VOLUME 8: NO. 4, A75
JULY 2011
ORIGINAL RESEARCH
A Qualitative Examination of the Role
of Small, Rural Worksites in Obesity
Prevention
Cam Escoffery, PhD, MPH, CHES; Michelle C. Kegler, DrPH, MPH; Iris Alcantara, MPH; Mark Wilson;
Karen Glanz, PhD, MPH
Suggested citation for this article: Escoffery C, Kegler MC,
Alcantara I, Wilson M, Glanz K. A qualitative examination
of the role of small, rural worksites in obesity prevention.
Prev Chronic Dis 2011;8(4):A75. http://www.cdc.gov/pcd/
issues/2011/jul/10_0185.htm. Accessed [date].
PEER REVIEWED
Abstract
Introduction
The prevalence of overweight and obesity in the United
States is highest in rural counties. We explored social support, policies, and programmatic resources that encourage
more healthful diets and participation in physical activity
among employees of small, rural worksites.
Methods
We conducted in-depth interviews with 33 employed
adults aged 50 years or older in rural Georgia about access
to healthful foods and opportunities for physical activity
at work; conversations about exercise, weight loss, and
eating healthfully in general; and worksite nutrition and
physical activity programs; and we asked for suggestions
for making the worksite more healthful. The research
team developed a codebook, and 2 coders coded each transcript. Data were analyzed and reports were generated for
thematic analyses.
Results
Participants from rural worksites, most with fewer than
50 employees, cited lack of vending machines and cafeterias, health promotion programs to address healthful
eating and exercise, and facilities for physical activity as
barriers to eating healthfully and engaging in physical
activity at work. Many participants reported conversations with coworkers about how to eat more healthfully
by making more nutritious choices or preparing food more
healthfully. Participants also discussed the importance
of engaging in physical activity on their own and gave
suggestions on ways to incorporate exercise into their
routines. Participants’ access to healthful foods at work
varied, but barriers such as being too busy, worksite location, and no worksite cafeteria were noted. Some workers
reported engaging in physical activity at work, and others
reported a heavy workload and lack of time as barriers.
Conclusion
Building on the social environment and implementing
policies for healthful eating and participation in physical activity may help address obesity prevention in rural
workplaces.
Introduction
The prevalence of overweight and obesity in the United
States continues to be a public health concern. In 2008,
32% of men and 35% of women in the United States were
overweight or obese (1). Overweight and obesity are associated with increased risk for diabetes, stroke, heart disease,
some types of cancers, hypertension, high cholesterol, and
arthritis (2). Obesity prevalence is lowest in urban counties throughout the United States and highest in rural
counties, particularly in southern states (3).
A growing body of research suggests that body weight
is determined both by behaviors (eg, eating less, being
more active) and environments (ie, social and built) (4-6).
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the
Centers for Disease Control and Prevention.
www.cdc.gov/pcd/issues/2011/jul/10_0185.htm • Centers for Disease Control and Prevention
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Worksites are practical settings for health promotion, and
worksite health promotion can improve employee productivity and health, including playing a role in modest weight
loss (7-9). Although results are mixed, worksite intervention studies aimed to improve dietary and physical activity
habits of employees are promising when combined with
strategies that also target social and organizational support, environmental change, and policy change (10-13).
However, despite the promise of worksite environments in
supporting employees’ healthful eating and participation in
physical activity, small or rural businesses typically have
fewer health promotion programs than larger employers
(8,14-16). A recent national survey of worksites indicated
that worksites with more than 750 employees consistently
offered more health promotion programs than did smaller
worksites (17). Small worksites face barriers such as lack
of financial resources and infrastructure to conduct health
promotion programs (8,14). Because more than 50% of
workers are employed by businesses that have fewer than
100 employees, learning more about small and rural worksites and their potential for providing health-promoting
environments and programs is important (14,16,17).
The purpose of this qualitative study was to learn more
about the available intervention strategies and policy and
social supports of worksites in rural areas. We examined the
social support, policy, and programmatic resources in rural
worksites that may encourage more healthful diets and participation in physical activity among their employees.
or white, aged 50 years or older, currently living with at
least 1 other person, and residing in the Georgia counties
of Calhoun or Terrell for at least 10 years. Calhoun (population 6,094) and Terrell (population 10,657) counties are
located in rural, southwest Georgia and are characterized
by high rates of poverty and low educational attainment
(18). We employed a snowball sampling approach to
recruit 60 participants, divided evenly by sex and race.
