Diffusion of Diffusion of InnovationsInnovations

Gerontology 820Gerontology 820

Ashley WaldochAshley Waldoch

October 18, 2010 October 18, 2010

OutlineOutline

IntroductionIntroduction Key ConceptsKey Concepts Stages of the Diffusion ProcessStages of the Diffusion Process Variables Affecting DiffusionVariables Affecting Diffusion Application to Health Behaviour and Health Application to Health Behaviour and Health

PromotionPromotion Application to AgingApplication to Aging

The Spread of Diabetes Prevention Programs from The Spread of Diabetes Prevention Programs from Finland to Australia Finland to Australia

Limitations Limitations Future ChallengesFuture Challenges

IntroductionIntroduction

There is a lag between the discovery of proven There is a lag between the discovery of proven concepts and programs and their concepts and programs and their implementation.implementation.

Example- Example- 1601- citrus juice demonstrated to prevent scurvy1601- citrus juice demonstrated to prevent scurvy 1795- The British navy introduces citrus juice into 1795- The British navy introduces citrus juice into

sailor’s dietssailor’s diets This chapter asks why some innovations diffuse This chapter asks why some innovations diffuse

quickly and widely, whereas others are weakly quickly and widely, whereas others are weakly or never adopted, and others are adopted but or never adopted, and others are adopted but subsequently abandoned?subsequently abandoned?

Key ConceptsKey Concepts

Diffusion- Diffusion- the overall spread of an innovation or the the overall spread of an innovation or the process by which an innovation is communicated process by which an innovation is communicated through certain channels over time among the members through certain channels over time among the members of a social systemof a social system

Dissemination-Dissemination- the planned, systematic efforts the planned, systematic efforts designed to make a program or innovation more widely designed to make a program or innovation more widely available.available.

Innovation- Innovation- an idea, practice, or object that is an idea, practice, or object that is perceived as new by an individual perceived as new by an individual

Communication Channels- Communication Channels- means by which means by which messages are spread, including mass media, messages are spread, including mass media, interpersonal channels, and electronic communicationsinterpersonal channels, and electronic communications

The Spread of InnovationsThe Spread of InnovationsA ContinuumA Continuum

Passive DiffusionPassive Diffusion The spread is unplanned and informalThe spread is unplanned and informal Mediated horizontally by peers and social Mediated horizontally by peers and social

networksnetworks Active DisseminationActive Dissemination

The spread is planned, formal, and The spread is planned, formal, and centralizedcentralized

Occurs through vertical hierarchiesOccurs through vertical hierarchies

Stages of the Diffusion Stages of the Diffusion ProcessProcess

Stage 1: Innovation DevelopmentStage 1: Innovation Development

Stage 2: Dissemination Stage 2: Dissemination

Stage 3: AdoptionStage 3: Adoption

Stage 4: ImplementationStage 4: Implementation

Stage 5: Maintenance Stage 5: Maintenance

Stage 6: SustainabilityStage 6: Sustainability

Stage 7: InstitutionalizationStage 7: Institutionalization

Stage 1: Innovation Stage 1: Innovation DevelopmentDevelopment

Social marketing used to Social marketing used to Design, target, refine, and implement health Design, target, refine, and implement health

promotion innovations promotion innovations

Stage 2: DisseminationStage 2: Dissemination

Planning to persuade target groups to Planning to persuade target groups to adopt an innovationadopt an innovation

The innovation must be The innovation must be Developed with the target population in mindDeveloped with the target population in mind Appropriate to the intended settingsAppropriate to the intended settings

Stage 3: AdoptionStage 3: Adoption

The decision to adopt is influenced by:The decision to adopt is influenced by: Awareness KnowledgeAwareness Knowledge Procedural KnowledgeProcedural Knowledge Principles KnowledgePrinciples Knowledge

Must know that the innovation exists, how Must know that the innovation exists, how to use it, and understand how it worksto use it, and understand how it works

Also requires attitude changeAlso requires attitude change

Stage 4: ImplementationStage 4: Implementation

Ask…Ask… What problems might arise?What problems might arise? What resources are available?What resources are available?

Research focus on…Research focus on… Improving the self-efficacy and skills of the Improving the self-efficacy and skills of the

adoptersadopters Trial of innovation Trial of innovation

Stages 5 & 6: Stages 5 & 6: Maintenance and Maintenance and

Sustainability Sustainability Continued use of the planContinued use of the plan

The capacity of the innovation to endure The capacity of the innovation to endure for an extended period of timefor an extended period of time

Stage 7: InstitutionalizationStage 7: Institutionalization

The innovation becomes cemented into The innovation becomes cemented into communities, organizations, or other communities, organizations, or other settings.settings.

An innovation may be sustained for a An innovation may be sustained for a period of time but never institutionalized.period of time but never institutionalized.

