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PubMed1990

Diffusion of technology innovation.

Within the context of nursing informatics as a field that addresses the use of information technology by nurses as they care for patients, carry out administrative tasks in health facilities, and educate others in the discipline, this article presents the theoretic perspectives of the adoption and implementation of such technologies. Research in the area of diffusion of innovations is reviewed from the perspective of classical diffusion theory and organizational theory. The state of the art and methodological issues of research in this area are addressed. Areas for future study are proposed.

Communication↗
PubMed1998

GIS uses and constraints on diffusion in Eastern European and the former USSR.

The authors examine the emerging uses of geographic information systems (GIS) in Eastern Europe and the countries that formerly were part of the USSR. "The paper, based on a communications survey, conference participation, and local sources, devotes particular attention to GIS applications in planning and services delivery and to variable rates of adoption of GIS technology in the region, as documented in a table of public-sector applications compiled by the authors. Factors limiting the utility of traditional innovation-diffusion models in understanding current patterns are identified."

Developed Countries↗
PubMed1998

An investment appraisal approach to clinical trial design.

In this paper, a general investment appraisal model is presented which shows how pharmaceutical companies could take profit considerations into account when making decisions about the design of randomized controlled trials. A general model is presented based on the net present value method of investment appraisal. The approach is illustrated with a hypothetical example which shows how optimal (net present value maximizing) designs can be determined based on choices about sample size and endpoint measurement. The method could be extended to accommodate considerations about other trial design features, and could be used to determine a portfolio of studies which maximizes the expected return on a given development or trial budget. Furthermore, the approach could be used by pharmaceutical companies to evaluate the incremental costs and benefits of incorporating non-clinical objectives into trials, such as quality of life research and economic evaluation studies. A number of practical difficulties would need to be overcome to utilize the approach. Directions for further research are therefore highlighted centred on the key components of the model: a trial cost function, a product demand function, innovation diffusion processes and Bayesian approaches to trial design.

Bayes Theorem↗
PubMed1995

Trends in the use of climacteric and postclimacteric hormones in Nordic countries.

The extent of menopausal and postmenopausal hormone use in Denmark, Finland, Norway, and Sweden during 1981-1992 was studied by means of drug sales figures and associations between hormone use, education, employment and occupational status, by questionnaire surveys in each of the respective countries in the 1980s-90s. According to sales figures, hormone use has been different in each of the countries studied. In 1981 use was three times more common in Denmark than in Norway. In 1992 use had increased in all the other countries except Denmark, and was highest in Finland and Sweden. Based on 1981 data for Norway, on 1987 data for Denmark and on 1989 data for Finland, use of hormone therapy was related to education, employment or occupational status in Finland but not in Denmark or Norway. Differences in the phases of innovation diffusion between these countries may offer a partial explanation for these results.

Climacteric↗
PubMed2005

White matter and behavioral neurology.

Although the study of higher brain function has traditionally focused on the cortical gray matter, recent years have witnessed the recognition that white matter also makes an important contribution to cognition and emotion. White matter comprises nearly half the brain volume and plays a key role in development, aging, and many neurologic and psychiatric disorders across the life span. More than 100 disorders exist in which white matter neuropathology is the primary or a prominent feature. A variety of neurobehavioral syndromes may result from these disorders; the concept of white matter dementia has been introduced as characteristic of many patients with white matter involvement, and a wide range of focal neurobehavioral syndromes and psychiatric disorders can also be related to dysfunction of myelinated tracts. Understanding the neurobehavioral aspects of white matter disorders is important for clinical diagnosis, treatment, prognosis, and research on brain-behavior relationships. Central to these investigations is the use of modern neuroimaging techniques, which have already provided substantial information on the characterization of white matter and its disorders, and which promise to advance our knowledge further with continued innovation. Diffusion tensor imaging is an exciting method that will assist with the identification of critical white matter tracts in the brain, and the localization of specific lesions that can be correlated with neurobehavioral syndromes. A behavioral neurology of white matter is thus emerging in which clinical observation combined with sophisticated neuroimaging will enable elucidation of the role of white matter connectivity in the distributed neural networks subserving higher brain function.

