Understanding and Addressing Risks of Low Socioeconomic Status and Diabetes for Heart Failure

Who May Qualify: - Adults from Johns Hopkins Medicine (JHM) who live in Baltimore City and adults from Johns Hopkins Community Physicians (JHCP) Hagerstown or Family Healthcare of Hagerstown who live in Washington County - Low socioeconomic status (SES) by high Area Deprivation Index (ADI) \[\>75th percentile for the state of Maryland\] plus low income) - Type 2 diabetes - Obesity (BMI≥30 kg/m\^2) Who Should NOT Join This Trial: - Age \< 30 or \>70 years - Prevalent heart failure - Uncontrolled glycemia (blood glucose \<60 mg/d or ≥ 300 mg/dl or most recent hemoglobin A1c ≥11%) - Uncontrolled blood pressure (Systolic blood pressure (SBP) ≥160 or diastolic blood pressure (DBP) ≥100 mm Hg, either on or off medications) - Known coronary artery disease (unless \< 50% stenosis by angiography) - Moderate or severe valvular heart disease - Serious medical conditions limiting life expectancy or requiring active management - Inability to participate in moderate intensity physical activity as assessed by the self-report Physical Activity Readiness Questionnaire Plus (PAR-Q+). - Any condition or planned surgery/procedure precluding exercise for ≥ 150 minutes per week - End-stage renal disease - Current participation in another behavior change program - Active alcohol or substance abuse disorder - Already engaging in regular exercise with more than 60 minutes of moderate \[3-6 METS\] to vigorous \[\>6 METS\] physical activity per week - Active pregnancy - Evidence of ischemia, dangerous arrhythmia, or other clinical instability on baseline exercise stress test Always talk to your doctor about whether this trial is right for you.