Background: Given sparse knowledge on dissemination, this study sought to explore key benefits, barriers and contextual factors that are perceived to be important to the adoption and implementation of the "Community Guide's" evidence-based physical activity recommendations. Design: We conducted case studies in two states where extensive adoption and implementation of the Guide's recommendations have occurred and in two states where widespread dissemination has lagged. Interviews (n = 76) were semi-structured and included both quantitative and qualitative methods. Participant perceptions from the following areas were examined: (i) priority of physical activity, (ii) awareness of and ability to define the term "evidence-based approaches" and (iii) awareness, adoption, facilitators, benefits, challenges and barriers to Guide adoption. Results: Key enabling factors among high capacity states included: funds and direction from the Centers for Disease Control and Prevention; leadership support; capable staff; and successful partnerships and collaborations. Restraining forces among low capacity states included: the Guide recommendations being too new; participants being too new to current job; lack of time and training on how to use the Guide recommendations; limited funds and other resources and lack of leadership. Conclusion: To be effective, we must gain an understanding of contextual factors when designing for dissemination.