A Comparative Analysis of the Diffusion and Participatory Models in Development Communication

Diffusion and Participatory Models

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A Comparative Analysis of the Diffusionand Participatory Modelsin Development Communication

The field of development communication is dominated by two conceptual mod-els: diffusion and participation. These models have distinct theoretical rootsand differing emphases in terms of program designs and goals. This article ex-amines the extent of the gap and the overlap between them by comparing theobjectives and outcomes of 44 projects. The two approaches differ in the un-derlying philosophies, frameworks, program strategies, and measurement tools,but the gap between these approaches is being bridged by proponents of bothmodels, who knowingly or unknowingly have borrowed elements from oneanother.

Communication is a key component of many overseas aid programs.Efforts to improve living conditions in the world’s poorer areas throughsocial service and infrastructure development are often accompanied bycommunication campaigns aimed at the general population. Such devel-opment communication has been defined as “the strategic applicationof communication technologies and processes to promote social change”(Wilkins, 2000, p. 197). The field of development communication isdominated by two conceptual models: diffusion and participation. Thesemodels have distinct theoretical roots and differing emphases in termsof program designs and goals. This article compares the objectives andoutcomes of projects based on these models. It takes an inductive approachto constructing a basis for theorizing about development communicationby examining published studies and working papers that report on specificinterventions—commonly termed campaigns or programs.1

Development projects have many goals, including educational, envi-ronmental, and economic improvement. This article focuses on inter-ventions concerning health, particularly infant health, HIV/AIDS, fam-ily planning, and general health promotion. It favors studies publishedin the last decade, and interventions carried out in what has come to becalled the developing world—Africa, Latin America, and the less indus-trialized countries of Asia. Also included are several campaigns that ap-plied participatory principles in indigenous or isolated populations indeveloped countries.

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Pages225–248

Nancy Morris

Copyright © 2003 International Communication Association

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The stated aims of these campaigns fall largely into categories thatderive specifically from differences in the diffusion and participatoryapproaches. The diffusion model, named for Everett Rogers’s (1962)“diffusion of innovations” theory, derives from modernization theoryof the 1950s and 1960s (Lerner, 1958; Schramm, 1964). The diffusionmodel regards behavior change as the goal of a communication cam-paign and views persuading individuals to change their behavior by pro-viding them new ideas and information as the purpose of communica-tion campaigns. The standard formulation of this model is Knowledge/Attitudes/ Practice, or KAP: Information provides Knowledge, whichleads to a change in Attitudes, which in turn leads to Practice—the de-sired behavior change. Within the diffusion model fall such activities asentertainment-education and social marketing. Interventions basedon any variety of the diffusion model center on messages carried bymass media.

The participatory model emerged in part as a reaction to the underly-ing assumptions of the diffusion model (Huesca, 2000, p. 74; Thomas,1994, p. 54). It holds that development communication is not a verticalprocess of information transmission from the knowledgeable to the lessknowledgeable, but rather a horizontal process of information exchangeand interaction. Proponents of this approach stress the model of dia-logue as a catalyst for individual and community empowerment adoptedfrom the work of Brazilian educator Paulo Freire (1970). This modelposits that the purpose of development is to empower people to havegreater control over decisions that affect them and, in this way, to fostersocial equity and democratic practices. Several 1970s United Nations“popular participation” measures contributed to the recognition andadoption of the participatory approach in development communication(Midgley, 1986, p. 21). Many participatory health researchers cite as aguiding principle the 1978 World Health Organization Declaration ofAlma Ata, which states that “the people have the right and duty to par-ticipate individually and collectively in the planning and implementa-tion of their health care” (para. 4).

The essence of the participatory approach lies in working with citi-zens to determine their needs and to design and implement programs toaddress these needs, rather than imposing an intervention on a commu-nity. No standard definition of participation exists (cf. Melkote, 2000,p. 41; Midgley, 1986, p. 25). Despite this absence, or perhaps because ofit, White (1994) has observed, “Now, no respectable development projectcan be proposed without using this ‘in’ word” (p. 16). Although somedevelopment projects are thus perceived as merely giving lip service tothe notion of participation, genuinely participatory projects are seen tobe those in which there is grassroots control over key program decisions(Melkote, p. 41; Midgley, p. 10; Servaes, 1996; White, p. 17).


