that could influence health status (e.g., work overload, exposure to toxic chemicals). As employees, consumers, customers, clients, and patients, people are influenced by the organizations to which they belong.

Porras (1987) and Porras and Robertson (1992) suggest four major categories of work settings that are targets for change: organizing arrangements, social factors, technology, and physical settings. Organizing arrangements include organizational goals and strategies for progressing toward them, organizational structure (e.g., formal division of labor, authority relationships, lines of communication), policies and procedures (the formal rules that govern the organization), and reward systems. Social factors include management style, informal social networks, and interaction processes (e.g., problem-solving, decision-making, conflict resolution). The technology category includes job design factors, work flow design, and technical systems. Physical settings include spatial configuration, interior design, and physical ambiance factors such as temperature, lighting, and noise. In their original typology, Porras and Robertson (1992) included individual attributes under the social factors umbrella. However, given the emphasis placed on individual beliefs, attitudes, and skills in health behavior research, those individual factors are suggested as a fifth category in the work setting for targeting change interventions.

Organizational Culture and Change

Organizational culture is the base upon which organizational and related individual behavior change occurs. The culture prescribes the “right way” to do things (Schein, 1990). An organizational culture that supports health is likely to adopt policies, procedures, and priorities that facilitate the healthy behaviors of employees; enhance employee health by reducing environmental risk factors; facilitate healthy behavior on the part of clients, customers, or members; and facilitate linkages to other organizations for health-enhancing purposes. The more health-enhancing policies an organization adopts, the more likely it is to be perceived as having a health-conscious culture (Basen-Enquist et al., 1998).

Organizational development (OD) is a set of behavioral-science-based theories, values, strategies, and techniques aimed at planned change in the organizational work setting (Porras and Robertson, 1992). Three important foundations are briefly described here: systems theory, employee participation in change efforts, and action research. Systems theory (Katz and Kahn, 1978) says that a change in one part of the system will influence



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