Diffusion of the D.A.R.E and Syringe Exchange Programs

University of Akron, Akron, Ohio, United States
American Journal of Public Health (Impact Factor: 4.55). 09/2006; 96(8):1354-8. DOI: 10.2105/AJPH.2004.060152
Source: PubMed


We examined the diffusion of the D.A.R.E program to reduce use of illicit drugs among school-aged children and youths and the diffusion of syringe exchange programs to reduce HIV transmission among injection drug users. The D.A.R.E program was diffused widely in the United States despite a lack of evidence for its effectiveness; there has been limited diffusion of syringe exchange in the United States, despite extensive scientific evidence for its effectiveness. Multiple possible associations between diffusion and evidence of effectiveness exist, from widespread diffusion without evidence of effectiveness to limited diffusion with strong evidence of effectiveness. The decision theory concepts of framing and loss aversion may be useful for further research on the diffusion of public health innovations.

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Available from: Don C Des Jarlais
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    • "These include understanding how physicians adopt a new drug or evidence-based medical practice, how public health officers adopt a new policy, how health professionals intervene on heart disease risk factors, and how health organizations adopt new administrative practices (Green 2008). Examples of some successful public health innovations (Greenberg 2006) include: Alcohol bans for people who are underage (Blocker 2006), syringe exchange programs among injection drug users (Des Jarlais et al. 2006), family planning programs, immunization campaigns (both, Sharma and Kanekar 2014), the role of vitamin D in cancer prevention (Garland et al. 2006), clean indoor air legislation (Abrams et al. 2006), and conducting HIA in the industrial sector (Dannenberg et al. 2006). Use of DoI theory is not always compatible with health innovations as it can sometimes be difficult to apply to preventive innovations because the rewards from preventive innovations are usually delayed (Hahma et al. 2011). "
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    ABSTRACT: This paper looks into the applicability of diffusion of innovation (DoI) theory and the implementation of a Health Impact Assessment (HIA) approach, focusing mainly on the resource extraction sector in low- and middle-income countries (LMICs). The paper begins with a review of DoI theory and discusses how HIA adoption in a LMIC context might be understood from the perspective of DoI theory. It then asks whether knowledge translation theories and approaches might be relevant to DoI, and if so, how. Based on the findings of the literature review and practical applications of DoI theory in HIA implementation, this paper is concluded by arguing that DoI is useful as an overarching theoretical framework to plan and implement adoption strategies and activities, to identify potential challenges.
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