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Results for “Diffusion of Innovation”

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At least 235 records · Page 13Linked to original sources

PubMed2006

International diffusion of new health technologies: a ten-country analysis of six health technologies.

OBJECTIVES: The objective of this study was to examine and explain the differential international diffusion of six health innovations. METHODS: A retrospective diffusion study was undertaken of sildenafil, cyclooxygenase-II (COX II) inhibitors, beta interferon, verteporfin, deep brain stimulators, and drug-eluting coronary stents in ten countries-Australia, Canada, Denmark, France, The Netherlands, Norway, Spain, Sweden, Switzerland, and the United Kingdom. We plotted diffusion curves of daily defined doses per quarter, vials or implants per million population, and examined the association between diffusion and five key variables. RESULTS: Canada, Switzerland, and Sweden are generally high users of new technologies; Spain, Denmark, and particularly the United Kingdom are low users. Almost all countries experienced rapid adoption of sildenafil with diffusion to a similar level; there was variable adoption and diffusion of COX II inhibitors, verteporfin, and interferon beta; drug-eluting stents penetrated the market in a similar way in all but one country; and two countries had very different adoption patterns for deep brain stimulators. Above average health spending and the presence of health technology assessment (HTA) or other guidance reports are consistently associated with increased diffusion. Early warning activity and a national coverage decision being taken are more likely to be associated with a reduced diffusion. CONCLUSIONS: The significant differences in diffusion between different countries are not consistent with a neat evidence-based world. The tools available to policy makers to control diffusion (early warning systems, HTA, and a fourth hurdle) play some part in influencing diffusion but need close scrutiny of how successfully they operate.

Australia↗

PubMed1988

Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

Accounting↗

PubMed2005

Implementation of an innovative health service a "real-world" diffusion study.

BACKGROUND: Although reporting on the healthcare-setting level of continuance or discontinuance of an intervention once a trial is completed has been recommended, such "real-world" diffusion studies are rare. The present example was made possible by funding to explore opportunities for post-trial implementation of an innovative health counseling intervention for cardiovascular prevention in The Netherlands. METHODS: Between 2001 and 2004, in a longitudinal case study, we compared two healthcare settings: a cardiology outpatient clinic and general practices. Rogers' diffusion of innovations theory served as the theoretical background. Information was extracted from minutes of meetings and informal conversations with health counselors, and checked by the project manager. Additional data were collected from physicians with a short questionnaire. RESULTS: Implementation of the health counseling intervention was successful in the cardiology outpatient clinic, but was unsuccessful in the general practices. Success was related to a centralized diffusion system, stronger "change agent" efforts, avoidance of post-trial interruption of service delivery, easily achievable "reinventions," and positive physician perceptions of the service (i.e., not complex and compatible with current practice routines). Support came from changes in the organization of care that created opportunities for, instead of competition with, the innovative service. However, coincidental events may also have played a part. CONCLUSIONS: Our findings confirm the importance of most theoretically predicted individual and organizational diffusion variables. This implies that the implementation of innovative healthcare services requires attention at both levels.

Ambulatory Care↗

PubMed1999

Health promotion research and the diffusion and institutionalization of interventions.

To examine the extent to which health promotion research is providing an empirical basis for the diffusion and institutionalization of effective interventions, we conducted a systematic audit of all articles in 12 public health and health promotion journals for the 1994 calendar year. We identified empirical/non-empirical and health promotion/non-health promotion articles. For each study, the health behaviours or outcomes studied, the target group, gender and setting were categorized. Each study was also categorized as belonging to one of four stages: basic research and development, innovation development, diffusion research, and research into institutionalization or policy implementation. Of all articles coded (n = 1210), 33.9% were identified as non-research, 39.5% were health promotion research and 26.6% were non-health promotion research. The vast majority of studies fell within the basic research and development stage (89.6%), with less than 1% categorized as diffusion research and only 5% as institutionalization or policy implementation research. The published studies reviewed provide a limited empirical basis for diffusion and institutionalization of health promotion programs. These findings suggest a need to more systematically monitor research input (funding) and research output (publications), and to develop a more explicit focus on the relevance of the stages of research innovation and development, the issues and/or behaviours addressed, the target population, and the research setting.

