ABSTRACTS

Volume 9, Supplement
June 2004

Vol. 9, Supplement: Contents | Editorial | Abstracts

Forty Years of Diffusion of Innovations: Utility and Value in Public Health
    MUHIUDDIN HAIDER A1, GARY L. KREPS A2

A1 Department of Global Health, The George Washington University School of Public Health and Health Services, Washington, DC, USA
A2 Health Communication and Informatics Research Branch, National Cancer Institute, Bethesda, Maryland, USA

This special issue is created to mark the 40th anniversary of Everett Rogers' Diffusion of Innovations (DOI) model. Diffusion is the process through which an innovation, defined as an idea perceived as new, spreads via certain communication channels over time among the members of a particular social system. A great deal of research in a variety of academic disciplines (about 5000 published studies so far) has been conducted on the diffusion of innovations over the past six decades. The areas of application for these studies range from hybrid seed corn to modern math, to the snowmobile to antibiotic drugs, to HIV/AIDS prevention (Rogers, 1995). These investigations have led to a general model of the diffusion of innovations, which can be applied to the recent spread of the Internet or to any other new idea. Everett Roger's ground-breaking model has contributed to a greater understanding of behavioral change, including the variation in rates of adoption of innovations, and it has held a broad scope of practical applications in the field of public health.

A Prospective and Retrospective Look at the Diffusion Model
     EVERETT M. ROGERS A1

A1 Department of Communication and Journalism, University of New Mexico, Albuquerque, New Mexico, USA

In this article we discuss how the diffusion model originally was created, some of the most important ways in which it has evolved over the past 30 years, and its future prospects.

Improving the State of Health Programming by Using Diffusion Theory
     JAMES W. DEARING A1

A1 School of Communication Studies, Ohio University, Athens, Ohio, USA

Year by year, the gaps between what is known about behavior change and what is actually practiced in social programs grow larger, especially for community-based programs intended to help minority populations, the poor, and those living in inner-city and rural areas. Internationally, such gaps between the state of knowledge and the state of practice lead to disparities in health, education, and development among societal groups, demographic sub-populations, communities, and countries. Data about disparities are used as evidence of inequality.

Here, I discuss uses of certain diffusion of innovation theory-based concepts to systematically redress problems of inequality and disparity by reducing the differences between evidence and practice in social programs that are implemented by intermediaries (practitioners) and communicated by them to needy populations. The emphasis here is on the integrated application of knowledge about innovation attributes, opinion leadership, and clustering from diffusion theory to achieve the objective of more extensive and more rapid diffusion of especially effective programs. A set of implementation steps are offered for researchers, funders of international health programs, and the intermediaries who implement health programs.

From Innovation to Social Norm: Bounded Normative Influence
     D.LAWRENCE KINCAID A1

A1 Center for Communication Programs, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland

Correction: Every innovation begins as a deviation from existing social norms. Given the strong effect of social norms and pressure, how can any innovation ever diffuse to the point where it becomes a new social norm? The seeming paradox of how a minority can influence the majority has not been explained well by prevailing social science theory. Computer simulations of the diffusion of a new behavior within the social network of a Bangladesh village led to the discovery of a new principle of social change that resolves this paradox. The results revealed the important but overlooked role played by boundaries that emerge within a social network and how such local boundaries affect the creation of a new social norm. A minority position can become the social norm by means of the process of bounded normative influence. As long as a minority maintains its majority status within its own, locally bounded portion of the network, then it can survive, recruit converts in the near surround, and establish its behavior as the norm for the netwrok as a whole. The process is accelerated when the minority subgroup is centrally located in the network and communicates more frequently and persuasively than the majority.

Diffusion Methodology: Time to Innovate?
     GARY MEYER A1

A1 College of Communication, Marquette University, Milwaukee, Wisconsin, USA

Over the past 60 years, thousands of diffusion studies have been conducted in numerous disciplines of study including sociology, education, communication, marketing, and pubic health. With few exceptions, these studies have been driven by a methodological approach that has become institutionalized in diffusion research. This approach is characterized by the collection of quantitative data about one innovation gathered from adopters at a single point in time after widespread diffusion has occurred. This dominant approach is examined here in terms of both its strengths and weaknesses and with regard to its contribution to the collective base of understanding the diffusion of innovations. Alternative methodological approaches are proposed and reviewed with consideration for the means by which they may expand the knowledge base.