Variables Affecting DiffusionVariables Affecting Diffusion

Characteristics of the InnovationCharacteristics of the Innovation Characteristics of the IndividualsCharacteristics of the Individuals Features of the SettingFeatures of the Setting

Characteristics of the Characteristics of the InnovationInnovation

Innovations should…Innovations should… have a have a Relative AdvantageRelative Advantage be be CompatibleCompatible with adopters’ values, norms, needs with adopters’ values, norms, needs are not too are not too ComplexComplex encourage encourage TrialabilityTrialability or experimentation or experimentation have benefits that are have benefits that are ObservableObservable or visible or visible

These are more easily adopted and quickly These are more easily adopted and quickly diffused. diffused.

Characteristics of the Characteristics of the IndividualsIndividuals

5 Adopter Categories5 Adopter Categories InnovatorsInnovators Early AdoptersEarly Adopters Early Majority AdoptersEarly Majority Adopters Late Majority AdoptersLate Majority Adopters LaggardsLaggards

Features of the SettingFeatures of the Setting

Geographical settingsGeographical settings Societal cultureSocietal culture Political conditionsPolitical conditions Globalization and uniformityGlobalization and uniformity

Application to Health Behaviour Application to Health Behaviour and Health Promotionand Health Promotion

Diffusion of effective programs and ideas is a Diffusion of effective programs and ideas is a significant challenge for health promotion.significant challenge for health promotion.

The Knowledge-Practice GapThe Knowledge-Practice Gap Failure to use research findings in real world Failure to use research findings in real world

practice of health and medicinepractice of health and medicine Need linking agents Need linking agents

Social and Political settings are especially Social and Political settings are especially important in the diffusion of health behaviour important in the diffusion of health behaviour innovationsinnovations Example- DARE and Needle Exchange ProgramsExample- DARE and Needle Exchange Programs

Maximize the FitMaximize the Fit

Between the attributes of the innovation, Between the attributes of the innovation, the adopting individual or organization, the adopting individual or organization, and the environment or context.and the environment or context.

Application to AgingApplication to Aging

The spread of diabetes prevention The spread of diabetes prevention programs from Finland to Australiaprograms from Finland to Australia

Efficacy trials demonstrate that lifestyle Efficacy trials demonstrate that lifestyle modification can contribute to a significant modification can contribute to a significant reduction in diabetes risk.reduction in diabetes risk.

But the trials have been focused on But the trials have been focused on individual counseling, which limits the individual counseling, which limits the spread of interventions to a wider spread of interventions to a wider audience or other health care systems. audience or other health care systems.

GOAL in FinlandGOAL in Finland Study- real world evaluation of a group based Study- real world evaluation of a group based

lifestyle change counseling program to prevent lifestyle change counseling program to prevent type 2 diabetes type 2 diabetes

Program was adapted from the Finish Diabetes Program was adapted from the Finish Diabetes Prevention StudyPrevention Study

Based on Social Cognitive Theory Based on Social Cognitive Theory Included municipalities, regional, and local Included municipalities, regional, and local

health care organizations as the organizational health care organizations as the organizational usersusers

Compared results of the GOAL implementation Compared results of the GOAL implementation trial to the original DPS efficacy trialtrial to the original DPS efficacy trial

Diabetes Prevention Program Diabetes Prevention Program (DPP) in Australia(DPP) in Australia

DPP was adapted from the GOAL programDPP was adapted from the GOAL program Result of collaboration between researchers in Result of collaboration between researchers in

Finnish Public Health Institute and an Australian Finnish Public Health Institute and an Australian UniversityUniversity

In order to “Maximize the Fit” to Australia In order to “Maximize the Fit” to Australia Language and cultural translationLanguage and cultural translation Change the program so that it aligns with the Australian Change the program so that it aligns with the Australian

national physical activity and dietary guidelinesnational physical activity and dietary guidelines The “key feature of this program, which facilitated The “key feature of this program, which facilitated

the relatively quick transfer and adoption of the the relatively quick transfer and adoption of the program between Finland and Australia, was the program between Finland and Australia, was the extensive interaction between research and extensive interaction between research and program leaders from both countries” (p.328).program leaders from both countries” (p.328).

Limitations Limitations

Pro-Innovation BiasPro-Innovation Bias Perpetuates the individual blame biasPerpetuates the individual blame bias Difficult to balance the complexity, Difficult to balance the complexity,

specificity, and feasibility of diffusion specificity, and feasibility of diffusion theory, research, and practicetheory, research, and practice

Future ChallengesFuture Challenges

Need to systematize the dissemination Need to systematize the dissemination processesprocesses

Diffusion study design and measurement Diffusion study design and measurement issues need to be more systematicissues need to be more systematic

New ICTs will improve opportunities for New ICTs will improve opportunities for program dissemination and sharing of program dissemination and sharing of research tools.research tools.