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Type 2 diabetes is increasing in the U.S. and constitutes a major public health problem (1). Preventing the onset of diabetes through lifestyle changes, such as improved diet, increased physical activity, and weight control, in individuals at risk presents an attractive public health opportunity. Recently, a randomized controlled clinical trial from Finland showed a 58% decrease in the incidence of type 2 diabetes when lifestyle interventions were conducted in high-risk subjects (2). Similar studies comparing lifestyle interventions and pharmacological therapies to prevent type 2 diabetes are currently underway (3). However, implementing diabetes prevention interventions in the general population will be challenging. From November 2000 through January 2001, the Montana Department of Public Health and Human Services conducted a random-digit household telephone survey of people ≥45 years of age living in two rural counties in Montana. Respondents were asked if they had ever been told by a physician that they had diabetes (including gestational diabetes), if they had a family history of diabetes (sister, brother, or parents), and if they had ever been told they had high cholesterol and/or high blood pressure. Respondents with a previous diagnosis of diabetes (except gestational diabetes) were excluded. The remaining respondents were asked, “Do you think you are at risk for diabetes?,” “Do you think that you can prevent getting diabetes?,” and “Has a doctor or other health professional ever told you that you may be at risk for developing diabetes?” …