This paper examines factors that facilitate or impede the implementation of heart health activities in Ontario public health departments using survey (n = 262) and depth interview (n = 56) data from Canadian Heart Health Initiative-Ontario Project (CHHIOP). The data were consistent in revealing factors related to leadership, staffing, resources, internal organization, and characteristics of the surrounding community as the primary facilitators or barriers. Diversity within these common themes reflected variation due to external factors in the communities served by the health unit and factors internal to the health unit itself. The findings advance knowledge of the factors that influence predisposition and capacity to undertake community-based heart health promotion in public health departments, and they underscore the challenge of achieving integrated programs among partner agencies.
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