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In its purest form, the participatory approach sees development inter-ventions “less as means to an end than as offering ends in themselves:the emphasis is not on outcomes but on processes” where people areregarded “as agents rather than objects; capable of analyzing their ownsituations and designing their own solutions” (Cornwall & Jewkes, 1995,p. 1670). Community participation can extend from the formative re-search phase through program planning and execution to evaluation ofthe program (Cornwall & Jewkes, 1995; Roe, Berenstein, Goette, &Roe, 1997). Such activities as “empowering evaluation” (Roe et al.,1997); “empowerment education” (Wallerstein, Sanchez-Merki, & Dow,1997, p. 196); participatory learning (Laverack, Sakyi, & Hubley, 1997),participatory research (Cornwall & Jewkes, 1995); participatory actionresearch (Sarri & Sarri, 1992; Dickson, 2000); and community involve-ment in health (Hildebrandt, 1994) fall into the participatory communi-cation category. Participatory campaigns employ interpersonal commu-nication channels almost exclusively: group meetings, workshops, andsometimes localized “small media” such as community theater (Boeren,1992, p. 47; Kalipeni & Kamlongera, 1996) or interactive posters(Laverack et al., 1997).

Although participatory communication is often defined in contrast tothe more traditional diffusion model, the two are not polar opposites.The diffusion model has evolved in a participatory direction since itsinitial formulation, and participatory projects necessarily involve someelement of information transfer. Nonetheless, most development com-munication projects tend to situate themselves in one or the other cat-egory. In addition to the specifics of campaign activity and evaluationimplied by the choice of framework, all development campaigns are sub-ject to strictures imposed by funding agencies. These externally deter-mined constraints can greatly affect campaign planners’ choices (GumucioDagrón, 2001, p. 11; Wilkins, 2000, p. 204).

The studies included in this review were selected on the basis of thefollowing criteria: Each was an empirical study of one or more commu-nication interventions that included information on the objectives andnature of the intervention, the method of evaluation, and the outcomes.This review refers to some studies that do not meet these criteria, butthis review is based on studies for which that information is provided.These studies are summarized in Table 1. All of the studies, regardless oftheir framework, were examined for evidence of outcomes identifiedwith the diffusion model (i.e., changes in knowledge, attitudes, and prac-tices) and of outcomes identified with the participatory model (i.e., em-powerment, community building, and social equity).

These studies comprise an opportunistic sample of working papersand published articles on development interventions. They were foundthrough standard database searches and by tracing bibliographical and

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Internet references. Although the 44 projects examined do not consti-tute an exhaustive collection of relevant material, the inclusion of morestudies seems unlikely to have produced patterns undetected from thispartial review.

Although some projects’ evaluations were manifestly more rigorousthan others, for the most part researchers’ assessments of outcomes areaccepted as stated. There are several reasons for not delving into issuesof research methods, reliability and validity, or justifications for claimsabout results. These reasons concern the amount of detail reported foreach study, the pitfalls of trying to compare different types of outcomes,and the varying requirements of the journals in which these studies appear.

First, many of the studies reviewed here contain insufficient detailabout how the evidence was gathered to gauge the quality of their con-clusions. Some quantitative studies specify how their samples may ormay not represent the population of interest, but not all of the articlesinclude this information. Most of the survey-based studies do not in-clude copies of the questionnaires used or verbatim transcriptions of keyquestions. The absence of explicit information on sampling proceduresand questionnaire content impedes assessment of survey validity. Like-wise, the studies based on qualitative methods—the prevailing approachfor evaluating participatory projects—generally provide few details oftheir procedures. Evidence for claims of community empowerment comesin the form of brief excerpts from interviews or meetings, or descrip-tions of interactions. At times, no evidence is provided; the researcherssimply assert that empowerment has occurred. These problems are ex-emplified by the author of one participatory study who flatly rejectsstandard evaluation norms and then makes a claim about results:

This presentation of findings neither evaluates the project nor establishes cause-and-effect relationships between specific project activities and certain participatory outcomes.Notwithstanding, some relationships are evident. . . . The data show that, over time, the[subjects] thrived as individuals and as a group and became known and respected in thecommunity. (Dickson, 2000, p. 195)

Without extensive descriptions of contexts, interactions, and other basesfor researchers’ interpretations of events, it is difficult to assess claimsbased on ethnographic methods such as participant observation.

