Maternal obesity, hyperglycemia and excessive gestational weight gain (eGWG) all associate with increased risk for overweight/obesity, metabolic syndrome and cardiovascular disease in the offspring. It is particular women with low socioeconomic status and from racial minorities that record highest prevalence of maternal obesity, while also reporting the lowest prenatal care visits. On par, Arkansas has seen the nationwide highest increase in pregnancies with obesity (22/4%) with ~4 out of ten women being affected. Thus, there is a critical need for a cost-effective, efficacious intervention, fit for implementation in vulnerable populations. Obesity is a chronic disease that requires effective self-management. Unhealthy eating patterns and low levels of physical activity (PA) are manageable behaviors that have been linked to eGWG and adverse health outcomes in mother and children, and behavioral counseling interventions (BCI) focused on diet counseling and PA uptake have shown a ~20% decrease in eGWG occurrence and pregnancy complications. However, over half of women in BCI groups still experience inappropriate GWG. A possible avenue of refinement is in the process measures given to individuals to track intervention adherence. Self-monitoring via continuous glucose monitoring (CGM) has shown improved healthful behaviors and glycemic control in adults with and without diabetes. Furthermore, preliminary data from our group show thus far feasibility in pregnant women with obesity but without diabetes diagnosis (79% compliance when wearing a CGM sensor for 14 days per trimester). Yet, the feasibility of continued CGM sensor wear throughout gestation as well as the behavioral feedback value of CGM data to enhance self-management in pregnant with obesity but without diabetes (PWOWD) has yet to be established. To address whether a future definite RCT of adding CGM as a self-management tool to an existing BCI in PWOWD is feasible, we propose the following aims: Aim 1: Complete formative research per the Replicating Effective Programs (REP) framework to identify key elements for including CGM into an existing BCI for use in Arkansas women from urban and rural areas. Aim 2: Determine feasibility of the adapted procedures and planned outcomes in a randomized pilot and feasibility trial. Overall Impact: Results from this study will provide essential data to inform an R01 application (RFA-OD-23- 014) to conduct a definite RCT for testing the efficacy of an existing BCI enhanced by process measures from wearable technology. Leveraging feasibility assessments to incorporate formative work will demonstrate new avenues to improve BCI efficacy in future research designs and ultimately deliver impactful lifestyle interventions that will improve maternal and child health.