Table 3 SLIM elements identified (step 1), including applicability (step 2) and subsequent adaptations (step 3)

Target population

1

Selection from study cohort

N

GP is the location of finding high-risk groups for diabetes

selection by GP

GP actively search their database for patients with IFG and refer them to intervention

2

Selection with OGTT

N

OGTT not used

selection with FBGM

3

Only Caucasian subjects

N

ethnicity of patients not known

only Dutch speaking subjects

Techniques and instruments

4

Appropriate risk communication to participants

Y

5

Dietary advice: motivational interviewing

Y

6

Dietary advice: goal setting

Y

7

Dietary advice: invite partner

Y

8

Dietary advice: fixed theme per visit

N

themes are tailored to patient

order of themes may be changed

all themes should be addressed

9

Dietary intake with 3-day food record

N

- great variability in intake procedures

- no standard dietary intake

- no / simple nutritional diaries

- nutritional diaries not obliged

10

Exercise training tailored to middle-aged people with overweight

Y

11

Exercise intake with maximal test

N

- great variability in intake procedures

exercise intake with submaximal test (steep ramp)

standard use of steep ramp test during intake

- maximal tests require medical supervision

Delivery mode

12

Dietary advice: individual, group meeting once a year

Y

13

Exercise training in groups of 4-6

Y

14

Exercise training in special SLIM groups

N

creating separate groups is costly

organise special SLIMMER groups

Intensity

15

Dietary advice

N

Frequency and duration are

- decreasing time intervals between visits

no tailoring of frequency and duration to patient

- every 3 months

tailored to patient

- duration 60 minutes

- intervals ≤ 2 months

- duration 30 minutes

- group meeting 90 minutes

- duration 15-30 minutes

16

Exercise trainings

Y

- 1-2 times a week

- duration 60 minutes

Step 1

Step 2

Step 3

SLIM elements identified

Applicability as judged by health promotion expert / local steering comittee

Adaptations proposed by SLIM developers and accepted by local health care professionals

Applicable Yes / No

Argument

Adaptation of SLIM protocol

Adaptation of real-life working procedures

Materials

17

Patient brochures

N

black-and-white, text-only documents

up-to-date patient brochures from national institutes

18

Manuals

N

- incomplete manuals

- manual developed for exercise training

- scientific language

- no distinction between intervention and research

- manuals in readable language, tailored to local professionals

Organisational structure

19

Intervention deliverers are employed by the university; local organisations are not involved

N

Intervention delivery is complex cooperative process between local organisations

- roles and responsibilities described

- information meeting added to facilitate collaboration

Political and financial conditions

20

Intervention embedded in national policy

Y

21

Intervention embedded in local policy

Y

22

Research subsidies

N

- structural finances needed

(not fulfilled)

(not fulfilled)

- no natural financer