The CAB decided to focus on adults aged 50 or older
because members thought that prevention of cancer and
other chronic diseases would be more salient for adults in
this age range.
Interviewers recruited participants through snowball sampling, starting with personal contacts, local businesses,
and organizations. They were also recruited by going
door-to-door in neighborhoods and at civic associations
and by using advertisements in local papers. Interviewers
screened potential participants in person to ascertain eligibility, inquiring about age, living with another person,
and time lived in Calhoun or Terrell counties. Sixty participants were interviewed in their homes or public areas,
and all provided written informed consent. All interviewers attended a 1.5-day training about the project and
qualitative interviewing methods. They completed several
pilot interviews and received feedback on their technique.
The trained local residents conducted the interviews using
a semistructured interview guide; they were race- and sexmatched to respondents.
Instrument
Methods
The Emory Prevention Research Center (EPRC), its
Community Advisory Board (CAB) of representatives from
multiple community sectors, and the Southwest Georgia
Cancer Coalition partnered to conduct this research.
The CAB assisted with decisions about study design, the
data collection instrument, and interpreting results. A
Southwest Georgia Cancer Coalition staff member supervised data collection and the local residents trained in
interviewing techniques by Emory faculty and staff who
conducted the interviews. The Emory University institutional review board approved the research protocol.
Sample and procedures
The study was conducted during May through September
2005. Eligibility requirements were being African American
The full interview guide explored how social and physical
environments in the home, work, and church influence
healthful eating, participation in physical activity, and
tobacco use. Only themes regarding how the worksite
affects healthful eating and participation in physical activity are reported here. Data on the role of the home and
neighborhood environments on these behaviors have been
published elsewhere (19).
Questions about worksite environments that promoted
healthful eating and weight loss asked about the availability of a cafeteria and vending machines, discussions
with coworkers about eating healthfully and losing weight,
and availability of worksite programs to help people eat
healthfully or lose weight (Appendix). Questions about
physical activity environments and opportunities asked
about participating in physical activity at work, conversations with coworkers about participating in physical
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
2
Centers for Disease Control and Prevention • www.cdc.gov/pcd/issues/2011/jul/10_0185.htm
VOLUME 8: NO. 4
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activity, and the availability of worksite programs or
facilities for participating in physical activity. We also
asked participants to offer suggestions on how to improve
their worksites. The interviews typically took 60 minutes
to complete. Interviewers gave participants a $20 gift card
from Walmart as compensation for their time.
Data analysis
The interviews were transcribed verbatim. We excluded
2 interviews in the final analysis because of tape-recording problems. The research team developed a codebook to
cover major themes for each topic covered in the interview
discussions. Two coders then coded each transcript independently and resolved discrepancies through consensus. QSR-N6 software (QSR International, Cambridge,
Massachusetts) was used for data storage, retrieval, and
analysis. The coders generated N6 reports with all comments associated with particular codes. Content analysis
was performed to identify the range of responses and
major themes (20). To identify patterns and themes by sex
and race, matrices were constructed (21,22). For example,
staff generated a report to retrieve all text associated
with availability of healthful food choices at work by sex
and race. One researcher identified themes and a second
confirmed the themes (eg, vending or cafeteria options).
The researchers defined strength of a theme by number
of responses: 5 or fewer responses being weak, 6 to 14
responses being moderate, 15 responses or more being
strong.
Results
Of the 58 respondents, 33 (57%) reported being currently
employed outside of the home. Of these 33, most were
white men and had a mean age of 59 years (Table 1). Most
worksites employed 50 or fewer people; 16 participants
reported working with 4 or fewer people. Many participants worked in small retail stores and offices (eg, art
shop, florist, bookkeeping), and others worked at factories,
in construction or education, or were self-employed (eg,
landscaper, computer repairman).
machines in these rural worksites. Approximately half
of respondents reported that cafeterias were not present
at their worksites. Those participants whose worksites
had cafeterias described prepared meals, meats and fish,
sandwiches, side items, and desserts as being generally
available:
When we had the meal, I had the vegetables and
all, but then they quit cooking anything but the
chicken and chicken tenders and so I wound up
eating chicken tenders. I would make me a chicken
tender sandwich, and that was fried and it was not
good for me. (white female participant)
A little more than half of respondents reported that vending machines were not present at their worksites. Of
participants whose worksites had vending machines, only
2 stated that they purchased food daily from a vending
machine. Vending machines typically offered food such
as snacks (eg, candy, chips), beverages, and occasionally
salads and sandwiches:
They have these vending machines and you know
they have sandwiches, and sometimes they put
salads in there. . . . No fruits, they used to put
apples in them but none of them do now. . . . Well,
I buy something [like a] sandwich made with
brown bread [or] a salad, you know, a green salad.
