Adapting a culturally grounded diabetes prevention program for Latino families in the Phoenix, Arizona metropolitan area – A mixed methods approach

Objective: Latino families experience a disproportionate burden of type 2 diabetes, yet diabetes prevention programs (DPPs) are rarely adapted for family-based delivery, despite the role of familismo in supporting behavior change. This study describes the adaptation of a DPP for Latino families in Phoenix, Arizona. Methods: Guided by community-based participatory research (CBPR), an academic-community partnership adapted a youth DPP into the Family Diabetes Prevention Program, positioning the family as the unit of change. Adaptations were identified across refinement phases using qualitative and programmatic data sources (e.g., curriculum) collected between 2020 and 2023. Content analysis applied the Framework for Reporting Adaptations and Modifications-Enhanced, expanded to capture adaptation leadership, timing, and rationale. Results: Sixty-six adaptations were identified, primarily during grant preparation and post-pilot refinement. Most were co-led by academic and community partners (62.1%). Content adaptations predominated (76.4%), with additional modifications to evaluation, context, and training. Adaptations were driven by organizational constraints and stakeholder feedback and included integrating family processes, adding home visits, and revising session structure. Conclusions: This study systematically documents the adaptation of a DPP for Latino families using a CBPR approach. Findings offer a culturally grounded yet transferable model for diabetes prevention across diverse populations and settings.