title: Using the intervention mapping protocol to develop a maintenance programme for the SLIMMER diabetes prevention intervention.
abstract: BACKGROUND
  Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands.
  
  
  METHODS
  The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention.
  
  
  RESULTS
  The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme.
  
  
  CONCLUSIONS
  The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.
authors.affiliation: Division of Human Nutrition; Academic Collaborative Centre AGORA, Wageningen University, P,O, Box 8129, 6700, VE, Wageningen, The Netherlands. ellen.elsman@gmail.com.
authors.forename: Ellen B M
authors.initials: EB
authors.lastname: Elsman
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Leerlooijer
authors.forename: Josien
authors.initials: J
authors.lastname: Ter Beek
authors.forename: Geerke
authors.initials: G
authors.lastname: Duijzer
authors.forename: Sophia C
authors.initials: SC
authors.lastname: Jansen
authors.forename: Gerrit J
authors.initials: GJ
authors.lastname: Hiddink
authors.forename: Edith J M
authors.initials: EJ
authors.lastname: Feskens
authors.forename: Annemien
authors.initials: A
authors.lastname: Haveman-Nies
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D017144:Focus Groups; D006801:Humans; D008019:Life Style; D009426:Netherlands; D016730:Program Development; D040242:Risk Reduction Behavior