Bibliometrics↗

PubMed1999

National treatment systems in global perspective.

Drug policy development is mostly viewed as emerging within the nation state. Processes of diffusion of innovative policies have been neglected to a large extent. The comparative study of public policy has demonstrated, however, that diffusion is an important predictor of early policy adaptation. Thus, the analysis asks the general question of the relative importance of endogenous and exogenous effects on the development of drug policies in various countries. Specifically it describes the Swiss debate leading to the popular initiative on 'Youth Without Drugs' as well as the international reactions regarding its liberal outcome. Results of an expert survey show two broad types of reactions. There is one set of countries where chances for the introduction of limited heroin-prescription trials during the next 5 years are considered probable and a second set of countries which seems to be strictly status quo oriented. In the concluding section a model is suggested which systematically considers endogenous as well as exogenous predictors of 'soft' or 'hard' drug policy adoption. Results of a first tentative test of the model are encouraging for future empirical research on diffusion processes of drug policies.

Attitude to Health↗

PubMedDate not supplied

Investment, innovation, and disparities: a complex relationship.

Robert Hurley and colleagues find growing disparities in health care. Their methods are rigorous, but key-informant interviews have limitations. Part of their argument rests on observations regarding the diffusion of technological and administrative innovations. The development of disparities will depend on how quickly innovations diffuse to underserved populations. While we look for other supporting data, decreasing public coverage for the poor, medications, and mental health services sends a clear signal from emergency departments. Human suffering reinforces the need to redouble our efforts to patch up coverage holes during good times and keep coverage from unraveling during lean times.

Delivery of Health Care↗

PubMed2003

Influence of information sources on the adoption of uterine fibroid embolization by interventional radiologists.

OBJECTIVES: The purpose of the research was to (1) understand the influence of information sources on the awareness and adoption of uterine fibroid embolization (UFE) by interventional radiologists in Michigan and (2) to decipher communication relations in the social network of interventional radiologists that were most conducive to the flow of information about UFE. METHODS: Diffusion of innovations theory and constructs in social network analysis formed the basis for the development of an interview guide. Thirty-two interventional radiologists in Michigan were interviewed over the phone. Chi-square statistics were employed to analyze the awareness and adoption of UFE. Factor analysis was applied to decipher important communication relations in the social network of interventional radiologists. RESULTS: Conferences were found to be an initial source of information, creating awareness among early adopters (P < 0.05), but other individuals were found to be influential sources in the adoption of UFE by later adopters (P < 0.05). Radiologists rarely browsed Websites for information. Work relations in everyday clinical practice were the communication relations most conducive to the flow of information about UFE. Preliminary qualitative data indicated that opinion leaders in the diffusion of UFE in Michigan were located in hospitals primarily dedicated to practice rather than in hospitals affiliated with universities. CONCLUSIONS: Journals are important information sources for creating awareness and stimulating adoption of innovation among both early and late adopters of new procedures in interventional radiology. Conferences, however, are significantly more important for creating early awareness, while interactions with colleagues is the most important factor in stimulating use of the innovation among later adopters. Among colleagues, opinion leaders in nonacademic hospitals may be more influential than individuals in the academic community.

Adult↗

PubMed2006

Clarifying the concepts in knowledge transfer: a literature review.

