David B Abrams

Professor of Social and Behavioral Sciences

Professional overview

Dr. David Abrams' career focuses on systems and social learning frameworks to inform population health enhancement. He has experience in testing theory, research design, measuring mechanisms of behavior change and outcome, and evaluating clinical trials (behavioral and pharmacological). His interests span topics from basic bio-behavioral mechanisms and clinical treatments to policy across risk factors and behaviors (e.g. tobacco/nicotine; alcohol, obesity, co-morbidity of medical and mental health), disease states (cancer; cardiovascular; HIV-AIDS), levels (biological, individual, organizational, worksite, community, global, and internet based), populations and disparities. His interests converge in the domain of implementation science to cost-efficiently inform evidence-based public health practice and policymaking.

Through transdisciplinary and translational research strategies, Dr. Abrams provides scientific leadership in tobacco control. His current focus is in strengthening global and United States tobacco and nicotine management strategies. Deaths of 1 billion smokers are estimated by 2100 caused overwhelmingly by use of combustible (smoked) tobacco products, not nicotine. Harm minimization is a key overarching systems strategy to speed the net public health benefit of emergent disruptive technologies for cleaner nicotine delivery. The goal is more rapid elimination of preventable deaths, disease burdens, and the widening gap in health disparities driven disproportionately by disparities in smoking.

Dr. Abrams was a professor and founding director of the Centers for Behavioral and Preventive Medicine at Brown University Medical School. He then directed the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). Until 2017, he was Professor of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health and the founding Executive Director of the Schroeder National Institute of Tobacco Research and Policy Studies at Truth Initiative (formerly the American Legacy Foundation).

Dr. Abrams has published over 250 peer reviewed scholarly articles and been a Principal Investigator on numerous NIH grants. He is lead author of The Tobacco Dependence Treatment Handbook: A Guide to Best Practices. He has served on expert panels at NIH and National Academies of Sciences, Engineering and Medicine on Obesity, Alcohol Misuse and Ending the Tobacco Problem: A Blueprint for the Nation. He has also served on the Board of Scientific Advisors of the National Cancer Institute (NIH-NCI) and was President of the Society of Behavioral Medicine.

For a complete list of Dr. Abrams' published work, click here.

Education

BSc (Hons), Psychology and Computer Science, University of the Witwatersrand, Johannesburg, South Africa

MS, Clinical Psychology, Rutgers University, New Brunswick, NJ

PhD, Clinical Psychology, Rutgers University, New Brunswick, NJ

Postdoctoral Fellow, Brown Medical School, Providence, RI

Honors and awards

Research Laureate Award, American Academy of Health Behavior (2014)

Joseph W. Cullen Memorial Award for Tobacco Research, American Society for Preventive Oncology (2008)

Distinguished Alumni Award: Rutgers University, The Graduate School, New Brunswick, NJ (2007)

The Musiker-Miranda Distinguished Service Award, American Psychological Association (2006)

Distinguished Service Award, Society of Behavioral Medicine (2006)

Outstanding Research Mentor Award, Society of Behavioral Medicine (2006)

Book of the Year Award: Tobacco Dependence Treatment Handbook. American Journal of Nursing (2005)

Distinguished Scientist Award, Society of Behavioral Medicine (1998)

Areas of research and study

Behavioral Science

Chronic Diseases

Evaluations

Implementation and Impact of Public Health Regulations

Implementation science

Population Health

Public Health Pedagogy

Public Health Systems

Research Design

Systems Integration

Systems Interventions

Tobacco Control

Translational science

Publications

Publications

Transdermal clonidine for smoking cessation : A double-blind randomized dose-response study

Abrams, D., Niaura, R. S., Brown, R. A., Goldstein, M. G., Murphy, J. K., & Abrams, D. B. (n.d.).

