BACKGROUND In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in‐school physical activity (ISPA) recommendations and state‐level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state‐mandated ISPA policies in the Mississippi Delta. METHODS Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. RESULTS A total of 6 themes were developed. In that, 2 themes addressed participant‐described barriers (primary challenges and interferences and excuses). Three themes highlighted participant‐described facilitators (compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant‐described need to address educating the whole child. CONCLUSIONS There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low‐income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.