(African American female participant)
Food from home. About half of the respondents reported
seldom or never bringing food with them from home to eat
at work. The most common explanation for this was that
participants usually went home to eat lunch (moderate
theme). Other reasons mentioned by a few participants
were lack of time in the morning, the convenience of eating out or eating at the worksite cafeteria, or only eating
once per day:
Of course, I could bring stuff from home, but we
have to be at work at 7:45 AM and so to get up and
fix food to bring, you know, it’s a trade-off between
a little more sleep or fixing food. (white female
participant)
Healthful eating at work
Opportunities for healthful eating at work
Cafeterias and vending machines. Two strong themes
that emerged were the lack of cafeterias and vending
We eat at the China Berry café most every day.
It’s right next door, so . . . you know it’s convenient
and it’s easy to go down there and eat. (white male
participant)
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
www.cdc.gov/pcd/issues/2011/jul/10_0185.htm • Centers for Disease Control and Prevention
VOLUME 8: NO. 4
JULY 2011
A few respondents mentioned reasons for bringing food to
work, which included not being able to leave work during
the day to get food, the convenience of bringing food or
snacks with them to work, and concern for the nutritional
quality of the foods they eat:
It usually has to do with tight schedules. Like,
when we’re shipping something and I just can’t
leave because I don’t know when the truck’s going
to pull up. (white male participant)
A couple of respondents mentioned that refrigerators or
microwaves were available for them to store and prepare
food at their worksite:
We do have a refrigerator that soft drinks and
water are kept in, but other than that. . . . We do
have a microwave where people bring in [food to
reheat]. (white male participant)
Eating out on a work day. Approximately half of all
respondents reported never or rarely going out to eat during the work day. The rest reported typically going out to
eat 1 or 2 times per week, and 2 respondents said that they
eat out every day. Respondents were divided on whether
the meals eaten out were healthful:
I want to say pretty health[ful]. Now they . . . usually have 3 vegetables and 1 meat. . . . We have
salads with tomatoes and then the vegetables, and
then they also have bread, which is usually cornbread or something like cornbread. (white male
participant)
They . . . cook soul food, butter beans, and chicken.
. . . Don’t say nothing about their broccoli casserole
[laughing]. It’s bad, and they cook breakfast. . . .
Sometimes we buy breakfast. (African American
female participant)
Conversations with coworkers about healthful eating and weight loss
Two strong themes that surfaced were conversations
about eating healthfully and losing weight with colleagues
at work (Table 2). Most respondents (n = 17) reported having conversations with coworkers about eating healthfully,
with the exception of African American male participants.
Moderate themes from the conversations centered on the
types of food participants eat (healthful or unhealthful)
and methods to eat healthfully. Weaker themes were the
methods participants use to prepare foods and discouraging coworkers from eating unhealthful foods.
Many conversations about losing weight at the worksite
involved 1 coworker offering advice to other coworkers on
how to lose weight, with exercise mentioned most often as
a moderate theme. Participants also discussed conversations about eating healthfully to lose weight. Strategies
mentioned were using weight-loss programs (eg, Weight
Watchers), eating prepackaged meals (eg, Lean Cuisine,
Healthy Choice) and eating home-cooked meals for lunch.
Barriers to healthful eating at work
More than half of respondents identified barriers to healthful eating at their worksite. One moderate theme that
emerged was the lack of time. Other barriers that emerged
as weak themes were the presence of “tempting” foods,
limited selection of healthful food options at worksites, job
stress leading to eating unhealthful foods, and location of
worksites, which could limit access to healthful foods.
Participants who reported no barriers to eating healthfully
at work had flexible schedules, which allowed them more
choices to eat healthful lunches, and others felt it was easy
to bring in healthful lunches or snacks to eat throughout
the day:
It’s not anything wrong about the health [of] the
place because you know you bring what you’re
going to bring. You know it’s good for you to eat.
