PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Diffusion of Innovation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources

The real new economy.

During the soar-and-swoon days of the late 1990s, many people believed that information technology, and the Internet in particular, were "changing everything" in business. A fundamental change did happen in the 1990s, but it was less about technology than about competition. Under director Diana Farrell, the McKinsey Global Institute has conducted an extensive study of productivity and its connection to corporate IT spending and use during that period. The study revealed that information technology is important--but not central--to the fate of industries and individual companies. So if information technology was not the primary factor in the productivity surge, what was? The study points to competition and innovation. In those industries that saw increases in competitive intensity, managers were forced to innovate aggressively to protect their revenues and profits. Those innovations--in products, business practices, and technology--led to the gains in productivity. In fact, a critical dynamic of the new economy--the real new economy--is the virtuous cycle of competition, innovation, and productivity growth. Managers can innovate in many ways, but during the 1990s, information technology was a particularly powerful tool, for three reasons: First, IT enabled the development of attractive new products and efficient new business processes. Second, it facilitated the rapid industrywide diffusion of innovations. And third, it exhibited strong scale economies--its benefits multiplied rapidly as its use expanded. This article reveals surprising data on how various industries in the United States and Europe were affected by competition, innovation, and information technology in the 1990s and offers insights about how managers can get more from their IT investments.

Commerce↗

Integrated Academic Information Management Systems (IAIMS). Part II. Planning and implementing integrated information services. The management of change: lessons learned from the IAIMS experience.

The critical elements of the change process were designed into the strategic planning process and the pilot project for the Integrated Academic Information Management System (IAIMS) at the University of Maryland. These elements were: Support by the institutional leadership; a critical mass of interested participants from diverse groups across the organization, committed to the project and with ownership of the plan; a motivating level of dissatisfaction with the status quo; the construction of a scenario describing the desired future and an assessment of needs to achieve it; technical and consulting help; a pilot project with replicable features to demonstrate the concept and feasibility of the approach; and participation of opinion leaders initially with later identification of additional opinion leaders who would become part of the pattern of acceptance of the innovation and diffusion of the technology across the campus.

Academic Medical Centers↗

Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

Developing Countries↗

Innovation theory and its applicability to our understanding of the diffusion of new management practices in health care organizations.

There has been a longstanding interest in understanding how new management practices and organizational structures are diffused through the health care system. This article reviews current literature on innovation and diffusion to provide insight into how new management practices and organizational structures are introduced into the system. Understanding the process may help in accommodating new developments and provide managerial opportunities to take a more active role in encouraging or discouraging their further evolution.

Canada↗

Quality assurance as a managerial innovation: a research perspective.

Quality assurance is defined and concepts from innovation theory are applied to the study of quality assurance programs. Two distinct although not mutually exclusive perspectives on innovation are considered--the diffusion perspective, focusing on the innovation itself and its implementation, and the adoption perspective, highlighting factors characteristic of the adoption unit (i.e., the organization or individuals within it) that facilitate or impede the adoption process. Directions for future research are suggested.

Diffusion of Innovation↗

[Innovation and obsolescence (author's transl)].

The economists analyse the facts of our everyday--or professional life to insert management--or anticipation rules from them. The progress of innovations and their obsolescence fall within these studies. Recent works have shown that the spreading of innovations in the medical fields was practically identical to that in the industrial field, and that its function in relation to time was written under the form of: P = K divided by 1 + e-(a+bt) P representing the proportion of departments which adopted an innovation at the time t, K representing the proportion of those which will adopt this innovation (a and b are constants). The derivated coefficient in relation to t, that is to say the variation of the proportion of departments adopting innovations in relation to time, measures the speed of diffusion of this innovation (Louise B. Russel, 1977). But can this equation be applied in the field of health, to organisational innovations as well as to those which have a material, therefore industrial support? On the other hand do techniques and equipments become obsolete simultaneously? Finally does the public or the private hospital slow down or speed up the appearance of innovations and their obsolescence? Such are the problems we will endeavour to set... before being able to solve them.

