Health Education Research Advance Access published online on May 9, 2008
Health Education Research, doi:10.1093/her/cyn019
Using organization theory to understand the determinants of effective implementation of worksite health promotion programs
1 Department of Health Policy and Administration, CB 7411, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
2 RTI International, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA
3 Department of Health Behavior and Health Education, CB 7440, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Correspondence to: * Correspondence to: B. J. Weiner. E-mail: bryan_weiner{at}unc.edu
The field of worksite health promotion has moved toward the development and testing of comprehensive programs that target health behaviors with interventions operating at multiple levels of influence. Yet, observational and process evaluation studies indicate that such programs are challenging for worksites to implement effectively. Research has identified several organizational factors that promote or inhibit effective implementation of comprehensive worksite health promotion programs. However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs. The model is adapted from theory and research on the implementation of complex innovations in manufacturing, education and health care settings. The article uses the Working Well Trial to illustrate the model's theoretical constructs. Although the article focuses on comprehensive worksite health promotion programs, the conceptual model may also apply to other types of complex health promotion programs. An organization-level theory of the determinants of effective implementation of worksite health promotion programs
Received on October 30, 2007; accepted on March 4, 2008