Behavioral Sciences↗
PubMed2002

Identifying barriers to the use of research faced by public health physicians in Norway and developing an intervention to reduce them.

OBJECTIVES: To explore why public health physicians seldom use research-based information and to develop an intervention to remedy this on the basis of this study, other research literature and suitable theories of information-seeking and professional behaviour change. METHODS: A qualitative study was conducted using focus groups, observation of individuals and interviews. The setting was Norwegian public health practice; 52 public health physicians from all over Norway participated in the study. RESULTS: We identified several barriers to the use of scientific literature that could be categorised as: psychological variables; environmental variables; and source characteristics. We developed an intervention that attempts to address these barriers, informed by previous research on the effectiveness of interventions to change professional practice and incorporating elements from social cognitive theories and the theory of innovation diffusion. CONCLUSIONS: The Norweigian public health physician works in an isolated environment which does not facilitate searching or obtaining scientific information, which does not ask for this information and far less encourages its use as a basis for decision-making. An intervention tailored to reduce some of the barriers to research use may lead to more frequent and extensive use of such information in public health decision-making.

Anecdotes as Topic↗
PubMedDate not supplied

Health behavior research: the quality of the evidence base.

All 1210 manuscripts published in the 12 most prestigious health promotion research journals in 1994 were reviewed and coded based on stage of research and setting. Of the total, 34% were nonresearch articles, 35% were health-behavior research, and 31% were related to innovation, diffusion, and institutionalization. Of the 469 health behavior research articles, 57% were observation studies, 11% were methods development, 19% were intervention studies, 1% were meta-analyses, and 13% addressed diffusion and institutionalization. Half (46) of the intervention studies had randomized controlled designs. Studies were conducted in nonspecific community settings (206), health care settings (88), schools (75), specific community settings (53), workplaces (32), and universities (11).

Evidence-Based Medicine↗
PubMed1990

Social and demographic principles in an alternative typology of cities.

"The authors challenge some conventional notions regarding the USSR's urban hierarchy and settlement network and the basis for functional city classifications. They assign a key role to technological and social change in the overall growth and development process and downplay the role of territorial production complexes vis-a-vis large cities as major regulators of future economic development. Considerable attention is devoted to identifying stages of urban interaction (especially via migration and innovation diffusion) with the rural hinterland and of social-demographic transformations accompanying scientific and technical progress. A city typology based on stages in the 'social-demographic transition' is outlined briefly."

Demography↗
PubMed2005

A community hospital acute pain service.

This article provides readers with a guide to developing and implementing an acute pain service in a community hospital. Kanter's theory of innovative diffusion is used to frame the author's experiences as a lead nurse in two community hospital acute pain services. Health-care providers recognize the importance of quality pain assessment and management. One initiative for improving pain management has been the implementation of an acute pain service (APS). In Canada, most university-affiliated teaching hospitals have now developed an APS to improve pain management. Community hospitals, however, have only recently begun to adopt the concept. Improving pain management through an APS provides an excellent opportunity for nursing leadership at all levels. Nursing administration may take the lead in proposing the idea and benefits of acquiring an APS. An advanced practice nurse can provide leadership through the coordination and provision of enhanced pain management as a lead nurse in an APS. Staff nurses can provide leadership in improving pain management on a daily basis and ensuring that quality pain care reaches the bedside, Nursing practice is at the core of making a difference in pain management.

Hospitals, Community↗
PubMed1990

Barriers to prescribing the Copper T 380A intrauterine device by physicians.

From a questionnaire sent to all obstetricians and gynecologists and all family and general practitioners in San Diego County, California, regarding the Copper T 380A intrauterine device, substantial barriers to prescribing it were identified. Of all physicians responding, 40% reported that they were not recommending the Copper T 380A to anyone, the single most common reason given being concern about medical liability. A lack of knowledge about the new device, a lack of intrauterine device insertion skills, and certain medical practice settings were also important barriers to prescribing it. The new intrauterine device is considered in the context of innovation-diffusion theory. Substantial amounts of education and training and improvement in the medical-legal climate are needed before current barriers to prescribing the new device are removed.