Animals↗

Breaking the cycle of violence among youth living in metropolitan Atlanta: a case history of kids alive and loved.

More teenagers in the United States die from gunshot wounds than from all natural causes of disease combined. Firearm-related mortality accounts for almost half of all deaths among African American teens. Residents of central cities have the highest probability of experiencing violent crimes. This article describes an innovative community-based intervention designed to break the cycle of violence among youth in metropolitan Atlanta. The intervention, Kids Alive and Loved (KAL), emerged from the African American community as one mother's response to the violent death of her 17-year-old son. The authors describe how her response to tragedy gave birth to a culturally appropriate intervention for youth exposed to violence. This article delineates the evolution of KAL, the role of community partners in the design of the intervention, and how diffusion of innovation theory has implications for understanding the KAL approach to breaking the cycle of violence.

Adolescent↗

Determinants of adoption of cognitive behavioral interventions in a hospital setting: example of a minimal-contact smoking cessation intervention for cardiology wards.

OBJECTIVE: The aim of our study was to identify the psychological and organizational determinants of adopting a smoking cessation intervention in cardiology wards, using the Integrated Change Model (I-Change Model) as the theoretical basis. METHODS: A cross-sectional survey by means of questionnaires was conducted among the heads of all 121 cardiology wards in Dutch hospitals, of whom 77 (64%) responded. RESULTS: Adopters had a significantly lower level of formalization and more nurses working on the ward. Adopters also had a significantly more positive attitude towards working with the intervention, perceived more positive social influences from their direct environment and had higher self-efficacy. Psychological determinants explained adoption to a greater extent than organizational determinants did. CONCLUSION: It is very important to take psychological factors into account when studying the adoption of preventive innovations and developing diffusion strategies. PRACTICE IMPLICATIONS: Programs for dissemination of preventive innovations in a hospital setting should primarily focus on psychological characteristics like social influence and self-efficacy.

Adult↗

Information constraints in medical encounters.

This article describes three kinds of information constraints in medical encounters that have not been discussed at length in the medical ethics literature: constraints from the concept of a disease, from the diffusion of medical innovation, and from withholding information. It describes how these limit the reliance rational people can justifiably put in their doctors, and even the reliance doctors can have on their own advice. It notes the implications of these constraints for the value of informed consent, identifies several procedural steps that could increase the value of the latter and improve diffusion of innovation, and argues that recognition of these constraints should lead us to devise protections which intrude on but can improve these encounters.

Communication↗

The inevitable failure of current cost-containment strategies. Why they can provide only temporary relief.

Current strategies for controlling hospital costs have focused primarily on eliminating care that is presumed to be of no medical value. These efforts have neglected the central fact that eliminating such care reduces current expenditures, but has little or no influence on three key factors responsible for the upward trend in real costs--population growth, rising input prices ("the hospital market basket"), and technologic innovation and diffusion. Aging of the population and the rising costs of malpractice insurance have received undue attention; together they can account for only three tenths of a percentage point in the upward trend. Gradual elimination of presumably useless care, perhaps as much as 30% of inpatient-days, can save many billions of dollars, but can only offset for a few years the forces causing costs to rise in US community hospitals. Indeed, in 1984, the reduction in patient days and resultant slowing in the real rate of rise to 2.1% appear simply to have concealed an underlying real rate of increase that was close to 7%. After all unnecessary days have been eliminated, the underlying rate of increase will reemerge unless limitations are placed on technologic innovation or beneficial services are rationed.

Cost Control↗

Peer-led HIV prevention among gay men in London: process evaluation.

