Theoretical Developments in Organizational Change: Implications for Implementing Policy and Environmental Strategies for Health Promotion

Many federal and state health promotion initiatives are encouraging policy and environmental change as the most effective way to improve population health. These strategies typically require changing practices and policies within organizations such as schools, worksites or health care settings. Most of the theories in health education and health promotion, however, still focus on psychosocial factors and how they influence individual behavior change. Theoretical development outside of health education may provide some insights into how to understand the organizational change process and how to facilitate organizations to adopt and implement policy and environmental change. The Consolidated Framework for Implementation Research (CFIR) attempts to synthesize existing theories on the implementation of innovations within organizational systems. It identifies five domains that affect such innovations: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and process of implementation. The CFIR will be presented, along with examples of the types of research needed to further test the utility of this model and related theories for understanding and facilitating policy and environmental changes that support health within organizations.