2017). Integrating scriptural references one study resulted in an improvement in health behaviour (Padela et al., 2018). The integration of ethnoreligious elements, including Quranic references, gender-specific programmes, delivered in familiar languages, reportedly improved engagement among Muslims and better health and social care outcomes overall.

Discussion

Ethnicity and religion, as part of the broader socio-cultural system, impacts health behaviours and experiences of wellbeing (Kawachi, 2020). International researchers and world health institutions recognize how Islamic faith interacts with health beliefs, health and social care outcomes (Alomair et al., 2021; Shahin et al., 2021; Stroope et al., 2019). For example, the Amman Declaration affirms 60 Islamic teachings about healthy and harmful behaviours, which are important for physical, mental and social wellbeing (WHO, 1996). Muslims hold the messages of Islamic Classical texts, including from the Quran, as way of life. Such texts explain that the source of human peace and comfort comes from following Islamic guidelines (Attum et al., 2021).

A holistic biopsychosocial approach to health must incorporate religion for Muslims, where religion is integral to their overall wellbeing. Adaptations of services are an important implementation strategy (Miller et al., 2020). Religious considerations when designing programmes and interventions ensures a holistic biosocial approach in the care of Muslim-minority populations (Attum et al., 2021; Irajpur & Moghimiyan, 2018). When designed in accordance with Islamic teachings, the studies we reviewed indicated considerable potential to improve intervention outcomes. However, this required a wide range of skills and expertise, from health and non-health professionals to local religious authorities.

Most of the studies we reviewed focused on Muslim-minority populations in the USA, UK, and Canada, where there have been rapid changes in migration, population patterns, culture, and religion. In applying the QHOM to understand socio-cultural influences, we noted the importance of religious integration in health and social care policy, programmes, and messages when engaging with these populations. Two studies (Vu et al., 2018; Zoellner et al., 2018) provided strong evidence in the importance of interdisciplinary and interorganizational collaborations when co-designing programme materials. Imams were perceived as trusted messengers among the Muslim communities and their engagement in co-design was found necessary to leverage community engagement and change.

In the studies reviewed, researchers and practitioners allied with Imams to elaborate capacity to extend health and social care messages for Muslim-minorities experiencing health and social disparities. Consistent with broader understandings, Imams are regarded as key advisors who endorse Muslims’ health and social behaviour changes in accordance with Islamic principles (Cohen-Dar & Obeid, 2017; Usman & Iskandar, 2021). While Imams were identified as important research collaborators, there were some difficulties identified in this review due to different knowledge expertise brought by each of the religious leaders and researchers. In addition to religious tailoring and co-design, bilingual professionals or community workers were crucial for culturally appropriate communications and monitoring of intervention outcomes.

It is generally agreed that religious-based health and social care programmes in the community, with minority groups, are more likely to contribute to better health and social wellbeing outcomes (Alomair et al., 2021; Shahin et al., 2021; Stroope et al., 2019). This is because religion influences values, knowledge, behaviours and understanding of health and wellbeing. When many Muslims judge Quranic messages as important for coping, and that following religious guidelines will result in peace and comfort (Attum et al., 2021), then the positive impact of religion on health and wellbeing seems logical. While some studies reported little or no association between religiosity, health status and adjustment to illness (Fitchett et al., 1999; Irajpur & Moghimiyan, 2018; Page et al., 2020), overall our review indicated positive outcomes from religious tailoring due to identified associations between cultural relevance and the greater likelihood of sustained health behaviour change.

The studies in our sample more likely reported effective outcomes when religiously tailored interventions focused on health behaviours related to tobacco use, physical activity, alcohol and drug use, or lifestyle diseases such as cardiovascular disease and diabetes. Even though interpretations of religion, ethnicity and culture were diverse, the commitment to Allah in all aspects of life were drawn upon to deliver health and social care concepts collectively to Muslim people in dissemination of health messages. The heightened need for connectedness to the Quran and Sunnah, the need for spiritual peace, and the need for comfort among Muslim-minorities, is likely to make religiously tailored health messages more effective. This is consistent with findings of a comprehensive review by Abuelezam et al. (2018) of 247 studies on Arab Americans’ health behaviours and health outcomes, through religiously tailored messages that significantly altered the people’s preventative health-related behaviours.

