Process evaluation findings from FUEL Your Life, a worksite translation of the Diabetes Prevention Program

The epidemic of obesity has prompted many employers to seek ways to help employees reduce their risk of obesity and related comorbid conditions. At the same time, there has been increased interest in translating effective programs into practice settings. We recently adapted and translated the Diabetes Prevention Program for broad-scale implementation in a workplace environment. To meet the time and cost restraints of typical worksites, the translated program, FUEL Your Life, was primarily a self-study intervention supported by trained peer health coaches and occupational health nurse(s) at the worksites. The intervention was tested at six Union Pacific Railroad maintenance facilities with a predominantly blue-collar male (94%) employee population with high rates of overweight and obesity (> 60%). Overall, participants receiving the intervention maintained their body weight while participants in control sites experienced weight gain (BMI +0.3), the differences were statistically significant. Process evaluation data were collected from observations, participant surveys, and interviews with key informants. The FUEL Your Life program had local management support and was well received by participants (99% of survey respondents gave the program a positive rating). Data indicate that the occupational health nurse provided regular information about the program; however, the peer health coaches were underutilized. The findings from the process evaluation will be presented using the RE-AIM framework. We will discuss the challenges of working with peer health coaches, factors that influenced the success of program implementation and possible strategies for increasing the intensity of the intervention to achieve meaningful weight loss.