Table 1 INDIA-WORKS planned core components and adaptive elements

Lifestyle education program

 Class format

16 weekly hour-long core sessions plus 8 monthly maintenance sessions based on the curriculum developed for the D-CLIP and DPP studies. Order of lessons is set and should not be adapted.

Individual lessons include a mix of teaching/learning styles including didactic instruction, role playing, group discussions, and question and answer sessions.

Timing of classes

Composition of class cohorts

 Lifestyle change curriculum

Educational curriculum focused on diet improvement (increasing fiber and fruit and vegetable intake, decreasing intake of high fat and high carbohydrate foods, portion sizes), increasing physical activity, decreasing stress and dealing with stress in a healthy way, and maintaining healthy behaviors

Most classes included substantial time for group activities and discussions which could be tailored to the needs of the sites and individual classes

 Physical activity education

All participants provided with training on starting and increasing exercise, exercise safety, overcoming barriers, and increasing activities of daily living.

Participants were taught a simple routine of stretches and strength training using their own body weight.

Sites with exercise facilities and in-house gym staff could provide more extensive exercise training.

Worksites in or near Chennai, India provided a detailed 16 week physical activity curriculum to their participants and it was delivered by certified trainers.

 Class instructors

Education team made up of trained peer educators and professional health educators

Although all peer educators were encouraged and empowered to lead lifestyle classes, the balance of teaching between the peer educator and the professional health educator could vary by site.

 Additional support to intervention class participants

SMS text messages delivered weekly reinforcing lessons taught during lifestyle classes after the core classes

Food and activity diaries to support and track changes.

Weight, waist circumference, and blood pressure tracking.

Pedometer step counts.

Tools for sharing information and peer support.

Information or support could be shared via different channels (e.g., listserv, WhatsApp Messenger, in person)

 Participant goals

All participants given two goals to achieve during the intervention: (1) increase physical activity to at least 150 min per week of moderate level activity and (2) lose at least 5% of their baseline body weight (via diet and activity changes).

Participants were given choices for how to reach study goals and then could work towards these goals choosing the tools that are right for them individually.

Worksite health promotion efforts

 Canteen changes

Worksites encouraged and supported in making positive changes to the types of foods and serving sizes in the company canteens

There was flexibility in what healthy foods the canteen will offer, and the type and extent of changes made depend on capacity and resources at the worksite

 Health screening

Health screenings offered to all interested employees.

Health screens could be offered in a way that best suited the worksite (e.g., single day screening events for all workers, scheduled visits for individual workers, etc.)

 Physical activity promotion

Walking groups at the worksites open to all employees.

Activation of dormant gyms or activity areas at worksites

Sites supported in making other changes to promote more active choices among employees including informational signage, designating areas for walking or other activities, and proving exercise training on site.