The Multi-level Outcomes for Structural Action and Inclusive Community Health for Type-2 Diabetes (MOSAIC-T2D) Prevention Framework is a conceptual and practical framework that captures how individual, community, and societal factors, called determinants, work together to influence the risk of type 2 diabetes. The framework was developed through a co-design process involving researchers, community and patient partners, public health practitioners, and policymakers in Peel Region, Ontario, Canada. Its purpose is to guide type 2 diabetes research and prevention efforts that are grounded in community realities, needs, and priorities.
The MOSAIC-T2D framework is designed to support both research and program implementation by providing a structured approach to understanding and addressing diabetes risk across micro-, meso-, and macrolevel determinants. The framework enables users to identify measurable indicators, link determinants to relevant data sources, and design interventions informed by a comprehensive view of risk. By organizing determinants across levels, it supports researchers, community organizations, and policymakers in developing and evaluating interventions that address multiple drivers of diabetes risk. Recognizing that individuals and societies change over time, it also helps guide prevention efforts that remain responsive to evolving needs. Beyond informing research, the framework is intended to serve as a bridge between evidence generation, policy development, and community action, helping stakeholders align prevention efforts around a shared understanding of diabetes risk and its determinants.
The MOSAIC-T2D framework should be viewed as an evolving model for diabetes prevention. As it is applied, evaluated, and informed by ongoing engagement with communities, practitioners, and policymakers, it will continue to evolve. This reflects the recognition that diabetes risk and its determinants are dynamic and require prevention approaches that can learn and adapt over time.
Download the MOSAIC-T2D Prevention Framework here.