Publication year

1996

Journal title

Experimental and Clinical Psychopharmacology

Volume

4

Issue

3

Page(s)

285-291

10.1037/1064-1297.4.3.285

Abstract

Abstract

A 4-week trial tested the effects of 4 doses (placebo, 0.1 mg/d, 0.2 mg/d, and 0.3 mg/d) of transdermal clonidine on smoking cessation and nicotine withdrawal. After a 1-week baseline, smokers (N = 72) started the drug and tried to quit by Week 3. Significantly fewer smokers who received a placebo were abstinent at 5 days after quitting as compared with smokers who received clonidine at any dose (19% vs. 57%, respectively, p = .007). Blood clonidine concentration interacted with nicotine dependence (p < .05): High-dependence smokers who achieved higher blood clonidine concentrations survived longer before smoking a cigarette after quitting, as compared with high-dependence smokers who achieved lower blood levels. Changes from baseline in heart rate, blood pressure, appetite, irritability, and anxiety were inversely associated with blood clonidine concentrations.

Treating nicotine dependence: Pharmacologic and behavioral approaches

Niaura, R. S., Abrams, D., Bock, B., Goldstein, M., & Brown, R. (n.d.). (H. Rommelspacher & M. Schuckitt, Eds.).

Publication year

1996

Abstract

Abstract

~

Use of a 24-hour recall diary to assess exposure to environmental tobacco smoke

Abrams, D., Emmons, K. M., Marcus, B. H., Abrams, D. B., Marshall, R., Novotny, T. E., Kane, M. E., & Etzel, R. A. (n.d.).

Publication year

1996

Journal title

Archives of Environmental Health

Volume

51

Issue

2

Page(s)

146-149

10.1080/00039896.1996.9936008

Abstract

Abstract

Methods to assess exposure to environmental tobacco smoke need to be valid and relatively easy to use. We therefore explored the use of a 24-h environmental tobacco smoke exposure-recall diary by comparing data from the 24-h diary with questionnaire responses and levels of salivary cotinine—a biochemical marker of environmental tobacco smoke exposure. A total of 875 nonsmokers at five Rhode Island worksites participated in the study. Twenty-five percent of the participants lived with smokers, and 96% had regular exposure to environmental tobacco smoke at work. Individuals who lived with smokers reported more exposures in the 24-h diary, both outside of work and during work hours, compared with those who had no smokers in their household. The correlation between saliva cotinine concentrations and the exposures recorded in the diary was weak (r =.10). Brief instruments for assessment of environmental tobacco smoke should be viewed cautiously, and use of this 24-h recall diary is not recommended.

Women who work in manufacturing settings : Factors influencing their participation in worksite health promotion programs

Abrams, D., Emmons, K. M., Linnan, L., Abrams, D., & Lovell, H. J. (n.d.).

Publication year

1996

Journal title

Women&#39;s Health Issues

Volume

6

Issue

2

Page(s)

74-81

10.1016/1049-3867(95)00049-6

Abstract

Abstract

~

Work site-based cancer prevention: Primary results from the Working Well Trial

Abrams, D. (n.d.).

Publication year

1996

Journal title

American Journal of Public Health

Volume

86

Page(s)

939-947

Abstract

Abstract

~

Coping and social skills training

Monti, P., Rohsenow, D., Colby, S., & Abrams, D. (n.d.). (R. Hester & W. Miller, Eds.; 2nd ed.).

Publication year

1995

Abstract

Abstract

~

Cue exposure treatment in alcohol dependence

Abrams, D., Rohsenow, D., Monti, P., & Abrams, D. S. (n.d.). (D. Drummond, S. Glautier, B. Remington, & S. Tiffany, Eds.).

Publication year

1995

Page(s)

189-196

Abstract

Abstract

~

Distribution of smokers by stage in three representative samples

Abrams, D., Velicer, W. F., Fava, J. L., Prochaska, J. O., Abrams, D. B., Emmons, K. M., & Pierce, J. P. (n.d.).

