Type 2 diabetes among adults is a major public health issue in the United States and it is rapidly becoming soamong children and adolescents. Indeed over one-third of children are overweight and nearly 1 in 5 obese.Concomitant with increased pediatric obesity type 2 diabetes (T2D) has increased in youth (greater than 30%between 2001 and 2012) foreshadowing an earlier age of onset of T2D. Without effective intervention thenumber of youth with T2D is expected to quadruple by 2050 resulting in an unprecedented health and financialburden on millions of Americans. To address the critical need for effective diabetes prevention programs thattarget at risk youth our objective is to test the feasibility of integrating a family-focused lifestyle behaviorchange intervention within a Federally Qualified Health Center (FQHC) to reduce risk of incident T2D. TheFQHC that will participate in this project serves those among the highest risk of diabetes: low income Latinofamilies. Building upon previous work in which the investigators independently demonstrated the benefits ofYMCA-based family-focused approaches in T2D prevention we will adapt a successful YMCA-based diabetesprogram for delivery to mothers and their 8-12-year-old children by trained FQHC health and wellness staff. Inorder to determine potential for long-term program sustainability within this novel healthcare setting we willevaluate program acceptability implementation integration with FQHC infrastructure cost and potential forexpansion and maintenance. Preliminary impact of the 16-week family-focused intervention on diabetes andCVD risk factors (weight status glucose control lifestyle behaviors) will be assessed in 60 mother-child dyadsparticipating in the 16-week group-randomized trial. Women who are at risk of T2D (based on metabolicphenotype and medical history) and their 8-12-yr-old child will be recruited to participate. While all 60 dyads willbegin the study simultaneously 30 mother-child dyads will participate as wait-listed controls until the other 30dyads complete the intervention (after which they will also participate in the intervention). The proposed studyis significant for its focus on reducing obesity and T2D prevalence in Latino children and women at risk using afamily-focused community-based approach that leverages parent involvement and our partner FQHCsnetwork of facilities professionals and resources. The proposed study is innovative in that it is the first toaddress T2D risk of mother and child simultaneously using the concept of primordial prevention whereinparents are activated to modify the social and physical environment to halt risk transmission to their offspring. Itis novel in its engagement of mothers with metabolic phenotypes associated with T2D and known risktransmission to offspring (gestational diabetes mellitus) and leverages the combined work of the principalinvestigators to make family-based T2D prevention a reality for populations disproportionately burdened by thisdisease.