You can bring it with you. (African American
female participant)
Another strong theme was the lack of health programs.
None of the respondents stated that there were currently
programs at their worksites to facilitate healthful eating
or weight loss. A few participants described programs
that had been implemented in their worksites in previous years and commented that these programs had been
unsuccessful.
Suggestions for how worksites could encourage
healthful eating
Most respondents had suggestions for what worksites could
do to encourage more healthful eating among employees.
Suggestions that emerged as weak themes included providing more healthful food options, offering fresh fruits
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
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VOLUME 8: NO. 4
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and vegetables, using insurance premiums as incentives,
providing educational materials, and having a designated
lunch break for all employees. A few participants reported
that worksites could not do much to encourage healthful eating because of the small size of the work facility;
the varying location of the worksite, which may be miles
away from restaurants or stores; and the belief that eating
healthfully is a personal responsibility and not something
that should be determined or influenced by the worksite.
Physical activity at work
Opportunities for participating in physical activity
at work
Most respondents (n = 30) stated they are physically active
at work. Strong themes included walking at work and performing activity required by the job. Approximately half of
the respondents reported walking at work, and approximately half reported engaging in other types of physical
labor, including lifting boxes or books, climbing ladders or
stairs, loading trucks, hauling water, painting, sweeping,
shoveling, landscaping, working on a farm, doing laundry,
squatting, and operating power tools:
Walking from place to place and spot to spot and
pressing them clothes . . . I get plenty of exercise on
my job. (African American female participant)
Well, I think we’re physically active on the job, and
all my employees are physically active because not
many . . . sits down to work. Everybody stands up
or [is] just moving around, you know . . . so there’s
a pretty good bit of physical activity inside of the
grocery store even though it’s not planned that
way. (white male participant)
The few respondents who said they were not physically
active at work explained that their job was sedentary in
nature (ie, involved sitting at a desk for most of the day).
A few respondents noted that physical activity should be
completed during personal time outside of the workplace.
Conversations with coworkers about physical
activity
Approximately half of the respondents described having
conversations with coworkers about physical activity.
Common topics included sharing their own exercise practices (moderate theme) and encouraging one another to
exercise (weak theme). A few respondents talked about
how age had affected their physical activity level (Table
3).
Facilities and programs to encourage participation
in physical activity at work
Almost all of the respondents reported no exercise facilities were provided at work, a strong theme. Two of the 3
exceptions were teachers who mentioned having access
to a gym and a track. None of the respondents reported
having exercise programs at their worksites, though a few
informal activities existed. Two respondents reported that
coworkers organized walking groups with other coworkers
at the worksite. A few respondents reported that employees take breaks during the work day to walk outside.
Barriers to physical activity at the worksite
Slightly more than half of the respondents felt there were
barriers to being physically active at work. Moderate
themes were the sedentary nature of the job or a schedule
that does not permit exercise during the work day, because
of heavy workload or irregular hours. Limited space for
exercise was also mentioned as a barrier.
Suggestions for how worksites could encourage
participation in physical activity
When asked, almost half of the respondents had no suggestions for what their worksite could do to help employees
be more physically active. Of those who had suggestions,
a few said that allotting time to employees to exercise
during the workday would be encouraging, and others
suggested that employers provide exercise equipment or
designate an area for employee exercise. A few others said
that it was not necessary because their jobs were already
physically demanding.
Discussion
This study was a qualitative examination of programs
and social support for physical activity and healthy eating
in rural, and primarily small, worksites. Other studies of
worksite health promotion have been quantitative and
have focused on large businesses (23,24). Findings from
this study were unique. Specifically, our results indicate
that small, rural worksites tend not to have vending
machines and cafeterias, have more collegial support
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
www.cdc.gov/pcd/issues/2011/jul/10_0185.htm • Centers for Disease Control and Prevention
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VOLUME 8: NO. 4
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for healthful behaviors, and have almost no established
health promotion programs.
Strong themes that emerged were respondents having
conversations with coworkers about eating healthfully,
losing weight, and engaging in physical activity. Small
worksites may provide a greater sense of community and
may offer a supportive social environment for behavior
change through colleagues or groups (14,16). Similarly,
Tessaro and colleagues found that women in rural worksites believed that social support in the workplace could
facilitate behavior change for healthful living (25). We
also found that, as previously reported, some employees
in these settings are already physically active on the job;
therefore, health promotion in these types of worksites
could focus on leisure-time physical activity or other health
issues (26). Social support may be important for promoting
health behaviors in smaller worksites by changing social
norms and company culture for healthful lifestyles and by
offering models and supports for behavior change (8,27).
