Diffusion of Innovation (DOI) Theory

Historically, research on the diffusion of innovations evolved from rural sociology. For example, in the early 1940s, Bryce Ryan and Neal C. Gross investigated the relative rapid diffusion of hybrid seed corn in two Iowa communities: They found that by 1941, about thirteen years after its release by agricultural researchers, this innovation was adopted by almost 100 percent of Iowa farmers! They wanted to understand this phenomenon so that it might be applied to the diffusion of other farm innovations. Since that time, the diffusion model has been applied in a wide variety of disciplines, including public health, education, communication, marketing, geography, sociology, and economics. In the 1960s, public health professionals in the United States and other nations began to use the diffusion model for health education and other health promotion programs. Successful examples of its application include:

• Use of Oral Rehydration Therapy (child health - prevents dehydration from diarrheal disease)
• Condom use for HIV/AIDS prevention

DOI Theory provides an explanation for how new ideas, products and social practices diffuse or spread through certain channels over time within a society or from one society to another.

The emphasis is on dissemination of a new behavior or technology:

• Innovation=technology or behavior
• Diffusion=process by which innovation is communicated

Pattern of health innovation adoption

Rogers (1985) described the process of innovation adoption as a normal, bell-shaped curve. As can be seen in Figure 1, time is an important element in this diffusion process. Five adopter categories are used to classify members of a social system on the basis of their innovativeness:

• Innovators: active information seekers of new ideas
• Early adopters: very interested in the innovation but not the first to sign up
• Early majority adopters: need external motivation to get involved
• Late majority adopters: are skeptics and will not adopt an innovation until most people in the social system have done so
• Laggards: Last to become involved

Identifying these groups within a target population can help you in planning different dissemination strategies for each. If, for example, you are trying to get restaurant chefs to adopt new, low-fat food, whom are you going to target first? If your preliminary research suggests that the innovators and early adopters might be up-and-coming chefs who are trying to make names for themselves, you might very well target those chefs first. After those chefs adopt the new healthy food offerings, you might design a publicity campaign to attract more chefs adopt the new recipes.

Key Processes in DOI

1. Innovation Development - refers to the development of the innovation itself (planning, research, and testing). During this phase, promotional strategies should also be considered.

2. Dissemination - process by which the innovation is communicated. It involves identifying the best communication channels for the diffusion of the innovation (e.g, press releases, workshops and seminars, videos, networking, creating a website, and community announcements). Mass media channels are the most rapid and effective ways to create an awareness/knowledge about an innovation. However, research suggests that interpersonal channels, which involve a face-to-face exchange between two or more people, are more effective in persuadingan individual to adopt a new idea.

3. Adoption - refers to the uptake of the innovation by the target population. The decision to adopt is influenced by three types of knowledge: awareness knowledge (innovation exists), procedural knowledge (how to use), and principles knowledge (understanding how the innovation works)

4. Implementation - initial use of the innovation, focus on improving self-efficacy and skills of adopters.

5. Maintenance - focus on sustainability, keeping adoption of the behavior.

Determinants of the speed and extent of diffusion

There are certain characteristics which are associated with successful diffusion efforts. These attributes of innovations can help to explain the different rates of adoption of innovations by individuals. Some of these include:

• Relative advantage: the level at which an innovation is perceived as better than the idea/behavior/technology it attempts to replace
• Compatibility - the level at which an innovation is viewed as being consistent with the existing values, past experiences and needs of the potential adopters
• Complexity - the level at which an innovation is viewed as difficult to use
• Trialability- the level at which an innovation can be experimented with on a "trial" basis
• Observability - the level at which the results of an innovation can be seen by others
• Reversibility-the level at which the innovation can be discontinued
• Modifiability-the level at which the innovation can be modified over time

Here is an interesting story about a Japanese government s health promotion program. When you read the story, try to answer the following questions:

1. What is the innovation here?
2. How is the innovation diffused?
3. Do you think that the program is going to have significant positive impact on workers health?
4. Any criticism for the program based on DOI theory?

Here is the link to the story (you may need to register at www.nytimes.com to gain full access to the article):
http://www.nytimes.com/2008/06/13/world/asia/13fat.html?em&ex=1213502400&en=c6f2623fbee96495&ei=5087%0A