Attaining and maintaining healthy weight is a major public health goal for preventing diabetes. While intensive lifestyle interventions are successful in weight loss and reducing risk of diabetes, low socioeconomic status (SES) populations, which have a higher burden of obesity, are difficult to reach with health system or population-based weight loss interventions.

This innovative study will test readily scalable and translatable interventions through a partnership with BJC HealthCare, a large health care employer with many low-wage workers, to reduce obesity and diabetes risk. This project will evaluate modifiable work environment and individual-level barriers and facilitators of healthy eating and activity; will aim to produce changes in the workplace environment that are acceptable, effective, and sustainable; and will develop and test an innovative multi-level intervention that includes an interactive obesity treatment program (iOTA) using SMS text messaging. This pragmatic study will advance the long-term goal of reducing obesity and obesity-associated illnesses including diabetes.