Project Summary/Abstract Family Diabetes Risk Reduction (Family D-Risk) An effective intervention focused on parents and children, designed in collaboration with the community, may decrease morbidity and mortality associated with Type 2 Diabetes (T2D) among African Americans (AA). The goal of this project is to utilize a community-engaged research (CER) approach to reduce T2D risk among AA families through the cultural tailoring of the Diabetes Prevention Program (DPP). Our long-term goal is to adapt and implement a sustainable, multilevel, evidence-based program for families at higher risk for T2D. We hypothesize that implementing a culturally appropriate, family-oriented adaptation of the DPP, Family D-Risk, will result in improvements in health indicators associated with increased risk for T2D among AA parents and their children. We seek to achieve the following aims: AIM 1: Utilize a CER approach to culturally tailor a DPP-based intervention for AA adults at high T2D risk and their children living in low resource rural areas in Albany, GA. We will conduct focus groups and in-depth interviews with community stakeholders and families to tailor the Family D-Risk intervention to prioritize both adults and children and better fit the needs of the AA community in Albany, GA. AIM 2: Evaluate the efficacy of the CER-adapted Family D-Risk intervention to improve weight, an important T2D risk factor, in AA parents with prediabetes (primary outcome) and cardiometabolic risk factors in parents and children (secondary outcome) who participate in the family intervention arm. We propose to implement a two-arm, randomized controlled trial with 140 families to compare: 1) family intervention (family arm) and 2) wait-list control (control arm). AIM 3: Assess sustainability of the Family D-Risk intervention through evaluation of the local determinants of mid- and long-term engagement, acceptability, uptake, fidelity, and compliance through measurement of components critical to program sustainability (i.e., community engagement, acceptability, and community input on how to sustain the program). If successful, the proposed study will provide evidence for the utility of using a CER approach to implement a culturally tailored, family-oriented adaptation of the DPP that will have positive effects on risk factors associated with T2D morbidity and mortality among AA families in low resource rural communities.