Participation is the issue, said one corporate human resources director, because "most people are too busy or not motivated enough."

Main concern: "Time crunch, employees can't seem to find the time to get into the onsite fitness center," said a company RN/fitness coordinator. "People in general just seem to be getting busier and busier!"

"It is just our lifestyles today as well as the mentality of employers — do more with less people," the coordinator added.

Likewise, a corporate training program coordinator's concern is with "how to develop sustainable programs that incent continued participation and needed results."

"Our company currently engages employees in wellness opportunities" the coordinator said. "However, each of the opportunities is utilized within a specific time frame with gaps in timing and a disconnect to continued health initiatives."

"Unless people participate we have less impact," observed a hospital director of wellness services. "People cite time, money and disinterest as reasons to not participate."

"Participation is always a challenge because it relates to budget," according to a hospital program coordinator. "If there is no participation there are no results."

Jan Renner, a hospital supervisor of community education and wellness, said motivating employees to participate in high-risk intervention programs is a main concern. "I think the companies feel the need to implement programs but the employees must want to make changes."

To continue programming, "we need to show success," Renner added. "Success will happen if we can get employees to participate and complete intervention activities."

Related to the employee participation issue is reaching certain categories of employees. For example, reaching low-wage earners is a concern said Margarita Chapman, executive director of Creating Healthy Liv