BRinging the Diabetes Prevention Program to GEriatric Populations (BRIDGE)

Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. Although the CDC’s National Diabetes Prevention Program (DPP) is an evidence-based strategy to prevent diabetes,1,2 it was not designed to be inclusive of the varied linguistic needs of older adults. This limitation is a barrier to participation among those with limited English proficiency (LEP),3 who are more likely to be foreign-born.4 While the DPP is available in Spanish, studies show that Spanish-speaking participants are significantly less likely to attend sessions than their English-speaking counterparts,5,6 suggesting the program is not sufficiently tailored for this population. A systematic review of Spanish-language diabetes prevention programs found that interventions are more effective when they adapted for literacy, incorporate culturally relevant foods and beliefs, and involve family members.6 However, these studies lacked a structured adaptation framework, limiting their reproducibility and scalability. Critically, older Spanish-speaking adults, have been largely overlooked in past adaptation efforts. In this 18-month administrative supplement, we will leverage the existing BRIDGE (BRinging the Diabetes Prevention Program to GEriatric Populations) trial to systematically adapt the DPP for older Spanish-speaking adults. In Aim 1, we will conduct surveys to identify key behavioral determinants and risk factors in this population, guiding the linguistic and contextual adaptation of BRIDGE materials using the CDC’s Map of Adaptation Process (MAP). In Aim 2, we will assess the acceptability of these adaptations through clinician interviews and focus groups with Spanish-speaking older adults and their families, to inform a future feasibility pilot of the adapted intervention.