Prostate cancer is the most common non-cutaneous malignancy for men and disproportionately affects those with low socioeconomic status, particularly men from racial and ethnic minority populations. This study describes the development of a culturally tailored Mediterranean diet intervention for medically underserved Black and Hispanic men with prostate cancer, using the Intervention Mapping Adaptation (IM ADAPT) framework. Conducted at a county safety-net hospital in Houston, Texas, which serves a population with high medical needs and low socioeconomic status, the project aimed to ensure the intervention was culturally relevant and evidence-based. A collaborative process was used, involving community scientists and patient stakeholders to identify dietary barriers and preferences, while existing interventions were reviewed for cultural fit. Guided by the six steps of the IM ADAPT framework, stakeholder feedback was incorporated throughout the adaptation process. The result was a culturally adapted intervention that included tailored dietary modifications, food provision strategies, and educational materials specifically designed for Black and Hispanic men. The finalized intervention is ready for pilot testing and may serve as a model for adapting evidence-based interventions to address health disparities in other racial and ethnic minority populations affected by cancer.

JRG: Consultant/Advisory board: Bayer and J&J AWH: Consultant/Advisory board: Janssen, Intellisphere, AVEO, Exelixis, Eisai, Pfizer, and Tolmar. Honoraria: Medscape, Binaytara Foundation, Projects in Knowledge, Curio Science, Dava Oncology, and Mashup Media. Institutional research funding from Bayer, Eisai, and Halda Therapeutics DEF: Familial relationship: March Biosciences, Biocity Biopharmaceuticals, and Barricade Therapeutics

This study did not receive any funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

IRB of University of Texas MD Anderson Cancer Center gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Conflicts of Interest: JRG – Consultant/Advisory board: Bayer and J&J, AWH – Consultant/Advisory board: Janssen, Intellisphere, AVEO, Exelixis, Eisai, Pfizer, and Tolmar. Honoraria: Medscape, Binaytara Foundation, Projects in Knowledge, Curio Science, Dava Oncology, and Mashup Media. Institutional research funding from Bayer, Eisai, and Halda Therapeutics, DEF – Familial relationship: March Biosciences, Biocity Biopharmaceuticals, and Barricade Therapeutics

All data produced in the present work are contained in the manuscript.