Attitude of Health Personnel↗
PubMed1992

Organizing for cancer control. The diffusion of a dynamic innovation in a community cancer network.

This paper examines the diffusion of a "dynamic" innovation--research on the prevention and control of cancer--in a community cancer network. By analyzing the social structures and communication strategies of network members, as well as the attributes of the innovation, the authors explain why this innovation is diffusing more slowly than its "formed" counterpart--research on the treatment of cancer.

Diffusion of Innovation↗
PubMed2004

Diffusion methodology: time to innovate?

Over the past 60 years, thousands of diffusion studies have been conducted in numerous disciplines of study including sociology, education, communication, marketing, and pubic health. With few exceptions, these studies have been driven by a methodological approach that has become institutionalized in diffusion research. This approach is characterized by the collection of quantitative data about one innovation gathered from adopters at a single point in time after widespread diffusion has occurred. This dominant approach is examined here in terms of both its strengths and weaknesses and with regard to its contribution to the collective base of understanding the diffusion of innovations. Alternative methodological approaches are proposed and reviewed with consideration for the means by which they may expand the knowledge base.

Diffusion of Innovation↗
PubMed1990

The holistic paradigm in nursing: the diffusion of an innovation.

Nursing today is affected by challenges to the beliefs and values underlying the delivery of health care services. Results of a bibliometric analysis of the nursing literature since 1966 revealed a process of paradigm change in which a scientific medical model is being replaced by a model based on the concept of holism. Key ideas representing a holistic paradigm of health appear with increasing frequency in the journals of the nursing field, demonstrating the diffusion of a new and different perspective in the practice of nursing.

Bibliometrics↗
PubMed2002

Measuring perceptions of innovation adoption: the diffusion of a federal drug prevention policy.

The purpose of this paper is to describe the testing of a new scale to assess the perceived attributes of a federal drug prevention policy. The 17-item scale was administered to 107 Safe and Drug Free Schools (SDFS) coordinators in 12 states as a part of a larger investigation examining the diffusion of a federal drug prevention policy. In developing this scale, the authors drew from theory, previously validated measures, expert review and pre-testing with SDFS coordinators. Factor analysis revealed three underlying constructs representing relative advantage/compatibility, complexity and observability. The constructs found were internally consistent with a Cronbach's alpha ranging from a high of 0.89 for relative advantage/compatibility to a low of 0.71 for observability. Each of these constructs was correlated with a district's adoption of the policy in predictable ways. The construct of relative advantage/compatibility appears to be especially useful in assessing policy adoption. This scale was developed to assess a specific innovation; however, we believe that it can be easily adapted to understand the adoption of other health education interventions.

Diffusion of Innovation↗
PubMed1975

A "desperation-reaction" model of medical diffusion.

Knowledge about the adoption and diffusion of innovations is briefly reviewed. A model is then proposed to explain how certain innovations, intended to address dire medical problems, might diffuse in a manner not previously reported, with extensive diffusion occurring during what would be a period of small-scale experimentation and limited adoption in the conventional innovation-diffusion environment. The model is illustrated with findings from a case study of the diffusion of drug therapies for four types of leukemia. Possible implications of "desperation-reaction" diffusion are suggested.

Adult↗
PubMed2004

Pursuing the course from research to practice.

Diffusion of Innovation Theory describes the typical course by which innovations become standard practice. Research-based prevention programs are one such innovation. These programs have passed through the early phases of diffusion-innovation development and adoption by progressive schools that seek out innovations. With one quarter of the nation's schools having adopted a research-based program, the field is currently in the early majority phase of diffusion. If the patterns of normal diffusion hold true, this phase is likely to be characterized by emerging tensions between program developers and adopting schools. There are several concerns that require attention from researchers and practitioners. Practitioners need to develop their capacity to implement programs with fidelity and to adapt programs appropriately to meet their circumstance. Program developers need to simplify and redesign programs to make them appealing and useful to teachers. Operational capacity to fulfill orders and provide training needs to be developed.

Diffusion of Innovation↗