Objectives Multilevel, multicomponent (MLMC) interventions are a promising strategy to address obesity, yet they are complex to implement with sufficient intensity. We report on the process evaluation of a MLMC to prevent/reduce obesity in Native American (NA) adults. Methods OPREVENT2 is a recently completed MLMC intervention in six NA communities (3 intervention, 3 comparison). OPREVENT2 worked with food stores to increase access to and promote healthy food choices, worksites to provide nutrition education and to improve physical activity (PA) opportunities, schools to educate children (grades 2–6) to act as change agents, media to reinforce key messages, and through a policy-oriented community action committee (CAC). OPREVENT2 was implemented in six phases targeting various foods, PA strategies and related behaviors. Implementation standards were set for each component and assessed reach, dose delivered, and fidelity. Data were collected using a combination of REDCap-programmed t...