A lack of methodological exposition is not unique to this body ofmaterial. A team of researchers reviewing write-ups of community ac-tion health programs found that none of the 17 articles they looked atprovided sufficient information on “sampling and control procedures,reliability and validity of instruments, analysis techniques, and specifi-cation of details of the intervention” to allow “rigorous scientific evalu-ation” of the studies (Hancock et al., 1997, p. 229). Reviewers of nutri-


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tion education projects similarly found that “[d]etailed descriptive in-formation about the program setting or context and the communicationor education strategy are commonly lacking” (Cerqueira & Olson, 1995,p. 57), and a review of 41 articles about HIV/AIDS prevention cam-paigns concluded that “conceptual and methodological rigor in report-ing fundamental communication components can be improved” (Myhre& Flora, 2000, p. 41).

The second reason that this analysis does not deeply scrutinize meth-ods is that there is a question of comparable measurement. Not only isthere no agreed-upon definition of participation, but the typical partici-patory outcomes of empowerment and equity do not have generally ac-cepted conceptual or operational definitions. Consequently, they are lessamenable to measurement than such outcomes as the percent change invaccinations before and after a campaign or even slippery hypotheticalssuch as the intention to use contraception. As Eng, Briscoe, andCunningham (1990) say, “Participation is not an objective that exists inspecific quantities or that can be measured in particular units to be com-pared over time,” nor is it “simply a yes-no variable that is either presentor absent” (p. 1350). Laverack et al. (1997, p. 26) put this more starkly,“Itis not very clear what measures of outcome can be used for demonstrat-ing that an individual or group has become ‘empowered.’”

Finally, although most published articles have been subject to peerreview, write-ups in different types of journals focus on different aspectsof the research process and supply varying depth of detail. To comparethe participatory and diffusion frameworks, the studies must be takenseriously, not rejected out-of-hand for providing insufficient evidence tosupport their claims. For all of these reasons, the studies discussed hereare for the most part examined and evaluated on their own terms.2

Outcomes: Diffusion FrameworkMany development interventions are in effect advertising campaigns forsuch “products” as contraception or immunizations. The use of estab-lished advertising techniques to promote development goals via mediasuch as TV, radio, newspapers, and billboards is termed social market-ing (Kotler & Roberto, 1989, p. 24). Social marketing has adoptednot only the forms of marketing, but also its tools: consumer re-search, pretesting, targeting, audience segmentation, and campaignevaluation (Andreasen, 1995; Backer, Rogers, & Sopory, 1992, p.32). Most media-based development projects draw from social mar-keting techniques.

Media-centered campaigns have produced varying degrees of success.Studies finding limited results from such interventions include Hornik(1988, pp. 140–144), McDivitt and McDowell (1991), Ogundimu (1994),

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Valente and Saba (1998), and Yoder, Zheng, and Zhou (1991). Evalua-tions of other projects have found the application of elements of socialmarketing to be broadly successful (Jato et al., 1999; Kincaid, 2000;McDivitt, Zimicki, & Hornik, 1997; Piotrow et al., 1990).

Two family-planning campaigns—one in The Gambia and the otherin Mali—combined social marketing and entertainment-education tech-niques, with interestingly contrasting results. The campaign in TheGambia resulted in improved knowledge, attitudes, and practices amongpeople with no education who heard the campaign’s radio drama (Valente,Kim, Lettenmaier, Glass, & Dibba, 1994, p. 98). This association wasreversed in Mali. Evaluators of a multimedia campaign found that un-educated respondents were not affected by campaign exposure, whereasthose with some schooling were (Kane, Gueye, Speizer, Pacque-Margolis,& Baron, 1998, p. 320).

The media-based campaign strategy of entertainment-education (E-E) has been enthusiastically embraced by many development communi-cation practitioners (Lettenmaier, Krenn, Morgan, Kols, & Piotrow, 1993;Singhal & Rogers, 1999; Piotrow et al., 1990). Drawing on Bandura’s(1977) social learning theory, E-E has been defined by leading U.S. pro-ponents in classic diffusion terms as “the process of purposely designingand implementing a media message to both entertain and educate, inorder to increase audience knowledge about an educational issue, createfavorable attitudes, and change overt behavior” (Singhal & Rogers, 1999,p. xii). Entertainment-education messages may be carried, for example,by a soap opera or popular song specifically written for that purpose orby vignettes inserted into variety shows. The key characteristic is that themedia fare is not presented in an overtly didactic way; it is presented andmeant to be consumed as entertainment.