Publication year

1995

Journal title

Preventive Medicine

Volume

24

Issue

4

Page(s)

401-411

10.1006/pmed.1995.1065

Abstract

Abstract

Objectives. A key variable for the design of individual and public health interventions for smoking cessation is Stage of Change, a variable which employs past behavior and behavioral intention to characterize an individual′s readiness to change. Reactively recruited samples distort estimates of the stage distribution in the population because such samples attract a disproportionate number of late-stage participants. Three representative samples are described which provide accurate estimates of the stage distribution in the population. These samples are of adequate size to permit within-sample comparisons with respect to sex, age, Hispanic or non-Hispanic origin, race, and education level. The implications of using stage distribution as a tool for planning intervention is discussed. Method. The first sample of 4,144 smokers was from the state of Rhode Island and involved a random-digit-dial survey. The second sample of 9,534 smokers was from the state of California and involved a stratified random-digit-dial survey. The third sample of 4,785 smokers was from a total of 114 worksites located in four different geographic locations. Results. The stage distributions were approximately identical across the three samples, with approximately 40% of the sample in Precontemplation, 40% in Contemplation, and 20% in Preparation. The stage distribution was generally stable across age groups with the exception of the 65 years and older group. Education level did affect the stage distribution with the proportion of the sample in Precontemplation decreasing as education level increased. In all three samples, minor differences in stage distribution were related to Hispanic origin and race, but the pattern was not consistent across the samples. Conclusions. The pattern of stage distribution has important implications for the design of interventions. Existing interventions are most appropriate for the Preparation stage, but the majority of the three samples were in the first two stages, resulting in a likely mismatch between the smoker and the intervention. The stability of distribution across age suggests that interventions that are appropriately matched to stage can be applied across all age groups. The differences found with respect to education, Hispanic origin, and race can serve as a guide to the tailoring of intervention materials.

Division 50 on addictions: Finding synergism with division 38.

Abrams, D., & Abrams, D. S. (n.d.).

Publication year

1995

Journal title

The Health Psychologist

Volume

17

Issue

35

Page(s)

4-5

Abstract

Abstract

~

ETS exposure in the workplace : perceptions and reactions by employees in 114 work sites

Abrams, D., Thompson, B., Emmons, K., Abrams, D. S., Ockene, J. K., & Feng, Z. (n.d.).

Publication year

1995

Journal title

Journal of Occupational and Environmental Medicine

Volume

37

Issue

9

Page(s)

1086-1092

10.1097/00043764-199509000-00009

Abstract

Abstract

Employees are often exposed to and bothered by environmental tobacco smoke (ETS) in the workplace; however, little is known about correlates of workers’perceptions of their exposure. In this study, 20,801 employees in 114 work sites in the United States were surveyed; variables related to perceptions of exposure and being bothered by ETS were entered into regression models. Many of the workplaces had total or partial restrictions on smoking in the workplace; however, over half of the respondents (52.4%) reported they were exposed to ETS at work. Smoking policy, smoking status, age, gender, living with a smoker, and occupation contributed to models for perceived exposure and being bothered by tobacco smoke. Work site smoking restrictions seem to have an impact on employee attitudes concerning exposure to ETS. About 35% of employees were bothered regularly by smokiness at their workplaces, which made their working conditions both uncomfortable and exposed them to an unsafe working environment.

Exercise enhances the maintenance of smoking cessation in women

Abrams, D., Marcus, B. H., Albrecht, A. E., Niaura, R. S., Taylor, E. R., Simkin, L. R., Feder, S. I., Abrams, D. B., & Thompson, P. D. (n.d.).

Publication year

1995

Journal title

Addictive Behaviors

Volume

20

Issue

1

Page(s)

87-92

10.1016/0306-4603(94)00048-4

Abstract

Abstract

We examined the effects of physical exercise on smoking relapse. Twenty previously sedentary female smokers were randomly assigned to smoking cessation plus exercise or smoking cessation with frequency contact control. The smoking cessation program included 12 professionally led sessions over 12 weeks. Exercise treatment included three supervised exercise sessions per week for 15 weeks. Contact control included three women's health/wellness lectures per week for 15 weeks. Smoking abstinence was validated by carbon monoxide and saliva cotinine. Mean exercise attendance for exercise subjects was 88% with an increase in estimated VO2 of 25%. The percentage of subjects who quit for 24 hours was 80% for the exercise and 90% for the contact group. One subject in the contact group remained abstinent at the end of the 12-week treatment and at 1-, 3-, and 12-month follow-ups, whereas three subjects in the exercise group were abstinent at these time points. These results suggest that exercise training improves short-term quit rates and may prove a useful strategy for long-term maintenance of smoking cessation.