A Meta-Analysis of the Effect of Mediated Health Communication Campaigns on Behavior Change in the United States
     LESLIE B. SNYDER A1, MARK A. HAMILTON A1, ELIZABETH W. MITCHELL A2, JAMES KIWANUKA-TONDO A3, FRAN FLEMING-MILICI A4, DWAYNE PROCTOR A5

A1 Department of Communication Sciences, University of Connecticut, Storrs, Connecticut, USA
A2 Campbell University, Buies Creek, North Carolina, USA
A3 North Carolina State University, Raleigh, North Carolina, USA
A4 University of Connecticut, Storrs, Connecticut, USA
A5 Robert Wood Johnson Foundation, Princeton, New Jersey, USA

A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior: r¥=.15 for seat belt use, r¥=.13 for oral health, r¥=.09 for alcohol use reduction, r¥=.05 for heart disease prevention, r¥=.05 for smoking, r¥=.04 for mammography and cervical cancer screening, and r¥=.04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size.

Expanding the Reach of Health Campaigns: Community Organizations as Meta-Channels for the Dissemination of Health Information
     KERI K. STEPHENS A1, RAJIV N. RIMAL A2, JUNE A. FLORA A3

A1 Department of Communication Studies, University of Texas, Austin, Texas, USA
A2 Department of Health Policy & Management, The Johns Hopkins University, Baltimore, Maryland, USA
A3 Palo Alto, California, USA

This study investigates whether, and to what extent, community organizations can serve as viable channels of health information. We use Putnam's (2000) findings on social capital to argue that organizations can serve two major functions in health campaigns: instrumental (e.g., providing material support) and affinity (social support). Through a secondary analysis of data from the Stanford Five-City Project, we find significant support for our predictions about who joins community organizations. Membership in community organizations explains greater variance in health outcomes than that explained by general media use, demographic indicators, and health-specific media use. Implications for health campaigns are discussed.

Diffusion of Innovations and HIV/AIDS
     JANE T. BERTRAND A1

A1 Bloomberg School of Public Health, Center for Communication Programs, Johns Hopkins University, Baltimore, Maryland, USA

As the HIV/AIDS epidemic continues its relentless spread in many parts of the world, DOI provides a useful framework for analyzing the difficulties in achieving behavior change necessary to reduce HIV rates. The DOI concepts most relevant to this question include communication channels, the innovation-decision process, homophily, the attributes of the innovation, adopter categories, and opinion leaders. The preventive measures needed to halt the transmission of HIV constitute a "preventive innovation." This article describes the attributes of this preventive innovation in terms of relative advantage, compatibility, complexity, trialability, and observability. It reviews studies that incorporated DOI into HIV/AIDS behavior change interventions, both in Western countries and in the developing world. Finally, it discusses possible reasons that the use of DOI has been fairly limited to date in HIV/AIDS prevention interventions in developing countries.

Diffusion of Innovations: Family Planning in Developing Countries
     ELAINE MURPHY A1

A1 Department of Global Health, School of Public Health & Health Services, The George Washington University, Washington, D.C., USA

One of the best examples of the validity of the theory of "diffusion of innovations" is the case of family planning in developing countries. The desire of health, development and environment advocates in rich countries to make modern contraceptive use and lower fertility a norm in developing countries was translated into organized efforts to reach top-level leaders in these countries. Once on board, these high-level leaders cooperated with bilateral and international funding agencies as well as private foundations to develop mass media and community education campaigns, while simultaneously setting up clinic infrastructure; training doctors, nurses and outreach workers; and developing a new and varied "cafeteria" of modern methods. Over the intervening decades, this innovation was indeed diffused and became a norm, but not without its controversies and missed opportunities.

Diffusion of Innovations: A World Tour
     KRISS BARKER A1

A1 Population Media Center Shelburne, Vermont, USA

This contribution to the 40th Anniversary celebration of the Diffusion of Innovations Theory discusses three health communication projects which applied the tenets of Diffusion of Innovation Theory with differing results:

Using voodoo practitioners to pave the way for HIV/AIDS education in Haiti.

A food-based approach to improving Vitamin A nutrition in Nepal.

Diffusion at the horizon of life: The difficulties of communicating reproductive health to youth in Mali.

The article illustrates a spectrum of circumstances in which diffusion theory has been applied, in order to show the application of the theory with different populations or target groups, in different sectors, and in different regions of the world.

Ev Rogers: Helping to Build a Modern Synthesis of Social Change
     WILLIAM SMITH A1

A1 Executive Vice President, Academy for Educational Development, Washington, DC, USA

This article does not have an abstract.

Some Reflections on Diffusion Theory and the Role of Everett Rogers
    ROBERT HORNIK A1

A1 Wilbur Schramm Professor of Communication and Health Policy, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA

This article does not have an abstract.

Everett Rogers' Diffusion of Innovations Theory: Its Utility and Valuein Public Health
     STEPHEN F. MOSELEY A1

A1 President and Chief Executive Officer, Academy for Educational Development

This article does not have an abstract.