The objective of this study was to identify contextual factors influencing the degree of integration of the ecological approach in disease prevention and health promotion (DPHP) programming initiatives for older adults in two public health organizations in Québec, Canada. A case study design was used and two organizations presenting contrasting profiles in the degree of integration of the approach in their DPHP programming for older adults were selected. Face-to-face interviews with professionals and managers and archival analysis were conducted. Several factors emerged as constraining the integration of the approach in both organizations, including the lack of data showing the effectiveness of DPHP interventions for older adults and the presence of macro-contextual political factors at odds with the ideology of DPHP. Resources and partnerships with academic milieus emerged as key factors distinguishing the two organizations. These results provide increased understanding of conditions required for planning DPHP programs for older adults.
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