Our review found that women’s health received scrupulous interest from the researchers. This was with consideration of Islam’s emphasis on health as a holistic state of physical, psychological, spiritual, and social wellbeing (Attum et al., 2021; Irajpur & Moghimiyan, 2018). Depending on the level of their religiosity, women are influenced by the Quran, Hadith, and Sunnah on healthy living in two ways: first, via direct statements advising what women should do; second, via examples of women as role models to follow (Darzi et al., 2021). The foundations of lifelong health, based on religious messages, therefore rest on holistic emphasis of health promotion and health prevention.

Based on the Islamic perspective, the foundations of holistic wellbeing for a Muslim are believed to form across four important stages, namely at conception, in the womb, at birth, and during infancy and childhood (Alimohammadi et al., 2020). As a result, religious teachings advise that Muslim women must maintain excellent physical, psychological, spiritual, and social health, especially during pregnancy, so that healthy offspring are born. While obeying religious guidelines may not be seen as an absolute requirement for good health, these principles provide a basis and guidance for being a healthy Muslim. In consideration, Jabbari et al. (2020), showed that listening to Quran recitation with or without translation during pregnancy significantly reduced perceived stress, anxiety, and depression levels in Iranian pregnant women. Participating in an act of worship, gave the women a feeling of being closer to piety and thus gave peace of mind and provided a source of strength and spirituality. In another study by Komariah et al. (2020), focused on Muslim women undergoing chemotherapy, they showed that Islamic-based care improved spiritual wellbeing, reduced anxiety and improved coping. This evidence brings to light the relevance of the Islamic principles that have significant impacts on women’s health beliefs, behaviours, and overall wellbeing.

Many of the studies included reported high intervention uptake rates among Muslims, arguably due to having appropriate religio-cultural tailoring in their designs. Acceptance was measured by programme completions as opposed to application of any acceptance measurement scale or measurement of behaviour change. According to Ajzen (1985) in his Theory of Planned Behaviour, Muslims’ behaviours can be understood via the principle of compatibility. This helps to explain how attitudes of Muslim women towards mammograms, for instance, and their actions in having mammograms need to occur without conflict. Therefore, if interventions are contextualized in accordance to religious and cultural values; acceptance, actions, and behaviour change (although not the only determining variables) are more likely.

Change outcomes depend on a range of factors that may not necessarily be under the control of individuals, such as availability of resources and opportunities to display the behaviours (Ajzen, 2005). Ajzen (2005) explained Muslim’s tendency to apply religious evaluation in weighing up positives and negatives influence attitudes towards a given behaviour. As well, there are normative beliefs formed around Muslims’ support systems, which will influence subjective norms and individual decision making. Past experiences, such as whether Muslims have ever engaged in a particular behaviour, will influence perceived control over circumstances and influence change outcomes accordingly. These were observed in one of the studies in our review, in which Padela, Malik, Vu, et al. (2018) explored how Muslim women’s behavioural beliefs, perceptions of pain and fear, normative beliefs on cultural taboos and a ‘women only’ issues, and control beliefs (i.e. Allah’s Will) may prevent women from undergoing mammograms. These distinctive beliefs provide insight into the underlying complex thought processes of human behaviour, including the role of Islamic beliefs that add to the multifaceted complexity of cognitive processes in the construction of Muslim behaviours.

Health and social care interventions can no longer be identified in terms of individual capacity to search, comprehend, and act on new information, but also the emphasizes the capacity of health information providers. The ‘Health People 2030’ defines organizational literacy as the capacity of organizations follow policies that equitably enable individuals to access information pertinent to improving, including health and social care professionals, health and wellbeing (Brach & Harris, 2021). Interventions to improve Muslim’s overall health and social wellbeing are unlikely to be effective when organizations or care providers do not deliver interventions in accordance with Islamic beliefs. For Muslims, health is a holistic state of physical, psychological, spiritual, and social wellbeing and is believed to be the greatest blessing Allah has given to humans. Islam attaches significant importance to health, so taking care of one’s health is a religious duty. Intervention programmes designed in conjunction with Islamic values, therefore, can effectively improve Muslims’ overall health.

