Purpose: To evaluate a dissemination strategy for breast cancer decision aids and determine factors influencing providers' decisions to accept or reject decision aids for treatment of breast cancer. Methods: We offered up to 10 free copies of five decision aids produced by the Foundation for Informed Medical Decision Making to breast centers in four states. The study progressed in two phases. In phase 1, 2004-5, we targeted 50 breast centers in Massachusetts and in phase 2, 2006-7, we targeted 40 breast centers in New Hampshire, Vermont and Rhode Island. We employed Rogers' (1995) theory of diffusion of innovations that outlines five steps for adopting an innovation (1. knowledge of an innovation 2. persuasion, or favorable attitude toward the innovation 3. decision to adopt 4. implementation of innovation and, 5. confirmation, or sustained use of innovation). We used a mix of mailing, fax, email and telephone contacts to interact with centers. We conducted telephone interviews with 12 phase 1 sites 6-12 months after deciding to adopt the decision aids to determine resources and barriers to implementation and sustained use. Results: The rates of success for each step in phase 1 were 1. 86%, 2. 68%, 3. 46%, 4. 20%, 5. 18%. We refined the dissemination process between phases to increase rates and the results to date for phase 2 were: 1. 100%, 2. 83%, 3. 50%, 4. 48%, 5. tbd. The majority of providers had favorable attitudes toward decision aids and about half also indicated a decision to adopt the innovation. Lack of physician involvement and nurses hesitation to delivery programs to some patients limited dissemination at some centers. Conclusion: Breast cancer providers in the community are receptive to decision aid interventions, and these can be translated into the routine practice. Further work is needed to identify resources and barriers to sustained use.