**Jaime R. Strickland \* , Anna M. Kinghorn, Bradley A. Evanoff and Ann Marie Dale**

Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA; akinghorn@wustl.edu (A.M.K.); bevanoff@wustl.edu (B.A.E.); amdale@wustl.edu (A.M.D.)

**\*** Correspondence: jaime.strickland@wustl.edu; Tel.: +1-314-454-7337

Received: 31 December 2018; Accepted: 14 February 2019; Published: 18 February 2019

**Abstract:** Participatory methods used in Total Worker Health® programs have not been well studied, and little is known about what is needed to successfully implement these programs. We conducted a participatory health promotion program with grocery store workers using the Healthy Workplace Participatory Program (HWPP) from the Center for the Promotion of Health in the New England Workplace. We recruited a design team made up of six line-level workers and a steering committee with management and union representatives; a research team member facilitated the program. Using a formal evaluation framework, we measured program implementation including workplace context, fidelity to HWPP materials, design team and steering committee engagement, program outputs, and perceptions of the program. The HWPP was moderately successful in this setting, but required a substantial amount of worker and facilitator time. Design team members did not have the skills needed to move through the process and the steering committee did not offer adequate support to compensate for the team's shortfall. The evaluation framework provided a simple and practical method for identifying barriers to program delivery. Future studies should address these barriers to delivery and explore translation of this program to other settings.

**Keywords:** Total Worker Health; participatory methods; program implementation; organizational readiness; process evaluation; logic model
