Open Access Open Badges Research article

Adapting the SLIM diabetes prevention intervention to a Dutch real-life setting: joint decision making by science and practice

Sophia C Jansen1*, Annemien Haveman-Nies12, Geerke Duijzer2, Josien Ter Beek1, Gerrit J Hiddink3 and Edith JM Feskens2

Author Affiliations

1 Community Health Service GGD Gelre-IJssel; Academic Collaborative Centre AGORA, GGD Gelre-IJssel, PO Box 51, 7300, AB, Apeldoorn, The Netherlands

2 Division of Human Nutrition, Wageningen University; Academic Collaborative Centre AGORA, AGORA, The Netherlands

3 Department of Social Sciences, Sub Department of Communication Sciences, Communication Strategies, Wageningen University, Wageningen, The Netherlands

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BMC Public Health 2013, 13:457  doi:10.1186/1471-2458-13-457

Published: 8 May 2013



Although many evidence-based diabetes prevention interventions exist, they are not easily applicable in real-life settings. Moreover, there is a lack of examples which describe the adaptation process of these interventions to practice. In this paper we present an example of such an adaptation. We adapted the SLIM (Study on Lifestyle intervention and Impaired glucose tolerance Maastricht) diabetes prevention intervention to a Dutch real-life setting, in a joint decision making process of intervention developers and local health care professionals.


We used 3 adaptation steps in accordance with current adaptation frameworks. In the first step, the elements of the SLIM intervention were identified. In the second step, these elements were judged for their applicability in a real-life setting. In the third step, adaptations were proposed and discussed for those elements which were deemed not applicable. Participants invited for this process included intervention developers and local health care professionals (n=19).


In the first adaptation step, a total of 22 intervention elements were identified. In the second step, 12 of these 22 intervention elements were judged as inapplicable. In the third step, a consensus was achieved for the adaptations of all 12 elements. The adapted elements were in the following categories: target population, techniques, intensity, delivery mode, materials, organisational structure, and political and financial conditions. The adaptations either lay in changing the SLIM protocol (6 elements) or the real-life working procedures (1 element), or a combination of both (4 elements).


The positive result of this study is that a consensus was achieved within a relatively short time period (nine months) between the developers of the SLIM intervention and local health care professionals on the adaptations needed to make SLIM applicable in a Dutch real-life setting. Our example shows that it is possible to combine the perspectives of scientists and practitioners, and to find a balance between evidence-base and applicability concerns.

Diabetes; Prevention; Decision making; Evidence-based; Real-life setting; Practice; Adaptation