Like fads in fashion, innovative health products and practices can spread like viruses among members of a social system. New things are more apt to be “contagious” if they: (a) are viewed as an improvement over the status quo but compatible with one’s existing lifestyle or setting, (b) are easy to adopt and can be tried out before a permanent commitment is made, (c) have positive consequences that are clear to an observer, (d) are adopted by cool or respected people first, and (e) are publicized through the right channels to the right people at the right points in the change process. For a while, a slowly increasing trickle of people adopts a new practice or product, but then the rate of adoption suddenly skyrockets. In other words, there is a “tipping point” in the rate of adoption of the practice and its penetration beyond opinion leaders into the mass audience. After reaching that point, diffusion is much easier.
Everett M. Rogers
Rogers, E.M. Diffusion of Innovation, 5th Edition, New York: Free Press.
Innovation (with characteristics of observability, trialability, complexity, relative advantage & ease of use), Social System (homogeneity or “homophily,” network structure, member roles such as opinion leader, member characteristics such as early vs. late adoption tendencies), Communication Channels (mass media vs. interpersonal), & Time
Kelly JA, Murphy DA, Sikkema KJ, McAuliffe RL, Roffman RA, Solomon LJ, Winett RA, Kalichman SC (1997). Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Community HIV Prevention Research Collaborative. Lancet, 350(9090), 1500-1505.
RE-AIM or a related framework may be a better conceptual fit when an organization or management group makes a conscious effort to spread a practice (e.g., an evidence-based intervention) among other organizations or subordinates. In other words, Re-AIM may be better than DOI at predicting the success of diffusion attempts that are “top-down” instead of “grassroots opinion leaders-out.”
National Cancer Institute, Theory at a Glance (see pages 27-29)
University of Twente, Diffusion of Innovation