This application addresses the following primary broad Challenge Areas and Specific Challenge Topics: Broad Challenge Area (05) Comparative Effectiveness Research (CER) and Specific Challenge Topic 05-LM-104 "Value of "Virtual Reality" Interaction in Improving Compliance with Diabetic Regimen. Diabetes, especially type 2, has been identified as an epidemic in the U. S. and is continuing to grow in prevalence. The burden of diabetes, including prevalence and risk of complications, is greater for low-income individuals and minority groups, especially African Americans. The Healthy People 2010 report notes that the burden of diabetes can be reduced through facilitating optimal self-management. The internet offers a new approach to reaching large populations with diabetes, while removing barriers often seen in underserved populations and managing costs. In particular, Second Life, the most frequently used virtual world environment, with 6.9 million registered users worldwide offers a unique opportunity for reaching people with diabetes. The purpose of this study is to develop, implement, and evaluate the feasibility, acceptability, and impact of a Second Life virtual reality intervention designed to provide diabetes self-management education, training, and support to facilitate optimal diabetes self- management in low-income African Americans with type 2 diabetes attending primary care clinics. This study will involve the development and evaluation of a Diabetes Second Life (DSL) intervention tailored for African American adults with type 2 diabetes. This intervention provides a series of interactive contextual experiences in a virtual world that will train them in basic diabetes self-care and problem solving mixed with intermittent educational interactions with multidisciplinary health care professionals and interactions with others with diabetes. Feasibility, acceptability, and parameters of use will be examined through the participants'interactions with the DSL intervention. Psychosocial, behavioral, and A1C outcomes will be examined across repeated measurements in a population of low income African American Adults receiving primary care services at a FQHC. If effective, this intervention has the potential to be easily expanded for other populations and to be easily implemented in other primary care clinics serving diverse populations. . Diabetes has been identified as an epidemic in the U. S. and the burden of diabetes, including prevalence and risk of complications, is greater for low-income individuals and minority groups, including African Americans. The Healthy People 2010 report notes that the burden of diabetes can be reduced through facilitating optimal self-management and the internet, especially virtual worlds, offers a new approach to reaching large populations with diabetes. This study will examine the impact of using Second Life to help educate and support underserved groups with diabetes.