Purpose: This study utilizes a qualitative design through the use of focus group discussions (FGDs) to identify barriers and facilitators to Health Risk Assessment (HRA) with resulting strategies to increase participation among male coal miners. Setting: Coal mine located in rural Southern Illinois. Subjects: Ninety-seven percent of employees are men (311/321). The age range of the nearly all male population at the coal mine is 20 to 67. The 18 members of the focus group represent the demographics of the mine as a whole. Measures: Objective outcome is measured by dividing the number who have had a health risk assessment by the number of eligible employees. Anticipated Outcome: The use of strategies based on coal miners’ voiced barriers and facilitators to HRA participation will lead to an increase in HRA participation rates from 58% in 2010 to 75% in 2011 Data Supported Outcome: The focus groups demonstrated need and desire for a change in the current HRA program however; the implemented strategies did not lead to an increase in attendance as revealed by the data. Evaluation: Despite identification of barriers and facilitators during FGDs attendance remained the same as the previous year. A multitude of reasons for the lack of increase in participation are noted by the investigator including employee turnover, change in management, conflicting events, and the lack of paid time for participating employees. Keywords: coal miners, men’s health, focus group discussions, health risk assessments, facilitators and barriers to participation.