East Harlem is a neighborhood in the northeast section of Manhattan that is quite unlike the rest of the island. One striking difference: the rate of diabetes in that neighborhood is 4 to 5 times that of the rest of Manhattan! Many factors contribute – diet, ethnic background and income levels are among them. Several months ago Yvonne Lin and I worked with an organization called CHW (City Health Works) looking for ways to understand the problem – and to find some solutions. The answer was clearly not to adopt the National Diabetes Prevention program established by the CDC (Center for Disease Control). We opted for a more “locally-attractive” attractive program – invite people into the program, lower the commitment and barriers to entry (for example, start by signing up for four weeks, not sixteen), and make the sessions flexible for instructors so that they can concentrate on their interests and strengths as educators.