Behavioral Nudges for Diabetes Prevention (BEGIN) Trial in Primary Care

"* Displays information about the benefits and risks of ILI and metformin~* Asks open-ended questions: What am I willing to do to prevent T2D? and What do I need to prevent T2D?~* Prompts patients to commit to immediate next steps~* Health educator schedules interested patients for first ILI session or sends message to provider about patients' interest in starting metformin, if chosen"

"* Defines prediabetes and includes individualized A1c values~* Present benefits and risks of intensive lifestyle intervention and metformin~* States that other prediabetic Erie patients are adopting intensive lifestyle intervention and metformin~* Encourages initiating intensive lifestyle intervention or discussing metformin with provider~* Include selected behavioral content from diabetes prevention program~* Initial message with automatic opt-in, allows opt-out for messages~* Subsequent messages include: information about T2D risk and treatments; prompts to directly schedule intensive lifestyle intervention or office visit to discuss metformin; selected behavioral content from diabetes prevention programming"

Patients receiving care at non-intervention clinic sites will not be exposed to treatment intervention.