Higher levels of health and social care literacy have associations with better compliance with interventions and sustained outcomes (Netemeyer et al., 2020). For example, the study by Elkalmi et al. (2021) recently provided insight into how health promotion information incorporating ‘Halal’ and ‘Haram’ impacted Muslims’ attitudes towards vaccination programmes. Vazifeh doust et al. (2020) demonstrated how Islamic-based treatments in hospital settings were effective in helping children with cancer to adapt to treatment. Ahaddour et al. (2020) showed how Islamic beliefs integrated into aged care facilities in Belgium provided older Muslim residents with a sense of dignity. These examples provide a seamless illustration depicting the harmony of personal and organizational health literacy, through respecting that Islamic beliefs are essential to a Muslim’s way of life, in childhood, throughout life and in death.

Limitations

Our initial interest in undertaking this review was to generate evidence to inform the development of health and social care interventions in Australia, as part of a Muslim and non-Muslim health promotion and social care partnership. While our Muslim partners advised of the importance of Mosque-based and Muslim community interventions to the people in their communities, a limitation of this review study is the small quantity of research that could be located via rigorous searching for relevant articles.

We extended our review from our initial focus on Australian Mosque-based interventions to Mosque- and Muslim-community-based interventions in Australia and other Anglophone countries, such as Canada, UK, and the USA. There were still relatively few studies located. We suggest that the limitation of this study is not necessarily due to any methodological insufficiency. Instead, we have learned through our Muslim and non-Muslim partnership, that Mosques may be perceived in Anglophone countries as places of worship as opposed to also being community services requiring funding to develop Mosque-based services in support of these communities-funding which is not often available. Concomitantly there is limited research about Mosque-based interventions when the interventions themselves are few. This is opposed to the unquestioned funding in Australia and other Anglophone counties in favour of Church-based and Christian community health and welfare interventions.

As a result, this study has both strengths and limitations. A particular strength of our integrative review was to summarize a combination of research utilizing diverse methodologies, systematically and rigorously. We have provided a comprehensive understanding of Muslim-minority health and social care interventions delivered in Mosque and Muslim community settings in non-Muslim countries, and the intervention outcomes in an emerging and also important field of practice in a rapidly evolving multicultural and religiously fluid world.

Conclusion

Evaluating religiosity as it relates to health and socio-cultural care provides insight into the meaningfulness of experiences associated with Islamic principles and resources, such as Quran and Sunnah (i.e. Prophetic stories). Religious and cultural care in the studies reviewed included focus on spirituality, faith, geographical locations, kinship, and ethnicity. While all aspects are important, intervening in ways that matter to Muslims was reported as likely to influence change in health beliefs, social care service engagement and health and wellbeing behaviours. Hence, health in Islamic terms must extend to physical, psychological, spiritual, and social aspects of health, social care, and wellbeing, to optimize intervention outcomes.

Capturing how religious involvement relates to interventions and health behaviour change in Islamic societies is a complex matter. Across the studies from Australia, Canada, UK, and USA, interventions were formulated with appreciation of religious and cultural principles. Each showed some level of effectiveness associated with religious tailoring and adaptations to programmes, but conclusions were generally not strong. Studies did not measure or consider participants' levels of religiosity, which is an important confounding variable in which to understand intervention effect. Consequently, it is still now known whether religiously tailored interventions with Muslims caused behaviour changes, in the programmes studied, any differently to non-religiously tailored interventions with Muslims. While certain favourable outcomes could be identified, our interpretations were limited by the strength and quality of evidence reported. In consideration that health and social care is a basic human right, further research to inform policy and practice advocacy is critically important when non-Muslim societies that have become increasingly diverse in religion and culture. This is needed to understand how religious tailoring, for whom and in what ways, offers the greatest benefit to health and social care.