H571 – Week 8
• Diffusion of Innovations Theory
• Tara
• Community-Based Research
– Intro (NCI)
• Alexandra
– Israel et al paper
• Coral, Kathryn and Alexandra
– Parker et al paper
• Connie and Jennifer
• Discussion Questions
DSC: Chapter 10
Diffusion of Innovations Theory
“The process by which an innovation
is communicated through certain
channels over time among members of
a social system” (Rogers, 1995, p. 10)
Community-Level Theory of Change
• Community, as one level embedded in the social
ecological model, is a complex and dynamic
system.
• While we have multiple theories of individual
change and organizational change, we have very
few theories of community change.
• This is one of the least understood processes in
public health, but perhaps the one with greatest
potential to impact population health.
PNRC framework for Creating Nurturing Environments
DISTAL
INFLUENCES
Poverty
Neighborhood poverty
Family poverty
Access to dental and health care
Relative deprivation and
inequality
Social Cohesion
Pro-social norms,
informal social control
Connectedness, social capital
Healthy community norms
Social exclusion,
discrimination
Physical Environment
Decay: abandoned buildings,
substandard housing
Neighborhood design,
land use
Access to alcohol, tobacco,
other drugs, firearms
Access to nutritious foods
Toxic exposures
Media
PROXIMAL
INFLUENCES
PRIMARY
OUTCOMES
Family
Involved in learning-related activities
Involved monitoring
Non-harsh limit setting
Reinforcing interactions
Positive role modeling
Health maintenance, hygiene
Involvement in positive activities
Cognitive
Development
Social/
Emotional
Competence
School
High-quality early childhood education
Effective instruction
Positive school climate
Positive behavior support
School attendance
Health education and prevention
After-school education and activities
Peer
Pro-social peers, role models
Exposure to alcohol, tobacco and
other drug use, violence and crime
Social networking technology
Absence of
Psychological
and
Behavioral
Problems
Physical
Health
Implications of Community-Based Approaches
for Health Promotion Practice
• Communities are increasingly key settings for
health promotion
• Building community capacity is increasingly a
focal outcome of health promotion
• Different approaches to community-based
health promotion interventions reflect differing
conceptualizations of community (e.g.,
worksites, media, schools, neighborhoods)
• A whole CBPR course online:
http://www.cbprcurriculum.info/
Discussion Questions
1. What concepts are common between DIT and CBPR? How do the
principles of CBPR relate to the elements of DIT?
2. What is the role of community-based action in diffusion of an innovative
intervention? Under what conditions is reinvention of an intervention
appropriate?
3. How can interventions be both disseminated through multiple
communities and community-developed?
4. How can the conflicting roles (and power) of researchers and community
members be reconciled? Does CBPR bias researchers’ objectivity?
Does this matter? How can it be avoided or minimized?
5. How can CBPR help professionals facilitate the diffusion of appropriate,
effective innovations through already existing or strengthened social
systems and communication channels?
6. How could you integrate the DIT and principles of CBPR to address the
varying agendas of groups involved in childhood obesity prevention?
7. What barriers do outsiders (researchers or public health practitioners)
face when entering a new community? How can they be overcome?
8. How can DIT and CBPR be used together to build coalitions, and then
disseminate interventions -- among underserved populations?