The strong theme of limited or no cafeteria options or
vending machines in rural worksites is in contrast to
larger worksites. A major barrier to healthful eating was
limited selection of healthful options and greater presence of unhealthful foods. Some comments focused on
the unhealthfulness of Southern-prepared meals such as
fried foods and sugary desserts. Expanding healthful food
options or increasing their visibility and offering healthful options in vending machines can influence healthful
eating in larger worksites (11). However, other methods
such as offering an opportunity to buy locally grown produce at work (28) or educating employees about healthful
eating at home, since many participants in our study
reported going home for lunch, may work better for rural
businesses. Furthermore, respondents were interested in
education, reminders, and incentives to encourage employees to eat more healthfully. These educational and policy
actions taken by employers can promote a more healthful
worksite (14).
Lack of facilities for physical activity at these rural
worksites was a strong theme, which is consistent with
previous research (16,29). Other reported barriers to
engaging in physical activity at work, which emerged
as moderate themes, were limited space, schedules, and
heavy workloads. Suggestions were made for provision
of equipment or allotment of time for physical activity
at the worksite. Worksites can provide opportunities for
exercise through policies of flexible schedules and breaks,
strategies that promote physical activity (12). Worksites
can offer enhanced opportunities for physical activity by
changing the local environment through creating walking
routes, providing exercise equipment, or providing access
to existing nearby facilities (30). Easier solutions for small
worksites may include creating walking routes around
facilities such as parking lots or arranging for services at
nearby fitness facilities.
Similar to previous studies in small businesses (16,24),
respondents reported that their businesses offered few
to no health promotion programs for nutrition or physical activity. Several strategies to reduce this barrier are
for businesses to pool costs or programs, refer employees
to community sources for services, and provide information from government and professional groups, which are
available for no or low cost (16). Additional resources for
wellness programs in rural areas are community organizations, community centers, schools, or churches.
Our study has several limitations. The sample of respondents may not be representative of workers in other rural
areas. We did not validate respondents’ reports of the presence of worksite cafeterias, vending machines, and program offerings by conducting on-site visits. Respondents
who reported being active at work may not meet the
amount and type of activity recommended by national
guidelines. Furthermore, we asked respondents to answer
questions about their workplace offerings to glean insight
into rural worksites; the reported availability of healthful
foods, programs, and facilities varied on the basis of worksite setting.
Given the fact that more than 55% of Americans work
for employers with fewer than 100 employees (15), access
to worksite health promotion is critical. Future research
could systematically assess the differences in policies that
are health promoting at worksites of varied sizes and the
effectiveness of social support programs, policies, and environmental changes on healthful eating and participation
in physical activity at rural worksites.
Acknowledgments
This publication was supported by cooperative agreement
no. U48 DP 000043 from the Centers for Disease Control
and Prevention.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention • www.cdc.gov/pcd/issues/2011/jul/10_0185.htm
VOLUME 8: NO. 4
JULY 2011
Author Information
Corresponding Author: Cam Escoffery, PhD, MPH, CHES,
Assistant Professor, Department of Behavioral Sciences
and Health Education, Rollins School of Public Health,
Emory University, 1518 Clifton Rd, NE, 5th Floor, Atlanta,
GA 30322. Telephone: 404-727-04701. E-mail: cescoff@
sph.emory.edu.
Author Affiliations: Michelle C. Kegler, Iris Alcantara,
Rollins School of Public Health, Emory University, Atlanta,
Georgia; Mark Wilson, Langdale Industries, Inc, Valdosta,
Georgia; Karen Glanz, University of Pennsylvania,
Philadelphia, Pennsylvania.
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of the Centers for Disease Control and Prevention.
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VOLUME 8: NO. 4
JULY 2011
Tables
Table 1. Demographics of Rural Workers in Calhoun and Terrell Counties, Georgia, 2005
Characteristica
No. of Men (n = 19)
No. of Women (n = 14)
Total No. (N = 33)
Race
White
11
7
18
8
7
15
11
8
1
8
14
8
14
12
18
<25,000
4
10
≥25,000
10
8
18
15
10
25
4
7
4
7
1
10
2
≤4
7
1
5-4
8
5
1
50-1
2
2
4
African American
Age,b
y
50-5
≥60
Education
High school graduate or less
Some college or college graduate
Annual household income, $
Marital status
Married
Otherc
County of residence
Calhoun
Terrell
Workplace size
a
Numbers may not sum to totals for n because of missing data.