A peer-led HIV prevention initiative, based on a diffusion of innovation model, was developed for gay men attending gyms in central London. Peer educators were recruited from people who used the gym regularly according to standard selection criteria. After initial training, peer educators agreed to talk to gay men at their gym about HIV prevention, focusing on sexual risk and steroid injecting behaviour. Outcome evaluation revealed that the peer education programme had no significant impact on the risk behaviours of gay men using the gyms. Process evaluation, based on interviews with peer educators, the health promotion team and gym managers threw light on this finding. While it was feasible to set up a peer education programme among gay men in central London gyms, attrition was an important factor. Only one in five potential peer educators initially identified remained with the project throughout, thus limiting the potential for diffusion. Those who did work as peer educators reported barriers to communication within the gyms further limiting the extent to which diffusion occurred. In fact, it appears that the critical mass required for diffusion was never established. This could explain why the intervention had no significant impact on gay men's risk behaviours. A person-time analysis demonstrated that the peer education programme required a substantial input from the health promotion team, equivalent to one team member devoting 2.5 days a week to recruit, train and support peer educators over 18 months. Peer education should not, therefore, be viewed as a low-cost approach to prevention. Many of the insights gained through this process evaluation can inform others planning peer education programmes in other settings.

HIV Infections↗

Health technology assessment: problems and challenges.

From a national perspective, the central prerequisite of the proper application of medical technology is the timely determination of efficacy, cost, safety, and societal impact. This applies to both the introduction of the new methods and the retirement of older methods that may have outlived their usefulness. Within that framework, the rapid diffusion of innovative methods of great value must be balanced against the cost of premature enthusiasm for techniques with little or no incremental diagnostic or therapeutic gain. A nongovernmental Council on Health Care Technology Assessment of the Institute of Medicine-National Academy of Sciences was established by the Congress in 1986. The Council was charged to serve as an information clearing-house, a center to promote research and education, and a stimulus to establish better methods of assessment and more prompt identification of potentially important technologies. It represents virtually all of the constituencies concerned with adequate evaluation of new and existing methods. The Council confronts the critical problems of timing, bias, the quality of primary data collection, new methods of secondary data analysis, the nature of the "laboratory" in which technology assessment is best accomplished, the "exploitative" character of technology assessment research, appropriate diffusion, and ethnical issues. The appropriate use of technology in modern health care depends on the resolution of these issues.

Organizations↗

Local opinion leaders: effects on professional practice and health care outcomes.

BACKGROUND: Both the theory of diffusion of innovations and the social influences model of behaviour change suggest that using local opinion leaders to transmit norms and model appropriate behaviour may improve health professional practice. OBJECTIVES: To assess the effects using local opinion leaders on the practice of health professionals or patient outcomes. SEARCH STRATEGY: We searched MEDLINE to May 1998, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. SELECTION CRITERIA: Randomised trials of the use of local opinion leaders (defined as health professionals nominated by their colleagues as being educationally influential). The participants were health care professionals responsible for patient care. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Eight studies were included involving more than 296 health professionals. A variety of patient problems were targeted, including acute myocardial infarction, cancer pain, osteoarthritis, rheumatoid arthritis, chronic lung disease, vaginal birth after caesarean section, labour and delivery, and urinary catheter care. Six of seven trials that measured health professional practice demonstrated some improvement for at least one outcome variable, and in two trials, the results were statistically significant and clinically important. In three trials that measured patient outcomes, only one achieved an impact upon practice that was of practical importance: local opinion leaders were effective in improving the rate of vaginal birth after previous caesarean section. REVIEWER'S CONCLUSIONS: Using local opinion leaders results in mixed effects on professional practice. However, it is not always clear what local opinion leaders do and replicable descriptions are needed. Further research is required to determine if opinion leaders can be identified and in which circumstances they are likely to influence the practice of their peers.

Health Services Research↗

A case for social marketing and education for acceptance and implementation of preventive health and occupational safety measure programs for rural communities.

The environment in which acceptance and implementation of preventive health and occupational safety occurs is not conducive to the message being heard, nor are people acting upon the message. Diffusion of innovation and community development models are explored for possible approaches to health education in the rural community. In particular, the community-oriented primary care approach to medical practice is discussed. In addition, the responsibility of the rural community is outlined.

