Diffusion of Innovations Gerontology 820 Ashley Waldoch October 18, 2010
Outline • Introduction • Key Concepts • Stages of the Diffusion Process • Variables Affecting Diffusion • Application to Health Behaviour and Health Promotion • Application to Aging • The Spread of Diabetes Prevention Programs from Finland to Australia • Limitations • Future Challenges
Introduction • There is a lag between the discovery of proven concepts and programs and their implementation. • Example- • 1601- citrus juice demonstrated to prevent scurvy • 1795- The British navy introduces citrus juice into sailor’s diets • This chapter asks why some innovations diffuse quickly and widely, whereas others are weakly or never adopted, and others are adopted but subsequently abandoned?
Key Concepts • Diffusion- the overall spread of an innovation or the process by which an innovation is communicated through certain channels over time among the members of a social system • Dissemination-the planned, systematic efforts designed to make a program or innovation more widely available. • Innovation- an idea, practice, or object that is perceived as new by an individual • Communication Channels- means by which messages are spread, including mass media, interpersonal channels, and electronic communications
The Spread of InnovationsA Continuum • Passive Diffusion • The spread is unplanned and informal • Mediated horizontally by peers and social networks • Active Dissemination • The spread is planned, formal, and centralized • Occurs through vertical hierarchies
Stages of the Diffusion Process Stage 1: Innovation Development Stage 2: Dissemination Stage 3: Adoption Stage 4: Implementation Stage 5: Maintenance Stage 6: Sustainability Stage 7: Institutionalization
Stage 1: Innovation Development • Social marketing used to • Design, target, refine, and implement health promotion innovations
Stage 2: Dissemination • Planning to persuade target groups to adopt an innovation • The innovation must be • Developed with the target population in mind • Appropriate to the intended settings
Stage 3: Adoption • The decision to adopt is influenced by: • Awareness Knowledge • Procedural Knowledge • Principles Knowledge • Must know that the innovation exists, how to use it, and understand how it works • Also requires attitude change
Stage 4: Implementation • Ask… • What problems might arise? • What resources are available? • Research focus on… • Improving the self-efficacy and skills of the adopters • Trial of innovation
Stages 5 & 6: Maintenance and Sustainability • Continued use of the plan • The capacity of the innovation to endure for an extended period of time
Stage 7: Institutionalization • The innovation becomes cemented into communities, organizations, or other settings. • An innovation may be sustained for a period of time but never institutionalized.
Variables Affecting Diffusion • Characteristics of the Innovation • Characteristics of the Individuals • Features of the Setting
Characteristics of the Innovation • Innovations should… • have a Relative Advantage • be Compatible with adopters’ values, norms, needs • are not too Complex • encourage Trialability or experimentation • have benefits that are Observable or visible • These are more easily adopted and quickly diffused.
Characteristics of the Individuals • 5 Adopter Categories • Innovators • Early Adopters • Early Majority Adopters • Late Majority Adopters • Laggards
Features of the Setting • Geographical settings • Societal culture • Political conditions • Globalization and uniformity
Application to Health Behaviour and Health Promotion • Diffusion of effective programs and ideas is a significant challenge for health promotion. • The Knowledge-Practice Gap • Failure to use research findings in real world practice of health and medicine • Need linking agents • Social and Political settings are especially important in the diffusion of health behaviour innovations • Example- DARE and Needle Exchange Programs
Maximize the Fit • Between the attributes of the innovation, the adopting individual or organization, and the environment or context.
Application to Aging • The spread of diabetes prevention programs from Finland to Australia • Efficacy trials demonstrate that lifestyle modification can contribute to a significant reduction in diabetes risk. • But the trials have been focused on individual counseling, which limits the spread of interventions to a wider audience or other health care systems.
GOAL in Finland • Study- real world evaluation of a group based lifestyle change counseling program to prevent type 2 diabetes • Program was adapted from the Finish Diabetes Prevention Study • Based on Social Cognitive Theory • Included municipalities, regional, and local health care organizations as the organizational users • Compared results of the GOAL implementation trial to the original DPS efficacy trial
Diabetes Prevention Program (DPP) in Australia • DPP was adapted from the GOAL program • Result of collaboration between researchers in Finnish Public Health Institute and an Australian University • In order to “Maximize the Fit” to Australia • Language and cultural translation • Change the program so that it aligns with the Australian national physical activity and dietary guidelines • The “key feature of this program, which facilitated the relatively quick transfer and adoption of the program between Finland and Australia, was the extensive interaction between research and program leaders from both countries” (p.328).
Limitations • Pro-Innovation Bias • Perpetuates the individual blame bias • Difficult to balance the complexity, specificity, and feasibility of diffusion theory, research, and practice
Future Challenges • Need to systematize the dissemination processes • Diffusion study design and measurement issues need to be more systematic • New ICTs will improve opportunities for program dissemination and sharing of research tools.