Why won’t they participate? Barriers to participation in worksite health promotion programmes

Research suggests that worksite health promotion (WHP) programmes, and specifically health risk assessment (HRA) surveys and health education workshops, can be effective in enhancing employees’ health. However, 50–75% of employees choose not to participate when offered the opportunity to do so. The reasons for nonparticipation and the characteristics of nonparticipants have largely been overlooked. Building on premises of Conservation of Resources (COR) theory, we hypothesize that nonparticipation results from lack or loss of resources, or from the perceived low value of resources. These barriers to participation are expected to be related to employees’ characteristics and beliefs (termed implicit barriers) and reflected in employees’ self-reported reasons for nonparticipation (termed explicit barriers). We surveyed a large random sample of participants and nonparticipants in a WHP programme (n = 1926 employees), which included two steps: a HRA survey and a health education workshop. Participants completed an anonymous web-based questionnaire. Implicit and explicit barriers that reflect resource availability (e.g., age, health status) and valuation (e.g., low value of making a lifestyle change) were identified. The magnitude and nature of these barriers differed between the HRA survey and the workshop. We discuss how future research on WHP programmes can build on these findings and propose practical implications for reducing nonparticipation.