Performance according to standards is the cornerstone of quality assurance in healthcare and the end result inspiring many quality assurance activities. However, even when locally appropriate, evidence-based standards are available, many health workers do not routinely follow them. Motivating and enabling health workers to perform in accordance with standards is deterred by many factors-behavioral, social, and organizational-as well as the nature of healthcare activities and their setting. This paper reviews several theoretical perspectives to increase understanding of the key determinants of health worker performance, including theories of behavior change, diffusion of innovation, health education, and social influence. The main types of interventions that have been used to encourage health workers to perform in accordance with standards are described, and evidence from empirical research for their effectiveness is summarized. (excerpt)