Integrating basic, clinical, and public health research for alcohol- tobacco interactions

Abrams, D., & Abrams, D. S. (n.d.). (J. Fertig & J. Allen, Eds.).

Publication year

1995

Abstract

Abstract

~

Interrelationship of smoking and alcohol dependence, use and urges to use

Abrams, D., Gulliver, S. B., Rohsenow, D. J., Colby, S. M., Dey, A. N., Abrams, D. B., Niaura, R. S., & Monti, P. M. (n.d.).

Publication year

1995

Journal title

Journal of Studies on Alcohol

Volume

56

Issue

2

Page(s)

202-206

10.15288/jsa.1995.56.202

Abstract

Abstract

Objective: The relationship between tobacco dependence and alcohol dependence has received little empirical scrutiny. The present study of alcoholics in treatment for alcoholism investigated pretreatment tobacco and alcohol history and dependence, as well as subjective responsivity to alcohol cues. Method: Eighty-three male alcoholics underwent a questionnaire assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues. Results: The analyses demonstrate that (1) pretreatment tobacco dependence and pretreatment alcohol dependence are related, (2) alcohol dependence predicts urges to smoke during alcohol treatment, (3) exposure to alcohol cues results in increased urge to smoke, (4) smoking when ill predicts urge to drink during alcohol cue exposure and (5) urge to smoke is positively correlated with urge to drink. Conclusions: These data, collected in a population of alcoholics not currently receiving smoking interventions, indicate that smoking may be a factor to address during alcohol treatment. The clinical importance of these data is discussed.

Overview of section II: Treatment, early intervention, and policy

Abrams, D., Abrams, D. S., Marlatt, G., & Sobell, M. (n.d.). (J. Fertig & J. Allen, Eds.).

Publication year

1995

Abstract

Abstract

~

Smoking among alcoholics during and after treatment: Implications for models, treatment strategies and policy

Abrams, D., Monti, P., Rohsenow, D., Colby, S., & Abrams, D. S. (n.d.). (J. Fertig & J. Allen, Eds.).

Publication year

1995

Abstract

Abstract

~

The Working Well Trial : Baseline Dietary and Smoking Behaviors of Employees and Related Worksite Characteristics

Abrams, D., Heimendinger, J., Feng, Z., Emmons, K., Stoddard, A., Kinne, S., Biener, L., Sorensen, G., Abrams, D. S., Varnes, J., & Boutwell, B. (n.d.).

Publication year

1995

Journal title

Preventive Medicine

Volume

24

Issue

2

Page(s)

180-193

10.1006/pmed.1995.1032

Abstract

Abstract

Background. The Working Well Trial, the largest randomized worksite health promotion trial to date, tests the effects of cancer prevention and control interventions on dietary and smoking behaviors of employees and the worksite environment. The trial is a 5-year cooperative agreement conducted in 57 matched pairs of worksites in 16 states by four study centers, a coordinating center, and the National Cancer Institute. The dual aims of this paper are to: (a) present a baseline description of the dietary and smoking habits of 20,801 employees, who are predominantly blue-collar workers; and (b) describe the social and physical environments of their worksites that may facilitate or hinder health behavior changes. Methods. The self-administered baseline survey of individuals consisted of a core set of questions common across all study centers on diet and smoking. The organizational survey consisted to eight instruments administered via interviews with key informants in each worksite. Continuous variables were analyzed by a mixed linear model and binary data were analyzed by the Generalized Estimating Equation. Results. The population represented is largely male (67.5%) and blue collar (53.5%). Mean levels of fat and fiber intakes were close to the national averages (36.6% of calories as fat and 13.1 g of fiber). Smoking prevalence (25.2%) was slightly lower than the national average. The worksites had a high level of health promotion activites (42% had nutrition programs, 53% had smoking control programs), but lacked environmental support for dietary behavior change and perceived support for smoking cessation. Conclusions. These findings replicate and extend previous research results to a large sample of diverse, largely blue-collar worksites. In addition the baseline results lay a foundation for the development of new insight into the relationship between individual and organizational level variables that may interact to influence behavioral and cultural norms.

