Adapting the Diabetes Prevention Program to the Spanish context using Intervention Mapping ADAPT: the PreveniDOS program

Spain has one of the highest prevalence rates of type 2 diabetes (T2D) in Europe. Primary Care Centers (PCCs) provide a strategic setting for implementing lifestyle interventions for T2D prevention. The Diabetes Prevention Program (DPP) has demonstrated that structured lifestyle change can significantly reduce T2D incidence. Its standardized curriculum, PreventT2 , was adapted for large-scale implementation within the U.S. National DPP and is delivered as a 12-month, group-based, coach-led intervention. However, cultural and contextual differences may limit its direct transferability to the Spanish healthcare system. Therefore, a systematic adaptation that preserves the intervention’s core components yet improves contextual fit is required. Using the first four steps of the Intervention Mapping-Adapt (IM-ADAPT) framework, we: 1) conducted a needs and assets assessment and developed a logic model of the problem and a logic model of change; 2) assessed basic fit to the context; 3) identified PreventT2 core components using Evidence-Based Intervention (EBI) Mapping and compared key component of the intervention with population and contextual needs; and 4) planned, pretested, and produced the adaptations, which were documented using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME). The process resulted in PreveniDOS , a 9-month group-based lifestyle intervention for adults with prediabetes adapted to Spanish primary care and delivered by trained healthcare professionals. The intervention preserves the core behavior change methods of PreventT2 (active learning, goal-setting, self-monitoring, feedback, and planning coping responses), while introducing structural, cultural and contextual adaptations, including family involvement, reduction of sedentary behavior and community-based asset-mapping. IM-ADAPT provided a rigorous method that balances fidelity with contextual fit. PreveniDOS will undergo pilot testing to assess its acceptability and feasibility before being evaluated in a full cluster randomized trial. ClinicalTrials.gov, NCT06871059. Registration date: 2025–03-11, https://clinicaltrials.gov/study/NCT06871059