 The MAINTAIN-PC study draws upon recommendations for the design of practical clinical and behavioral trials. The investigators will assess multiple relevant outcomes across clinically meaningful treatment strategies. The investigators will recruit a sample that is diverse in terms of gender, BMI and co-morbidity status, with a racialethnic mix reflective of the region, and that includes Agency for Healthcare Research Quality priority populations. The investigators will include clinical practices with diverse characteristics, and have selected interventionists who reflect the level of training typically seen among primary care clinic staff. The investigators will recruit 30-40 participants a month, with recruitment lasting 5-6 months, and each participant in both CC and TO arms receiving a 30 month intervention. The last year of the study will focus on analyses, including cost-effectiveness analyses. 