An evaluation of the relationship between self-report and biochemical measures of environmental tobacco smoke exposure

Abrams, D., Emmons, K. M., Abrams, D. B., Marshall, R., Marcus, B. H., Kane, M., Novotny, T. E., & Etzel, R. A. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

35-39

10.1006/pmed.1994.1005

Abstract

Abstract

To evaluate the relationship between self-reported exposure to environmental tobacco smoke and saliva cotinine concentrations, we studied 186 nonsmokers. Each participant completed an exposure questionnaire, kept a daily exposure diary for 7 days, and provided a saliva sample for cotinine analysis. Salivary cotinine concentrations were measured using gas chromatography/mass spectrometry. of the volunteers, 30% lived with one or more smokers, and 84% were regularly exposed to smokers at work. Eighty-three percent of the volunteers had detectable saliva cotinine concentrations (≥0.5 ng/ml) (median = 1.1; range = 0.5-7.4 ng/ml). Cotinine concentrations were related to exposure in the household and at the workplace. Volunteers who lived with smokers had significantly higher cotinine levels (median = 1.0; range =

Behavioral medicine for medical patients

Goldstein, M., Ruggiero, L., Guise, B., & Abrams, D. (n.d.). (A. Stoudemire & B. Vogel, Eds.; 2nd ed.).

Publication year

1994

Abstract

Abstract

~

Bridging research to action : A framework and decision-making process for cancer control

Abrams, D., Fields, A., Best, A., Brisson, J., Engstrom, P., Holowaty, E., Wigle, D., Young, J., Kaegi, E., Beatty, D., Sondik, E., Vayda, E., Iverson, D., Sanson-Fisher, R., Abrams, D., Till, J., & Cameron, R. (n.d.).

Publication year

1994

Journal title

Canadian Medical Association Journal

Volume

151

Issue

8

Page(s)

1141-1146

Abstract

Abstract

~

Cancer control at the workplace : The working well trial

Abrams, D., Abrams, D. S., Boutwell, W. B., Grizzle, J., Heimendinger, J., Sorensen, G., & Varnes, J. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

15-27

10.1006/pmed.1994.1003

Abstract

Abstract

Background. Few research studies have been conducted on cancer prevention and control at the workplace. This article presents an overview of the largest worksite cancer control trial in the United States-The Working Well Trial-conducted in 114 worksites by four study centers, a coordinating center, and the National Cancer Institute. The trial′s organizational structure, research design, dependent measures, and theoretical model for intervention are described. Special features of the trial include using the worksite as the unit of randomization, intervention, and evaluation and a theory-driven conceptual model of intervention that places emphasis on individual and organizational targets for change, uses the transtheoretical stage of change model to guide a sustained 2-year multiple risk factor intervention, and makes use of volunteer resources within the worksite to reduce cost, increase participation, and improve tailoring to individual needs. The trial will have a potential impact on over 25,000 workers. Conclusion. The issues raised in this overview have implications for the evaluation and dissemination of cancer prevention and control programs to defined populations.

Challenges facing behavioral medicine in the 1990's: The development and maintenance of health promotion programs in the private teaching hospital.

Abrams, D. (n.d.).