Mean age for men, 5.1 years (standard deviation [SD] = 7.8 y); mean age for women, 0.1 years (SD = .5 y); and mean age for total sample, 5.5 years
(SD = 7.2 y).
c Living with someone, divorced or separated, single, or widowed.
b
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
www.cdc.gov/pcd/issues/2011/jul/10_0185.htm • Centers for Disease Control and Prevention
VOLUME 8: NO. 4
JULY 2011
Table 2. Comments Related to Healthful Eating, by Topic and Theme, Among Employees of Small Worksites in Rural Georgia, 2005
Theme/Topic
Participant Comment
Conversations About Healthful Eating at Work
Commonly discussed
. . . I think in any working environment where it’s a small group, there’s that interaction about food constantly. I
mean that’s a pretty good topic for people to talk about. (white male participant)
Types of food
Occasionally we talk [about] why we don’t eat this particular thing because it has “x” number of calories or we
don’t need this . . . and we talk about eating fruit, because you need fruit [more] than that other stuff. (African
American female participant)
Yes . . . [we] talk about how they’re preparing food and what kind of foods they’re preparing. . . . I’ll bring a
sample of something that we had for dinner back to work . . . then talk to them about how they’re cooking their
foods. They’re pretty much meat and potatoes–oriented, you know. Try to expand that a little bit. (white male
participant)
Food preparation
Well, we’ll just talk about the need to have less fat or how greasy the food is in the lunch room and how we wish
they’d drain the stuff better, at least, that sort of thing . . . and the fact that they tend to empty the salt shaker
into the food. (white female participant)
Programs for healthful eating at work
It has none. In the past . . . they paid some lip service to that. At one point, they got some kind of grant — they
being the administration I guess — they got some type of grant, and they actually bought some exercise equipment, which was supposed to go in the teachers’ [lounge]. I don’t know when they thought they were going to
use it . . . but that kind of petered out, and I don’t even know what happened to the equipment. . . . We had a
couple of speakers one time several years ago talking to the teachers about that sort of thing, lifestyle, healthy
lifestyles. (white female participant)
Conversations About Losing Weight at Work
Physical activity
I’ve hired a couple of new men, and both of them are slightly overweight and I’ve talked to them about . . . losing weight and walking to work. . . . [One employee] has started walking to work. He lives approximately a half
mile from the station. (white male participant)
Eating choices
[A coworker] lost a lot of weight and then he got married, and now he’s gaining a little weight . . . so he talks
[about how] he’ll eat his Healthy Choice at lunch sometimes, and I don’t know what he eats when he goes
home. But yeah, it’s a big conversation down here about losing weight. (white female participant)
Barriers to Healthful Eating at Work
Lack of time
You’re on the go. You really don’t have time, so you’re going to grab something that’s quick and easy, and it’s
never healthy. Like, you know, run through McDonald’s on the way to taking a load of concrete out, you know,
just to not be hungry. You can get in there and be out in a minute or 2. (white female participant)
Presence of unhealthful food
The presence of the food on Friday makes it hard because it’s tempting . . . cinnamon buns and so forth. That’s
a real treat. (white male participant)
Well, first of all, they don’t have no healthy food on the job. . . . No, they don’t have anything but them vending
machines, you know, and there isn’t anything in them but snacks. (African American male participant)
Lack of access to healthful food
Like I said, where you work, the place you working at . . . [is] way out in the country somewhere or somewhere
not close to a store or a restaurant, so you have to say, “Go with what you got.” Or . . . somebody might go and
get a lunch for everybody, but you still have to buy that. (African American male participant)
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
10
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VOLUME 8: NO. 4
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Table 3. Comments Related to Physical Activity, by Topic and Theme, Among Employees of Small Worksites in Rural Georgia, 2005
Theme/Topic
Participant Comment
Conversations About Physical Activity at Work
Talking about own exercise efforts
The lady I work with tries to walk, but it’s very difficult for her in the heat . . . so that knocks out summer,
and then when it gets too cold, so she really doesn’t have much time, does she? [The conversations] are
usually about her walking and just what she’s doing, not what I do, she knows what I do. (white female
participant)
Encouraging each other to be physically active
Oh, we talk about it all the time, and we try to encourage each other, “I’m going to go home and I’m going
to walk 2 miles,” or whatever. Or, I should, yeah, [or we should] because she’s very health conscious, too.
