OBJECTIVES: The purpose of this study was to determine the feasibility of implementing a diabetes prevention program (DPP) in a rural African-American church. METHODS: A six-session DPP, modeled after the successful National Institutes of Health (NIH) DPP, was implemented in a rural African-American church. Adult members of the church identified as high risk for diabetes, based on results of a risk questionnaire, were screened with a fasting glucose. Persons with prediabetes, a fasting glucose of 100-125 mg/dL, participated in the six-session, Lifestyle Balance Church DPP. The primary outcomes were attendance rates and changes in fasting glucose, weight and body mass index measured at baseline, six- and 12-month follow-up. RESULTS: Ninety-nine adult church members were screened for diabetes risk. Eleven had impaired fasting glucose. Ten of 11 participated in the six-session intervention, for an attendance rate of 78%. After the intervention and 12-month follow-up, there was a mean weight loss of 7.9 lbs and 10.6 lbs, respectively. CONCLUSIONS: This pilot project suggests that a modified six-session DPP can be translated to a group format and successfully implemented in a church setting. Further randomized studies are needed to determine the effectiveness of such an intervention.