The diffusion and adoption of worksite health promotion innovations: an analysis of barriers.

While it is estimated that employee health promotion opportunities are made available in half of all large corporations in the United States, the interventions involved vary widely in terms of reported effectiveness, reliability of implementation, overall evaluability, and longterm stability. Providers of these interventions have tended to ignore the concept of "fit" between a particular program and a particular organizational setting into which it is introduced. They have generally underestimated the role that unique corporate structures and decision-making processes can play in determining program adoption and maintenance. This article describes three sets of factors related to effective dissemination and implementation of worksite health promotion innovations: the availability of the innovations, the acceptability of the innovations to the employees and other end users, and the feasibility of the innovations from the perspective of the corporate decision-makers. The role of each of these factors in effective program dissemination and implementation is described, and optimal approaches to worksite health planning, taking these factors into account, is reviewed.