Strong claims have been made about the power of the entertainment-education strategy. For instance, Singhal and Rogers (1989) wrote: “En-tertainment—through television, radio, and music—is one of the mosteffective communication strategies for reaching the public to pro-mote family planning and other public health issues” (p. 39). Al-though not all E-E interventions have achieved the desired effect(Sherry, 1997; Yoder, Hornik, & Chirwa, 1996), many entertain-ment-education projects have been judged to be successful(Lettenmaier et al., 1993; Piotrow et al., 1990; Rogers et al., 1999;Storey, Boulay, Karki, Heckert, & Karmacharya, 1999; Sypher, McKinley,Ventsam, & Valdeavellano, 2002; Ume-Nwagbo, 1986).

The social marketing and entertainment-education strategies rely onmass media as the agent of message diffusion. An aspect of developmentcampaigns that shows up in study after study, however, is the contribu-tion of interpersonal communication to behavior change. Communica-tion researchers dating back as far as Lazarsfeld, Berelson, and Gaudet’s


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(1944) classic formulation of the two-step flow process and Rogers’s(1962) Diffusion of Innovations have highlighted the link between me-dia messages and interpersonal communication.

Reardon and Rogers stated in 1988 that “almost every diffusion studyfinds that peer networks play an especially crucial role in decisions toadopt a new idea” (p. 295). This observation led them to term the aca-demic divide between interpersonal and mass communication a “falsedichotomy.” Substantiating this claim, many studies reviewed here notedthe role of media in sparking interpersonal communication, which inturn leads to changes in behavior. Although some campaign plannersdeliberately sought to encourage interpersonal communication, otherswere surprised to discover that postcampaign evaluations revealed a sig-nificant role for interpersonal communication.

One channel of interpersonal communication is found in the healthsystem. When health promotion campaigns attempt to stimulate de-mand—for contraceptives, immunizations, or other health services—con-tact with health system personnel becomes a source of information. Evalu-ations of several development communication interventions explicitly ex-amined interpersonal communication through this institutional channel.

As with other types of interventions, these have had mixed results.Some showed media to be more influential than interpersonal commu-nication (Lettenmaier et al., 1993; McDivitt et al., 1997). Other cam-paigns showed the converse, with interpersonal communication withhealth workers proving the key to behavior change (Ogundimu, 1994;Yoder et al., 1991).

Clearly, interaction with health service workers can be significant indevelopment campaigns, but as much research has indicated, a salientfactor in many people’s decision making is informal interpersonal com-munication with friends, family, peers, and other potential opinion lead-ers, innovators, or early adopters. Mass communication can trigger suchinterpersonal communication.

A study of a family-planning campaign in The Gambia found thatexposure to an entertainment-education radio drama “was associatedwith interpersonal communication about contraceptives with partnersor friends” and that these discussions, rather than the radio programsdirectly, led to increased clinic visits (Valente et al., 1994, p. 99). A fam-ily planning campaign in Ghana (Hindin, Kincaid, Kumah, Morgan, &Kim, 1994), and family planning and AIDS campaigns in Tanzania(Rogers et al., 1999; Vaughan, Rogers, Singhal, & Swalehe, 2000) showedsimilar results.

Some communication interventions rely on the interpersonal channel.Family planning campaigns are often designed to encourage spousal com-munication about contraception, which has been shown to be associatedwith contraceptive adoption (Rogers et al., 1999; Storey et al., 1999).

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Several studies posed research questions about the relative merits ofinterpersonal and mass media channels in achieving behavior change.Valente and Saba (1998, pp. 114–116) explicitly sought to compare theinfluence of mass media and interpersonal communication in a familyplanning campaign in Bolivia. They found that media exposure led toincreased knowledge and attitude change and to interpersonal commu-nication itself, which was more strongly associated with behavior change.They also found that media could, in effect, substitute for personalcontact by providing information to those respondents who did nothave contact with contraceptive users. The importance of interper-sonal communication aspects of campaigns was also highlighted byBoulay, Storey, and Sood (2000); Hussain, Aarø, and Kvåle (1997),and Storey et al. (1999).

