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Work-related stress in small and medium-sized enterprises (SMEs) is an increasing problem. However, knowledge regarding organizational-level interventions in SMEs is limited, and SMEs often lack professional facilitator resources to assist in change processes. An intervention program developed for large corporations, the PoWRS (Prevention of Work-Related Stress) program, has been modified to fit the conditions in SMEs, i.e., appointing employees as in-house facilitators. The aim of this paper is to examine the enablers and inhibiting factors of the PoWRS program when applied in four Danish SMEs. Three out of four of the case companies succeeded in implementing the program. The enablers and inhibiting factors related to three themes: persons and roles, program components, and organizational context. Findings show that the primary enabling factors were the in-house employee facilitators and the …