Expected products from this project include an evaluation of the training and the group visit intervention implemented in six Midwestern community health centers, the dissemination of best practices for implementing diabetes group visits in the community health center setting, and the subsequent development of this pilot program into a full scale randomized controlled trial across multiple community health centers. This pilot study will also help participating health centers problem-solve in order to overcome challenges in implementing and sustaining programs at their health center and understand how to provide better care to their patients in the areas of behavior modification and diabetes management. Finally the pilot conducted at the center selected to implement the text-messaging intervention in addition to the group visit intervention will provide information of the feasibility of additionally implementing a text-messaging intervention and explore whether such a combined intervention could have the potential to improve attendance at group visit appointments, change health behavior, and improve patient outcomes to a greater extent than group visits alone.