BACKGROUND: The United States is undergoing an epidemic of obesity with profound consequences on health and health care costs. Worksites have influence over, and access to, employees. Most hotel jobs require little education or training, and hotels employ large numbers of low SES persons and immigrants. Hawaii, with the world''''s most ethnically diverse population, has high rates of obesity and diabetes, particularly among those of Polynesian ancestry.

DESIGN NARRATIVE: Employees at 28 participating hotels will be invited to attend a brief assessment of height, weight and to complete a short questionnaire on intentions to lose weight and related issues. After the assessment, hotels will be randomly allocated to intervention or control sites. Control sites will have similar assessments 12 and 24 months later. Written pamphlets advising about optimal diet and physical activity patterns will be distributed at each assessment, but no other activities will take place in control sites. Intervention hotels will receive an intervention that has three components. First, a comprehensive environmental program will be applied to create a work environment that fosters health food choices, physical activity, and social support for making lifestyle changes to support health, and where needed, weight loss. Second, a series of one-hour groups will be offered to all employees at the worksite. These groups will focus on physical activity, diet and weight. Third, a series of more intensive after hours intervention groups will be made available to employees with a BMI greater than or equal to 30. These will take place outside of work and at a nearby location. At the end of two years, the impact of the program on BMI and lifestyle activities will be assessed.