(white female participant)
We talk [about] that we cannot do what we used to could do (laughing). (white female participant)
Age affecting physical activity
Oh, we talk a lot of times about being physically active, what we’re going to do today, what we’re going
to go down there to the Sandtrap at night or House of Jazz and stuff. I be just bullshitting . . . they’re not
going to go down there. Man, I can’t, I used to dance pretty good. I can still step before 2 men now. . . . If
I do get out there I’m huffing and puffing, I don’t want them to know nothing about it. (African American
male participant)
Exercise like I’m going to tell you right now, we’ll exercise sometime about twice a week, and we’ll walk
20 minutes on the inside, around and around there, the whole group. (African American male participant)
Programs for physical activity for work
. . . and sometime I will take a long walk around the plant, you know just to be going around the plant. I
got that idea from an employee. (African American female participant)
Barriers to Physical Activity at Work
Sedentary nature of the job
Well, a lot of it’s involved in standing behind the counter checking out books, or sitting at a desk cataloging books, and the only physical part is the shelving. (white female participant)
Workload
At lunchtime or after the children had left from school but usually I had things I needed to do to prepare
for the next day, so while I was at school I tried to do what I needed to do. (white female participant)
Irregular schedule
The long hours as it pertains to me, being a business owner . . . I don’t come at 8:00 AM and leave at
5:00 PM. I might come in at 7:00 AM one morning and not leave till after midnight the same day. In fact
one day this past Wednesday I was at work about 8:00 AM, 8:15 AM, on Tuesday morning and I didn’t get
home. . . . I stayed up all night Tuesday night and didn’t get home the following night, Wednesday night,
till :0 PM. (white male participant)
Limited space
Because you’re confined to your one little office to do your job that you’re sitting down at. (white female
participant)
Suggestions About Increasing Physical Activity for Worksites
Allot time for exercise
Probably just setting aside the time for it, you know, allowing a time within the work day to take a break
and do that. (white male participant)
Give you time and space, give you time to do things like that. (African American female participant)
Provide space for exercise
Well, if we had the space, maybe a place to maybe do yoga and that sort of thing at lunchtime, my daughter does that in her workplace . . . they enjoy it. (white female participant)
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
www.cdc.gov/pcd/issues/2011/jul/10_0185.htm • Centers for Disease Control and Prevention
11
VOLUME 8: NO. 4
JULY 2011
Appendix. Interview Questions and Probes Related to Rural Worksite Health Promotion, by
Topic, Georgia, 2005
Food Availability at Worksite
Is there a cafeteria or food service where you work?
How often do you buy food there?
What do you usually buy?
Do they sell healthful foods?
What kinds of healthful foods?
Do they sell fruits and vegetables?
Suggestions for How Worksites Could Encourage Healthful Eating and
Participation in Physical Activity
What about your job or your workplace makes it hard to eat healthfully?
Given that, what are the top couple of things your workplace could do to
encourage you to eat healthfully at work?
What about your workplace makes it hard for you to be physically active?
What are the top couple of things your workplace could do to encourage
you to be physically active?
Are there vending machines where you work?
How often do you buy foods from the vending machines?
What do you usually buy?
Do they sell healthful foods?
What kinds of healthful foods?
Do they sell fresh fruits?
Food Brought From Home/Eating Out on a Work Day
How often do you bring food from home to eat at work?
What kinds of foods do you typically bring?
How often?
Conversations With Coworkers About Healthful Eating, Weight Loss, and
Physical Activity
Do you and your coworkers ever talk about eating healthfully?
Can you tell me about one of those conversations?
Do you and your coworkers talk about losing weight?
Can you tell me about one of those conversations?
Do you and your coworkers ever talk about being physically active?
Opportunities for Physical Activity at Work
What types of physical activity, if any, do you do on the job?
What exercise or recreation facilities, such as gymnasiums or outdoor
fields, does your worksite have, if any?
Tell me about any programs your worksite might have to encourage
people to be physically active.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.
12
Centers for Disease Control and Prevention • www.cdc.gov/pcd/issues/2011/jul/10_0185.htm
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