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Worldwide, type 2 diabetes (T2DM) prevalence has more than doubled over two decades. In Australia, diabetes is the second highest contributor to the burden of disease. Lifestyle modification programs comprising diet changes, weight loss and moderate physical activity, have been proven to reduce the incidence of T2DM in high risk individuals. As part of the Council of Australia Governments, the State of Victoria committed to develop and support the diabetes prevention program 'Life! Taking action on diabetes' (Life!) which has direct lineage from effective clinical and implementation trials from Finland and Australia. The Melbourne Diabetes Prevention Study (MDPS) has been set up to evaluate the effectiveness and cost-effectiveness of a specific version of the Life! program. ; This study was funded by the National Health and Medical Research Council, grant number: 533819. We would like to acknowledge the Department of Health Victoria, which funded Life!, and Prof Greg Johnson and Dr Amy Timoshanko from Diabetes Australia Victoria

The successful Greater Green Triangle Diabetes Prevention Program (GGT DPP), a small implementation trial, has been scaled-up to the Victorian state-wide 'Life!' programme with over 10,000 individuals enrolled. The Melbourne Diabetes Prevention Study (MDPS) is an evaluation of the translation from the GGT DPP to the Life! programme. We report results from the preliminary phase (pMDPS) of this evaluation. ; This study was funded by the National Health and Medical Research Council (grant number 533819). The Life! programme is funded by the Victorian Government Department of Health. The authors would like to acknowledge Dr Ralph Audehm, Prof Greg Johnson and Dr Amy Timoshanko from Diabetes Australia Victoria, Thomas Coenen (MPH student) from Maastricht University

The Melbourne Diabetes Prevention Study sits within an evolving larger scale implementation project, the Life! program. Changes that occurred during the roll-out of that program had a direct impact on the process of conducting this trial. The issues and methods of recovery the study team encountered were conceptualised using an implementation salvage strategies framework. The specific issues the study team came across included continuity of the state funding for Life! program and structural changes to the Life! program which consisted of adjustments to eligibility criteria, referral processes, structure and content, as well as alternative program delivery for different population groups. Staff turnover, recruitment problems, setting and venue concerns, availability of potential participants and participant characteristics were also identified as evaluation roadblocks. Each issue and corresponding salvage strategy is presented. ; This study was funded by the National Health and Medical Research Council, grant number: 533819. We would like to acknowledge the Victorian Government Department of Health Victoria who funded Life! program and Diabetes Australia Victoria for implementing Life!, as well as MDPS project team members: Hayley Hellinger, Bridie Murphy, Prof Prasuna Reddy, Dr Deb Rankins, study nurses and recruiters.