Diffusion Of Innovations Theory, Principles, And Practice

Dearing, James W.; Cox, Jeffrey G.

doi:10.1377/hlthaff.2017.1104

Cited by 421 publications

(331 citation statements)

References 48 publications

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“…Despite the rapid development of technology, it seems that changes in TN organization and practice are slow. It is well known that the implementation and diffusion of innovations in health care can take a long time (Dearing & Cox, ); therefore, systematic and theory‐based approaches are needed.…”

Section: Discussionmentioning

confidence: 99%

Telephone nurses’ use of a decision support system: An observational study

Holmström

Gustafsson²,

Wesström³

et al. 2019

Nursing & Health Sciences

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Telephone nurses give advice and support and make assessments based on verbal communication only. Web-based decision support systems are often used to increase patient safety and make medically correct assessments. The aim of the present this study was to describe factors affecting the use of a decision support system and experiences with this system among telephone nurses in Swedish primary health care. Observations and semistructured interviews were conducted. Six registered nurses with at least 1 year of experience of telephone nursing participated. Field notes and interviews were analyzed by qualitative content analysis. The main findings of the present this study were factors that decrease the decision support system use or promote deviation from decision support system use, factors that are positive for decision support system use and the decision support system complicates the work.Underuse and deviations from decision support systems can be a safety risk, because decisions are based on too little information. Further research with observations of telephone nurses' use of decision support systems is needed to develop both telephone nursing and decision support systems. K E Y W O R D S content analysis, decision support system, participant observation, primary health care, telephone nursing

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Section: Discussionmentioning

confidence: 99%

Telephone nurses’ use of a decision support system: An observational study

Holmström

Gustafsson²,

Wesström³

et al. 2019

Nursing & Health Sciences

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“…To supplement the diffusion analysis, we then delve into different sectors of the SE and focus on how resources have been concentrated in the expansion of sharing economy sectors. Given that adopters have choice of technology in this case service delivery models, competing or complementing innovations are important in diffusion study (Dearing and Cox 2018), we also examine whether the nature of the relationships between service firms (Businesses, or B), consumers (C), institutional providers (Government, or G), and content producers (Peers, or P) has changed over time. This analysis follows the sectoral overview to identify the various permutations and directionalities that define the sharing economy.…”

Section: Methodsmentioning

confidence: 99%

Sectoral evolution and shifting service delivery models in the sharing economy

Mahmuda

Sigler

Knight

et al. 2020

Bus Res

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The rise of the sharing economy has had transformative impacts on extant service delivery models, with wide ranging implications for existing firms, regulators, and the workforce at large. This paper draws upon firm-level data to better understand how new forms of service delivery have accompanied the diffusion of the sharing economy. Unlike previous waves of technological innovation, sharing economy firms have emerged as digital intermediaries rather than direct service providers driven by shifting consumer practices and attitudes. We apply an innovation diffusion model to trace the development trajectory of the sharing economy across 1000 firms. Our model segments the evolution of the sharing economy into three distinct and overlapping phases, comprising an Embryonic Stage (

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“…Analyses of policy innovation and diffusion frequently highlight the role of “policy entrepreneurs.” According to Kingdon, a policy entrepreneur is an actor who focuses attention on a problem, molds its definition, mobilizes support behind a particular solution, and works for adoption by decision makers . Policy entrepreneurs can be individuals (subject matter experts, elected officials, established issue advocates) or groups (professional organizations, community organizations, a government office or agency) . Whatever the source, the function of entrepreneurship remains the same, that is, exploiting opportunities to enhance awareness of a cause while strategizing the path to institutional action.…”

Section: Act Origins and Spreadmentioning

confidence: 99%

“…One reason is resistance by program adopters who make changes to enhance an intervention's compatibility with idiosyncratic conditions, or to configure it for “scaling up” to more complex and high‐demand circumstances, as when pilot research is moving into general practice. Adjustments may happen either by means of “reinvention” during the preliminary design phase of the adoption process or by “course corrections” during a program's implementation phase . Those who originated the innovation may not favor such alterations, but adherence expectations that are perceived to be obligatory as well as extreme can prevent new actors from giving serious consideration to an otherwise appealing option.…”

Section: Factors Constraining Act Diffusionmentioning

confidence: 99%

“…This observation is consistent with scholarship on the dynamics of program diffusion. In his classic study, Rogers concluded that adoption outcomes depend on numerous variables, which he categorized in terms of attributes of the innovation, characteristics of adopters, and social and political context . Further, the decision in favor of, or against, an innovation is typically a comparative one, since rarely are competing or complementary proposals absent from a given policy space.…”

Section: Factors Constraining Act Diffusionmentioning

confidence: 99%

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Innovation and Its Discontents: Pathways and Barriers in the Diffusion of Assertive Community Treatment

Rochefort

2019

Milbank Quarterly

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Widespread diffusion of policy innovation is the exception rather than the rule, depending as it does on the convergence of a variety of intellectual, political, economic, and organizational forces. The history of Assertive Community Treatment (ACT) provides a compelling case study of this process while also showing how conditions may shift over time, altering the scenarios for continued program expansion. Diffusion of a program like ACT challenges government to play a nuanced role in which public endorsement and resources are used to strengthen a worthwhile service, but without suppressing flexibility and ongoing experimentation as core program values. Acceptance as a proven form of “evidence‐based practice” is a critical element in the validation of ACT and other community mental health interventions that combine clinical and social features in novel ways. However, the use of conventional evidence‐based research as a singular gold standard of program value narrows the range of stakeholder input, as well as the evaluation methodologies and forms of data deemed worthy of attention. Context Originating at the county level in Wisconsin in the early 1970s, Assertive Community Treatment is one of the most influential mental health programs ever developed. The subject of hundreds of research studies and recipient of enthusiastic backing from private advocacy organizations and government agencies, the program has spread widely across the United States and internationally as a package of resources and management techniques for supporting individuals with severe and chronic mental illness in the community. Today, however, ACT is associated with a rising tide of criticism challenging the program's practices and philosophy while alternative service models are advancing. Methods To trace the history of the Assertive Community Treatment movement, a diffusion‐of‐innovation framework was applied based on relevant concepts from public policy analysis, organizational behavior, implementation science, and other fields. In‐depth review of the literature on ACT design, management, and performance also provided insight into the program's creation and subsequent evolution across different settings. Findings A number of factors have functioned to fuel and to constrain ACT diffusion. The former category includes policy learning through research; the role of policy entrepreneurs; ACT's acceptance as a normative standard; and a thriving international epistemic community. The latter category includes cost concerns, fidelity demands, shifting norms, research contradictions and gaps, and a multifactorial context affecting program adoption. Currently, the program stands at a crossroads, strained by the principle of adherence to a long‐standing operational framework, on the one hand, and calls to adjust to an environment of changing demands and opportunities, on the other. Conclusions For nearly 50 years, Assertive Community Treatment has been a mainstay of community mental health programming in the United States and other parts of the worl...

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Diffusion Of Innovations Theory, Principles, And Practice

Cited by 421 publications

References 48 publications

Telephone nurses’ use of a decision support system: An observational study

Telephone nurses’ use of a decision support system: An observational study

Sectoral evolution and shifting service delivery models in the sharing economy

Innovation and Its Discontents: Pathways and Barriers in the Diffusion of Assertive Community Treatment

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