Outcomes: Participatory FrameworkThe evaluation of participatory campaigns has a dual focus because thesecampaigns have two sets of goals. They seek to achieve some specificdevelopment end, referred to as an outcome and evaluated by “outcomeindicators,” and also to empower communities via participation, referredto as process and evaluated by “process indicators.” Evaluation of out-comes can be undertaken by observation of results such as clinic records.Evaluation of processes, empirically a less straightforward undertaking,was often a greater focus in the studies reviewed here. The task is com-plex, in part because of the lack of accepted definitions of community,empowerment, or participation (Gumucio Dagrón, 2001, p. 8;Manderson, 1992, p. 9).

This “conceptual fuzziness” (Huesca, 2000, p. 75) notwithstanding,researchers involved in participatory projects found evidence of successin their case studies. Dickson (2000) examined a Canadian health pro-motion project for older Aboriginal women. Focusing on process indi-cators, she found “many examples of the [subjects] reaching out andestablishing external community connections, relationships, and part-nerships; learning more about and critically analyzing community issuesthat are important to them; becoming activists, speaking out on issuesand being involved in decision-making” (p. 207).

Purdey, Adhikari, Robinson, and Cox (1994) reported on projects inNepal that were part of a Canadian initiative to support community-based participatory development. Focusing on the relationship betweencommunity members and funding agencies, the researchers reported thatthe group “gained confidence in their ability to work together and influ-ence agencies . . . [and] overcome not only physical, bureaucratic andinterpersonal difficulties but also the dependency attitude unwittinglycreated by outside development agencies” (p. 334).


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Another type of participatory project was a “healthy lifestyle” projectwith an Aboriginal population in Australia. In terms of outcome mea-sures, researchers found some improvements in health behaviors. In termsof process measures, 6 years after its inception, the program was still inoperation, had community support, and was run by community mem-bers. This, according to the reseachers, is “in our opinion, a measure ofsuccess in itself” (Rowley et al., 2000).

In some cases, researchers noted that participatory goals may havebeen overly ambitious (Laverack et al., 1997; Sarri & Sarri, 1992; Wright,Naylor, Wester, Bauer, & Sutcliffe, 1997). Rifkin (1996, p. 84–89) hassuggested that participatory interventions have set “unrealistic expecta-tions.” Reviewing several projects, she concludes that community par-ticipation is an elusive concept and that health and social service profes-sionals have been unable “to manipulate social change in the directionof their own preconceived notions of progress and development.”

A different sort of criticism of the empowerment model came fromBrunt, Lindsey, and Hopkinson (1997), who confront a central questionin development communication: “the dilemma posed when the world-views of one culture are juxtaposed with those of another” (p. 19). Get-ting away from such top-down imposition was part of the initial impetusfor the participatory model. Yet, working with rural ethnic Hutterites, atraditional religious group in Canada, the researchers found themselves

challenged by the prospect of working with a culture in which an emancipatory, grassrootsapproach runs counter to community norms, expectations, and desires. For example . . .[the Hutterite] deference to hierarchy rendered the grassroots approach, which is ideallypredicated on widespread community participation, largely ineffective. (p. 25)

Criticizing “the ethnocentricity of empowerment,” Brunt, Lindsey, andHopkinson concluded that the imposition of this model “may unwit-tingly undermine Hutterite cultural and spiritual values” (1997, 25–26).

Ends/MeansDiffusion and participatory interventions tend to define their objectivesin terms of diffusion and participatory ends. Few studies mention out-comes related to the other framework. Part of this disjuncture derivesfrom the different methods of data gathering favored by each approach.Certain sorts of results are amenable to certain sorts of measurement.Researchers are unlikely to find what they are not looking for and un-likely to look for what they do not believe they can evaluate. Neverthe-less, Table 1 indicates there is some overlap not only in the aims but alsoin the outcomes of projects based on each of these frameworks.

Participatory communication interventions necessarily have goals be-

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yond the primary ones of empowerment, equity, and community build-ing. Each project has a specific focus. Although most participatory stud-ies examined here claim at least some success in achieving participatorygoals, some, though not all, also discuss the behavior changes that arethe underlying rationale for the interventions. Some studies include littleinformation on these. For example, Dickson (2000) concentrates herdiscussion on the empowerment outcomes of a health program for eld-erly Aboriginal Canadian women, mentioning but not detailing “knowl-edge and skills developed in some areas” (p. 212). Hildebrant (1994)outlined a scale of “process criteria” for judging interventions but didnot detail either process or outcome results.

