Blending the social marketing and diffusion of innovations perspectives [pdf file] has been a passion of mine for many years. A presentation at a Cochrane Collaboration meeting provides another independent assessment of the value of social marketing to improve health service delivery through the better design and implementation of diffusion activities. From the authors' abstract:
Seven key areas, which interact in subtle and complex ways, made up our final model [for spreading good ideas for improving health services]: (1) The attributes of the innovation; (2) The adoption process as engaged in (or not) by individuals; (3) Communication and influence (including the impact of opinion leaders, champions, boundary spanners and designated change agents); (4) The inner (organisational) context (including structural determinants of innovativeness, receptive context for change in general, absorptive capacity for new knowledge, and tension for a particular change); (5) The outer (extra-organisational) context (including inter-organisational collaboration and networking, prevailing environmental pressures such as external competition, particular policymaking contexts and streams, and proactive linkage initiatives); (6) The nature of any active dissemination campaign (which incorporates the general principles of social marketing and knowledge construction); and (7) The nature of any active implementation process (which incorporates the general principles of effective management in a changing environment).
As we also are learning, the nature of the organizational network in which one attempts to introduce new practices also has a powerful effect on adoption: Highly linked and centralized coalitions are less likely to adopt new evidence-based public health programs than ones that are less dense and have more decentralized structures. Don't forget about the network!
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