J Occup Environ Med

ObjectiveTo assess the evidence regarding the adoption and efficacy of worksite health promotion programs (WHPPs) in small businesses.MethodsPeer-reviewed research articles were identified from a database search. Included articles were published before July 2013, described a study that used an experimental or quasiexperimental design and either assessed adoption of WHPPs or conducted interventions in businesses with fewer than 500 employees. A review team scored the study\u2019s rigor using the WHO-adapted GRADEprofiler \u201cquality of evidence\u201d criteria.ResultsOf the 84 retrieved articles, 19 met study inclusion criteria. Of these, only two met criteria for high rigor.ConclusionsFewer small businesses adopt WHPPs compared with large businesses. Two high-rigor studies found that employees were healthier postintervention. Higher quality research is needed to better understand why small businesses rarely adopt wellness programs and to demonstrate the value of such programs.T42 OH009229/OH/NIOSH CDC HHSUnited States