Studies that do note participatory outcomes as indicated by ethno-graphic measures include Purdey et al. (1994), Sarri and Sarri (1992),and Wallerstein et al. (1997), all of which claimed that communitymembers became increasingly empowered over the course of theprojects. Other participatory studies measured outcome indicatorswith clinic statistics. Rowley et al. (2000) found some health behav-ior change in an Aboriginal Australian community; Wright et al.(1997) found improved breastfeeding practices in Navajo mothers.Such outcomes are typical of those sought in projects based on thediffusion model. Notably, both of these outcomes are demonstratedby statistical analysis of clinic data, which allows findings character-istic of diffusion studies.

Few diffusion studies explicitly mention the types of outcomes typi-cally sought in participatory projects. Nonetheless, diffusion campaignsmay well reduce social inequality, an outcome consistent with goals ofparticipatory interventions, by extending health care to all levels of soci-ety. Just such a finding was made in Ecuador’s broad-based child immu-nization campaign. Asking whether the campaign’s effects were “equita-bly distributed across the socioeconomic spectrum,” evaluators foundthat compared to previous immunization efforts, which had resulted inmuch greater immunization coverage in higher socioeconomic strata,the increases in immunization coverage “were shared at least equallyamong social groups and possibly were relatively larger among the worse-off groups” (Hornik, Contreras-Budge, Ferencic, Koepke, & Morris,1991, p. 4).

Other diffusion studies that mention participatory ends include a ra-dio-based family-planning campaign in The Gambia that was felt to have“an empowering influence” on uneducated respondents because “otherforms of education rarely reach these women directly” (Valente et al.,1994, p. 100) and an entertainment-education soap opera in Tanzania,which was found to produce the empowering outcome of increasing“listeners’ sense of self-efficacy with respect to family-size determina-tion” (Rogers et al., 1999, p. 205).


235

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Combinations of Participatory and Diffusion ApproachesThe studies described so far are clearly self-identified as diffusion orparticipatory in approach. A literature search produced only one studythat explicitly tested participatory and diffusion approaches to healthcommunication against one another. Krishnatray and Melkote (1998)designed an experiment to compare condensed versions of two existingprograms in India that sought to further the treatment of leprosy bydestigmatizing the disease. Participants from three villages were assignedto either a diffusion group, a participatory group, or a control group.Each subject attended a one-day health education camp. The diffusiongroup was exposed to clinical information via video and slides; the par-ticipatory group engaged in dialogue with leprosy patients and healthworkers. Statistical analysis of pretest and posttest surveys showed thatthe participatory treatment was more effective than the diffusion treat-ment in effecting destigmatization. However, this study might be bettercategorized as a comparison of teaching methods than of participatoryand diffusion approaches. It does not meet the participatory criterion ofsome sort of community input into an intervention.3

Two other studies merit examination for the ways they link participa-tory and diffusion approaches and for their insightful analyses. Bothdescribe process indicators related to the participatory aspects of theprojects and use quantitative measures as evidence for their conclusionsabout the outcome indicators—health behaviors.

A campaign to promote breastfeeding on the Navajo reservation inArizona used techniques drawn from both social marketing and partici-patory frameworks (Wright et al., 1997). The program was evaluatedthrough examination of medical records, which showed statistically sig-nificant improvement in breastfeeding practices following the interven-tion. This program no doubt owes its success in achieving its outcomegoals to a carefully targeted intervention, multiple message channels,and the cultural awareness embodied in its design and execution. Itsprocess goals, however, were judged to have been less successfully metand were scaled down during the course of the project (Wright et al.,1997, p. 637).

A second study linking participatory and diffusion frameworks em-ployed quite a different research method. Eng et al. (1990) set out todiscover whether there existed a relationship between community par-ticipation in water supply projects and participation in other primaryhealth care activities by comparing villages in Togo and Indonesia thathad community-based water supply projects funded by the U.S. Agencyfor International Development. For each country the researchers col-lected data from 10 villages with participatory water supply projects, 10with nonparticipatory water supply projects, and 10 with no water sup-ply projects.

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As a gauge of community participation in other primary health careactivities, the researchers selected participation in an immunization pro-gram—an activity that is not directly influenced by water supply and forwhich detailed data are available. They found that villages with partici-patory water supply projects had consistently higher immunization rateson the immunization series selected as a measure than had the other twosets of villages. The researchers convincingly ruled out the possible alter-native explanation that the findings were due to preexisting differencesbetween the villages. They thus demonstrated that immunization, a goaltypically addressed by diffusion programs, could be achieved as a spillovereffect of community participation in another social realm.

