Evolution of Diffusion and Dissemination Theory

Center for Dissemination and Implementation Research, Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver CO 80237, USA.
Journal of public health management and practice: JPHMP (Impact Factor: 1.47). 03/2008; 14(2):99-108. DOI: 10.1097/01.PHH.0000311886.98627.b7
Source: PubMed


The article provides a review and considers how the diffusion of innovations Research paradigm has changed, and offers suggestions for the further development of this theory of social change. Main emphases of diffusion Research studies are compared over time, with special attention to applications of diffusion theory-based concepts as types of dissemination science. A considerable degree of paradigmatic evolution is observed. The classical diffusion model focused on adopter innovativeness, individuals as the locus of decision, communication channels, and adoption as the primary outcome measures in post hoc observational study designs. The diffusion systems in question were centralized, with fidelity of implementation often assumed. Current dissemination Research and practice is better characterized by tests of interventions that operationalize one or more diffusion theory-based concepts and concepts from other change approaches, involve complex organizations as the units of adoption, and focus on implementation issues. Foment characterizes dissemination and implementation Research, Reflecting both its interdisciplinary Roots and the imperative of spreading evidence-based innovations as a basis for a new paradigm of translational studies of dissemination science.

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Available from: James Dearing, Jun 20, 2014
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    • "Theory and research on the fidelity of implementation has evolved from a notion of assumed fidelity (Dearing, 2008) to a more robust implementation science, affirming the growing recognition of the need to move from multiple definitions and approaches (Nelson, Cordray, Hulleman, Darrow, & Sommer, 2012; O'Donnell, 2008) to a more unified, systematic evaluation framework, with compromised agreement on a common definition; standard, reliable, and valid measurements ; and analyses of the links between fidelity and student outcomes (O'Donnell, 2008) that can account for the complexity of fidelity measurement (Burns, Peters, & Noell, 2008; Vartuli & Rohs, 2009) and the mediating and moderating effects of student (Raudenbush, 2007) and teacher (Achinstein & Ogawa, 2006) characteristics. Recently there has been an emphasis on the a priori identification of and subsequent measurement of fidelity to the unique and critical components of the intervention (Darrow, 2013; Nelson et al., 2012; O'Donnell, 2008; Shapley, Sheehan, Maloney, & Caranikas-Walker, 2010), with the understanding that evaluation theory is guided by program theory (Donaldson & Lipsey, 2006), which guides the determination of core components (O'Donnell, 2008). "
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    ABSTRACT: Publication details, including instructions for authors and subscription information: Research Findings: We evaluated the fidelity of implementation and the sustainability of effects of a research-based model for scaling up educational interventions. The model was implemented by 64 teachers in 26 schools in 2 distal city districts serving low-resource communities, with schools randomly assigned to condition. Practice or Policy: Although a logical expectation would be that, after the cessation of external support and professional development provided by the intervention, teachers would show a pattern of decreasing levels of fidelity, these teachers actually demonstrated increasing levels of fidelity, continuing to demonstrate high levels of sustained fidelity in their implementation of the underlying curriculum 2 years past exposure. Different profiles of variables predicted separate aspects of sustainability.
    Full-text · Article · Mar 2015 · Early Education and Development
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    • "Factors include the features of an innovation such as its simplicity, comparative advantage and whether benefits can be observed (Fajans et al 2006; WHO and ExpandNet 2009, 2010 and 2011; Simmons et al 2010). The characteristics, needs and attitudes of potential adopters -the 'receiving environment' – influence their willingness or ability to accept new practices or technologies, and 'change agents' such as policy champions and community opinion leaders can influence government adoption, and community acceptance of an innovation (Ryan and Gross 1943; Rogers 1962; Greenhalgh et al 2004; Fajans et al 2006; Cooley and Kohl 2006; Dearing 2008; WHO and ExpandNet 2009, 2010 and 2011; Linn et al 2010; Simmons et al 2010; Yamey 2011; Bradley et al 2012). The political, economic and social contexts within which innovations are introduced are important. "
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    ABSTRACT: Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development partners, civil society organisations and externally funded implementers, professional associations and academic institutions in 2012/13 to explore scale-up of innovative interventions targeting mothers and newborns in Ethiopia, the Indian state of Uttar Pradesh and the six states of northeast Nigeria, which are settings with high burdens of maternal and neonatal mortality. Interviews were analysed using a common analytic framework developed for cross-country comparison and themes were coded using Nvivo. We found that programme implementers across the three settings require multiple steps to catalyse scale-up. Advocating for government to adopt and finance health innovations requires: designing scalable innovations; embedding scale-up in programme design and allocating time and resources; building implementer capacity to catalyse scale-up; adopting effective approaches to advocacy; presenting strong evidence to support government decision making; involving government in programme design; invoking policy champions and networks; strengthening harmonisation among external programmes; aligning innovations with health systems and priorities. Other steps include: supporting government to develop policies and programmes and strengthening health systems and staff; promoting community uptake by involving media, community leaders, mobilisation teams and role models. We conclude that scale-up has no magic bullet solution – implementers must embrace multiple activities, and require substantial support from donors and governments in doing so.
    Full-text · Article · Sep 2014 · Social Science & Medicine
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    • "In other fields of social change research, key individuals are seen as performing important mediating roles in communicating innovative ideas and practices. The specific role of opinion leaders in assisting the diffusion of novel products and processes, for example, has been demonstrated in fields such as community health (Kelly et al. 1991, Locock et al. 2001, Hornik 2002, Dearing 2008, Nisbet and Kotcher 2009), sustainable practices in agriculture (Feder and Savastano 2006), and sustainable technologies (Moser and Mosler 2008). In the climate change policy sphere, the part played by some influential individuals (albeit supported by corporate interests) has proven instrumental in undermining public acceptance of the need for collective action, particularly to reduce greenhouse gas emissions (Oreskes and Conway 2010). "
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    ABSTRACT: he contribution of the informal community sector to the development of collective response strategies to socioecological change is not well researched. In this article, we examine the role of community opinion leaders in developing and mobilising stocks of adaptive capacity. In so doing, we reveal a largely unexplored mechanism for building on latent social capital and associated networks that have the potential to transcend local-scale efforts – an enduring question in climate change adaptation and other cross-scalar sustainability issues. Participants drawn from diverse spheres of community activity in the Sunshine Coast, Australia, were interviewed about their strategies for influencing their community objectives and the degree to which they have engaged with responding to climate change. The results show community opinion leaders to be politically engaged through rich bridging connections with other community organisations, and vertically with policy-makers at local, state, national and international levels. Despite this latent potential, the majority of community opinion leaders interviewed were not strategically engaged with responding to climate change. This finding suggests that more work is needed to connect networks knowledgeable about projected climate change impacts with local networks of community opinion leaders. Attention to the type of community-based strategies considered effective and appropriate by community opinion leaders and their organisations also suggests avenues for policy-makers to facilitate community engagement in responding to climate change across sectors likely to be affected by its impacts. Opportunities to extend understanding of adaptive capacity within the community sector through further research are also suggested.
    Full-text · Article · May 2014 · Local Environment
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