The digital transformation process is a critical yet challenging endeavor in shaping the digital future in the public health sector. It involves thousands of employees in the public health sector faced with the choice of embracing or resisting transformation. The collective impact of this choice holds enormous potential to accelerate transformation or erect barriers. We seek to understand the factors that contribute to resistance and acceptance among individuals by employing Rogers' diffusion of innovation theory. We conducted 40 interviews over two years in German public health institutions and contributed 33 factors that shed light on acceptance and resistance to digital transformation. As the importance of digitalization in the public health sector continues to grow, our research provides valuable insights to facilitate the acceptance of digital innovations.