Agriculture↗

Old and new models for office automation.

The emerging generation of office automation systems combines new and existing software and procedures. While managers may be able to select from a broad array of software tools, they may also be required to use certain others. This article discusses organization design as the context for office automation; mature computer-based systems as one application of organization design variables; and emerging office automation systems as another application of those variables. The article concludes that Management Information System models developed for mature systems may be helpful where the use of software application is required for the individual worker; diffusion of innovation models recently developed for computing systems may be helpful where the type of software is optional for the individual worker.

Automation↗

Latin American Cancer Research Coalition. Community primary care/academic partnership model for cancer control.

The Latin American Cancer Research Coalition (LACRC) was funded by NCI as a Special Populations Network to 1) provide training to clinic staff in cancer control and foster development of Latino faculty training, 2) conduct a needs assessment with the community clinics, 3) enhance the ability of the clinics to promote healthy lifestyles, 4) collaborate on research projects to improve use of early detection, and 5) explore partnerships to increase access to culturally competent cancer care. The LACRC developed a model for cancer control focused on community-based clinics as the focal point for in-reach and community outreach targeted to Latinos to reduce cancer disparities. This framework was designed to link the community to local hospitals and academic centers, build capacity, and promote diffusion of innovations directly into delivery systems. Eight research projects submitted by junior investigator/clinic teams have been funded by NCI. These research projects range from recruiting for clinical trials to prevention to survivorship. The LACRC has trained 6 cancer control coordinators from partner sites and educated 59 undergraduate minority student interns in aspects of cancer control research. Central to LACRC's success to date has been the creation and maintenance of an infrastructure of trusting relationships, especially those developed between clinician/investigators and individuals within the greater Latino community. Community clinics can be effective agents for cancer control among Latinos. Latinos are likely to participate in research conducted by culturally representative teams of researchers using culturally appropriate recruiting strategies. Cancer 2006. (c) 2006 American Cancer Society.

Central America↗

STAND: a peer educator training curriculum for sexual risk reduction in the rural South. Students Together Against Negative Decisions.

BACKGROUND: The incidence of AIDS in rural areas continues to increase rapidly, with teenagers continuing to report high rates of sexual risk behaviors. Unfortunately, there is a dearth of effective HIV prevention programs targeting youth in rural settings where there are often formidable barriers to sex education programs. This paper describes a theoretically based intervention designed to meet the needs of rural youth. METHODS: Students Together Against Negative Decisions (STAND) is a 28-session teen peer educator training program implemented in a rural county in a southeastern state, promoting both abstinence and sexual risk reduction. The theoretical foundation of the curriculum includes both Diffusion of Innovations Theory and the Transtheoretical Model, focusing on both individual and community norm change. STAND is teen-centered and skills-based; activities focus on active learning. Educator trainees are selected on the basis of their opinion leadership within their peer group, resulting in a training group of both virgin and sexually active teens, balanced for gender and matched to the racial proportions of the school. RESULTS: Acceptance and participation in STAND suggest that adolescents in rural communities can be accessed through community-based interventions, that they are willing to participate in such intensive programs, and that they perceive the intervention as valuable and enjoyable. Moreover, the STAND program has thrived in a relatively conservative rural environment, and has had a positive impact on adolescents' sexual risk taking. Results from a pilot study showed significantly greater increases in condom use self-efficacy (16% vs a 1% decrease among controls) and in consistent condom use (+28% vs +15%). Adolescent trainees also reported a sevenfold larger increase in condom use (+213% vs +31%) and a 30% decrease in unprotected intercourse compared to a 29% increase among controls. CONCLUSIONS: STAND represents a new genre of HIV prevention program, one that utilizes complementary theoretical models to develop a program that targets both individual- and community-level change for rural adolescents.

Adolescent↗

The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee.

Appalachian Region↗