Challenges and barriers to implementing a worksite health promotion program in rural Mississippi: Lessons learned from Mississippi in Motion

Mississippi in Motion is a physical activity and nutrition education program based on Social Cognitive Theory and delivered in several worksites and communities in rural Mississippi. This 12 week program includes screenings, educational programs, and skill development sessions conducted by university faculty, students, and extension agents. The program served as a “kick off” for a multi-year collaborative worksite health promotion program. Although Mississippi in Motion has been successful in increasing physical activity among participants there have been many challenges and barriers in implementing such a program, particularly in rural worksites. During Mississippi in Motion, it was difficult to find educational session leaders to present various programs at the industrial sites. This was primarily due to the limited number of community agencies that are accessible and the large distance between the various worksites. Using university educators posed its own unique challenge as there was a significant perceived gap between community and academic professionals. Another barrier for employee participation was management concern about allowing work time to be used for health promotion related activities. Because the program was offered during lunch breaks, many employees did not or could not participate. Other barriers to the program were participant's lack of desire to participate, lack of trust in management, privacy concerns, management turn-over and time constraints. Some of these barriers were overcome through advocacy efforts, increased use of incentives, and use of employee peer leaders that assisted with program recruitment and sustainability.