Publication year

1994

Journal title

The Behavior Therapist

Volume

15

Page(s)

198-201

Abstract

Abstract

~

Cue Reactivity as a Predictor of Drinking Among Male Alcoholics

Abrams, D., Rohsenow, D. J., Monti, P. M., Rubonis, A. V., Sirota, A. D., Niaura, R. S., Colby, S. M., Wunschel, S. M., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Journal of consulting and clinical psychology

Volume

62

Issue

3

Page(s)

620-626

10.1037/0022-006X.62.3.620

Abstract

Abstract

Social learning theories suggest that conditioned responses may increase the risk for relapse. Responses to alcohol use cues (cue reactivity) are associated with variables suggestive of risk but little research exists on the relationship of cue reactivity to treatment outcome. Alcoholic men admitted for detoxification to a treatment program (n = 45) underwent a cue reactivity assessment protocol, and 91% received 3-month follow-up interviews. Greater salivary reactivity predicted greater frequency of drinking during follow-up. Attentional factors added independent variance to the prediction of drinking outcome, with greater attention to stimulus or to response predicting less drinking. Cue reactivity did not predict length of hospital stay or latency to first drink. Results are discussed in the context of information processing, social learning theories, and clinical implications for relapse prevention.

Matching high-dependence and low-dependence smokers to self-help treatment with or without nicotine replacement

Abrams, D., Niaura, R. S., Goldstein, M. G., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

70-77

10.1006/pmed.1994.1010

Abstract

Abstract

Background. This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence. Methods. One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association. Results. Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant. Conclusion. The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.

Mechanisms in Multiple Risk Factor Interventions : Smoking, Physical-Activity, and Dietary-Fat Intake Among Manufacturing Workers

Abrams, D., Emmons, K. M., Marcus, B. H., Linnan, L., Rossi, J. S., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

4

Page(s)

481-489

10.1006/pmed.1994.1066

Abstract

Abstract

Background. Individuals who have multiple poor health behaviors account for a disproportionately large percentage of the preventable U.S. health care cost burden. Understanding the relationships between multiple risk factors is important for the design of both individual and public health interventions. There have been few efforts to examine the cooccurrence of psychosocial and motivational mechanisms that mediate smoking, dietary fat intake, and physical activity in a defined population of blue collar workers. Methods. The sample comprised 1,559 manufacturing workers who participated in a self-help physical activity intervention and who completed a computerized assessment battery about their smoking, dietary fat intake, physical activity, and demographic characteristics. Results. Twenty-six percent of the sample were smokers, 51% did not exercise regularly, and 35% consumed more than an estimated 40% of calories per day from fat. Almost half of the sample was in the later stages of readiness for physical activity and dietary fat intake, compared with only 3% for smoking. Only 12% of the smokers had smoking as their only risk factor. Smokers were significantly more likely to engage in poor dietary and physical activity behaviors, compared with nonsmokers. The relationship among smoking status and the other risk factors was apparent both in terms of dietary fat and physical activity behaviors, as well as mediators such as motivation for change. Lower dietary fat intake was associated with an absence of the other two risk factors. Conclusions. The results suggest that there are important mediating mechanisms both within and among workers with one or more risk factors. Smokers are a particularly important target for health promotion interventions, and it may be possible to make initial contact with them through other health programs at the worksite. The role of other lifestyle changes as a gateway to smoking cessation has not yet been explored, but may have potential for reaching smokers who are very low in their motivational readiness to change. The implications of these findings for research and the design of multiple risk factor interventions are discussed.

Recruitment of work sites to a health promotion research trial implications for generalizability

Abrams, D., Biener, L., DePue, J. D., Emmons, K. M., Linnan, L., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Journal of Occupational Medicine

Volume

36

Issue

6

Page(s)

631-636

Abstract

Abstract

The characteristics of companies that either accepted or declined participation in a 5-year randomized trial of a multirisk factor health promotion intervention were compared to investigate potential limitations on the generalizability of research findings. A representative sample of 151 manufacturing work sites in the northeast was recruited to participate. Sixty-four of the companies were determined to be eligible and 10 others, which refused to have an administrator interviewed, were presumed to be eligible. Of this group, 27 companies agreed to participate. Workforce demographics, shift structure, and prior history of health promotion offerings were not significantly different in the two groups. However, participating companies employed fewer workers and had a more favorable financial outlook than did companies that declined to participate. Implications of these findings for research on work site health promotion are discussed.