AIM: The aim of this paper is to examine the concepts of opinion leaders, facilitators, champions, linking agents and change agents as described in health, education and management literature in order to determine the conceptual underpinnings of each. BACKGROUND: The knowledge utilization and diffusion of innovation literature encompasses many different disciplines, from management to education to nursing. Due to the involvement of multiple specialties, concepts are often borrowed or used interchangeably and may lack standard definition. This contributes to confusion and ambiguity in the exactness of concepts. METHODS: A critical analysis of the literature was undertaken of the concepts opinion leaders, facilitators, champions, linking agents and change agents. A literature search using the concepts as keywords was conducted using Medline, CINAHL, Proquest and ERIC from 1990 to March 2003. All papers that gave sufficient detail describing the various concepts were included in the review. Several 'older' papers were included as they were identified as seminal work or were frequently cited by other authors. In addition, reference lists were reviewed to identify books seen by authors as essential to the field. FINDINGS: Two similarities cut across each of the five roles: the underlying assumption that increasing the availability of knowledge will lead to behaviour change, and that in essence each role is a form of change agent. There are, however, many differences that suggest that these concepts are conceptually unique. CONCLUSIONS: There is inconsistency in the use of the various terms, and this has implications for comparisons of intervention studies within the knowledge diffusion literature. From these comparisons, we concluded that considerable confusion and overlap continues to exist and these concepts may indeed be similar phenomena with different labels. All concepts appear to be based on the premise that interpersonal contact improves the likelihood of behavioural change when introducing new innovations into the health sector.

Concept Formation↗

PubMed1989

Interorganizational collaboration and dissemination of health promotion for older Americans.

This article describes how a successful health promotion program for older adults was adapted and disseminated through collaboration of the American Association of Retired Persons, the American Red Cross, and the Dartmouth Institute for Better Health. The details of this effort are presented in three sections: the conceptual framework used to build the collaborative relationship, the outcomes, and an analysis of these experiences as they relate to the diffusion of innovations in organizations. The problems encountered are discussed as well as the need for more time to elapse before judging the ultimate success of the diffusion of the program.

Academies and Institutes↗

PubMed2000

Evaluating nursing administration instruments.

OBJECTIVE: To identify and evaluate available measures that can be used to examine the effects of management innovations in five important areas: autonomy, conflict, job satisfaction, leadership, and organizational climate. BACKGROUND: Management interventions target the context in which care is delivered and through which evidence for practice diffuses. These innovations need to be evaluated for their effects on desired outcomes. However, busy nurses may not have the time to locate, evaluate, and select instruments to measure expected nursing administration outcomes without research-based guidance. Multiple and complex important contextual variables need psychometrically sound and easy-to-use measurement instruments identified for use in both practice and research. METHOD: An expert focus group consensus methodology was used in this evaluation research to review available instruments in the five areas and evaluate which of these instruments are psychometrically sound and easy to use in the practice setting. RESULTS: The result is a portfolio of measures, clustered by concept and displayed on a spreadsheet. Retrieval information is provided. The portfolio includes the expert consensus judgment as well as useful descriptive information. CONCLUSIONS: The research reported here identifies psychometrically sound and easy-to-use instruments for measuring five key variables to be included in a portfolio. The results of this study can be used as a beginning for saving time in instrument selection and as an aid for determining the best instrument for measuring outcomes from a clinical or management intervention.

Conflict, Psychological↗

PubMed2004

Infant HIV infection: acceptability of preventive strategies in central Tanzania.

Safe, cost-effective interventions are being developed to reduce HIV transmission to children, suitable for lower income countries such as Tanzania. The interventions include Nevirapine treatment, replacement feeding, exclusive breast-feeding and heat-treating breast milk. This article reports on research to explore factors, which may influence the acceptability of these interventions. Data collection methods used were qualitative in-depth interviews with 12 health workers and focus group discussions with five community groups. Findings are presented with reference to the theory of diffusion of innovation, which seeks to explain how new ideas and products are disseminated through a community. Respondents describe the factors that may help and hinder this process. They propose ways to maximize this diffusion, such as integrating HIV and antenatal services, encouraging male participation, community-wide education, offering free HIV testing, and training health workers as change agents.

Adult↗

PubMed2006