Black churches are instrumental in reducing chronic diseases, yet there is a paucity of literature regarding the association of Black churches and pre-diabetes among African Americans. The purpose of this study was to examine the diabetes prevention perceptions and practices of African Americans with pre-diabetes who participated in a larger intervention study (the Hosea Project). Interviews and focus groups (n = 51) were conducted 2 months following the intervention. A thematic analysis was performed to identify six emergent themes: general understanding of pre-diabetes and diabetes, diabetes prevention knowledge, program benefits, program barriers, lack of participation from men, and behavioral changes after program participation. This study illustrates how Black churches should serve as an intervention setting to increase pre-diabetes health behavior and education. Tailored and culturally appropriate programs can be beneficial in helping African Americans implement strategies to prevent diabetes. [ABSTRACT FROM AUTHOR]