Background: Type 2 diabetes (T2D) is increasing in young people. Reporting on the processes used when developing prevention interventions is needed. We present the development of a family-based interactive lifestyle intervention for adolescents with risk factors for T2D in the future. Method: A multidisciplinary team in the UK site led the intervention development process with sites in Portugal, Greece, Germany and Spain. Potential programme topics and underpinning theory were gathered from literature and stakeholders. A theoretical framework based on self-efficacy theory and the COM-B (capability, opportunity, motivation, behaviour) model was developed. Sessions and supporting resources were developed and refined via two iterative cycles of session and resource piloting, feedback, reflection and refinement. Decision on delivery and content were made by stakeholders (young people, teachers, parents, paediatricians) and all sites. Materials were translated to local languages. Site-specific adaptations to the language, content and supporting resources were made. Results: The “PRE-STARt” programme is eight 90-min interactive sessions with supporting curriculum and resources. Iterative development work provided valuable feedback on programme content and delivery. Conclusion: Reporting on the intervention development process, which includes stakeholder input, could yield a flexible approach for use in this emerging ‘at risk’ groups and their families.

Healthcare has shifted from paternalistic model of care to patient-centered care where shared decision making is key. The need to share and manage contributions and expertise of different healthcare professionals underlines the relevance of collaborative knowledge management (CKM). However, CKM in healthcare requires one to understand the complexities in integrating multiple aspects of care and the challenges associated with interdisciplinary collaboration and knowledge sharing among healthcare providers. In this study, we use a system modeling approach to understand the complexities in collaborative management of knowledge on advance care planning for multi-morbid patients, within personalized integrated care. To achieve this, focus group discussions (FGD) with 11 participants from Basque Public Health System (Osakidetza) in Spain were involved in identifying the key challenges and developing a systemic thinking model. As a result, three key challenges were identified, i.e., (1) culture, where citizens are not willing to talk about death; (2) healthcare professionals, whose attitude and perspectives need to change; and (3) the current system, that has to change its care model towards a holistic and a shared care model. From the developed causal loop diagrams (CLDs), it is noted that perpetuation of fragmented and paternalistic care is likely to get worse without recognition of the advance care plan (ACP) as a social need and as a crucial part of the clinical practice change.