Diabetes is a leading cause of death in both the United States and Mexico, and the third leading cause of death in the US-Mexico border region. Although the exact cause of the disease is unknown, and no cure is forthcoming in the near future, it is known that besides genetic predisposition, a number of environmental, economic, social, and cultural factors and barriers may also contribute to this high prevalence rate. To deal with these factors and barriers the United States Mexico Border Diabetes Prevention and Control Project (USMBDPCP) is proposing to implement and evaluate a family-based participatory intervention delivered by Community Health Workers/Promotores de Salud (CHWs/PS) to help increase the knowledge of appropriate and effective prevention, and control strategies to improve the management of diabetes care among border populations. The USMBDPCP will evaluate the intervention against the standard diabetes care provided in the community, and will also assess the cost effectiveness of its implementation. If considered successful, the proposed model will be marketed as a viable intervention model to be implemented in communities and health-care systems along the US-Mexico Border region. Almost 2,000 participants (660 patients and 1.320 family members) will be recruited in eleven selected communities along the US-Mexico border. At each site, half of the participants will be randomly enrolled in the proposed intervention and half in a standard diabetes intervention control group. The research questions to be answered deal with the effectiveness of the intervention, specifically an increase in the number of patients monitoring their blood level, the improvement in the hemoglobin A1C levels and lipid profiles of patients, how the inclusion of the family, or other factors helped improve disease outcomes, and if the intervention was cost-effective. The intervention implementation process and procedures will be documented and all materials will be made available to CDC for dissemination and replication in other border areas and among other Hispanic populations throughout both countries. ? ? ?