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A Context-Adapted Diabetes Prevention Program (Small Steps for Big Changes) in Australia: Protocol for a Hybrid

Genevieve N Healy1, Sjaan R Gomersall1,2, David W Dunstan3,4

  • 1Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.

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Summary

This study evaluates the Small Steps for Big Changes (SSBC) program, an adapted diet and exercise intervention, for type 2 diabetes prevention in Australia. Findings will determine its effectiveness and implementation feasibility in the Australian context.

Keywords:
communitycultural adaptationdiabetes preventiondietexerciseimplementationinterventionmotivational interviewing

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Area of Science:

  • Public Health
  • Preventive Medicine
  • Health Services Research

Background:

  • Type 2 diabetes rates are increasing globally and in Australia, necessitating effective prevention programs.
  • The Small Steps for Big Changes (SSBC) program is a Canadian-developed, community-delivered intervention for diabetes prevention.
  • The suitability of SSBC in Australia is unknown, prompting the SSBC Australia trial.

Purpose of the Study:

  • To describe the protocol for a hybrid trial evaluating the effectiveness and implementation of SSBC Australia.
  • To assess the feasibility and acceptability of adapting and delivering SSBC in a South-East Queensland, Australia context.

Main Methods:

  • A 4-year, cluster nonrandomized, single-arm hybrid effectiveness-implementation trial in 5 community sites.
  • Recruitment of 500 participants and training of approximately 50 coaches.
  • Data collection via surveys, objective assessments, interviews, and site audits, guided by implementation frameworks (PRISM, RE-AIM) and criteria (ARECCI).

Main Results:

  • Ethics approval and trial registration are complete.
  • All 5 trial sites have been recruited and undergone pre-implementation evaluation.
  • SSBC Australia coach training is in progress, with client recruitment commencing in September 2025.

Conclusions:

  • The study will provide evidence on the effectiveness and implementation of the adapted SSBC program in Australia.
  • Findings will inform potential expansion of the diabetes prevention program to other community and health service settings.