Problems of MeasurementThe examples discussed so far suggest that the difficulties of assessingwhat works and of comparing the two frameworks are exacerbated bymeasurement issues, particularly the gulf between the types of measure-ment typically used in diffusion and participatory research. In some sense,comparing these two models is a question of apples and oranges. Al-though both approaches share the objective of improving health or othersocial conditions, participatory studies tend to focus more on the goalsrelated to the empowerment ends than the behavior change ends.

Most diffusion studies are based on quantitative survey data, whereasmost participatory studies are based on participant-observation and otherqualitative ethnographic methods. It is difficult to compare results ob-tained by such disparate means. This, too, has been found to be the casein other research reviews. Researchers evaluating literature on AIDS/HIV prevention campaigns encountered “many conceptual and mea-surement inconsistencies across studies” that hampered comparisons(Myhre & Flora, 2000, p. 41). A group of specialists assessing the evalu-ation of malaria intervention projects in Africa found it difficult to com-pare study results because the studies did not have a common set of“standardized outcome indicators” (Eisele, Macintyre, Eckert, Beier, &Killeen, 2000, p. 3). It might be too much to ask diffusion and participa-tory studies to share “standardized outcome indicators,” but even withinthe category of participatory studies, researchers have noted that “thereis little consistency in how community participation is conceptualizedand subsequently measured” (Eng et al., 1990, p. 1350).

For these reasons it seems pointless to try to compare these studies asif they were apples and apples. What can be said is that most studiesclaim some success and that few studies claim complete success for theprojects they evaluate. It should be noted that this review of researchmay be overstating the achievements of development communicationinterventions because, as analysts have pointed out, published studies


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are biased towards successful campaigns (Bauman, 1997, p. 667; Hornik,1997, p. 53).

CrossoverThe philosophical differences between diffusion and participatory practi-tioners, added to the differences in campaign strategies and measurementmethods, may exaggerate the apparent gap between the approaches. Yetcomments from evaluators of campaigns lodged in each of these frame-works acknowledged the need for elements of the other framework.

Many studies of interventions based on diffusion principles evincethoughtful reflection about the value of community participation. Evalu-ators of a project to encourage child spacing in Jordan acknowledgedthat the resources put into creating the campaign were wasted becausethe topic was considered too sensitive to be promoted in that country.They concluded with a hallmark of the participatory approach: “Onelesson to be learned from this experience is the importance of local par-ticipation in the choice of topics to be addressed” (McDivitt, 1991,p. 3). Correspondingly, Starosta (1994) criticized some family planningefforts in India, not in this case because of the nature of the topic, butagain because outsiders’ standards were imposed: Campaign materialswere based on United Nations-defined motives for adopting family plan-ning that were shown to be irrelevant to the intended audience. “Thereliance on international motives to reach local minds invites distortionand rejection of messages,” commented Starosta, who appealed for par-ticipatory communication: “The client must be given greater voice indefining his own needs. . . . Communication materials should reflect theinput of . . . groups of villagers” (1994, pp. 257–259).

Although an analysis of an immunization campaign in Nigeria criti-cized its top-down approach and failure to conduct adequate researchinto the local context (Ogundimu 1994), Piotrow et al. (1990) attributethe success of a family planning intervention in the same country pre-cisely to such research: “Involving health workers and members of theintended audience in the process of message development proved in-valuable,” remarked the evaluators (p. 266). They continued with a state-ment straight out of the participatory communication canon:

This process not only resulted in improved materials but also generated a sense of in-volvement in the process among health workers. Such involvement should be standardprocedure in all communication projects, which need to emphasize that communicationis a process, not a product. (Piotrow et al., 1990, p. 272)

Just as many researchers in the diffusion camp have recognized the valueof community participation, there also exists crossover in the other di-

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rection. Although participatory communication is often defined againstthe traditional diffusion model (Cornwall & Jewkes, 1995; Huesca, 2000,p. 74; Laverack et al., 1997; Rockefeller Foundation, 1999), evaluatorsof some participatory studies have called for activities that fit clearlywithin the diffusion model of knowledge transfer.

One example of this is a Rockefeller Foundation report on communi-cation for social change. Communication for social change is defined inparticipatory terms as “a process of public and private dialogue throughwhich people define who they are, what they want and how they can getit” (1999, p. 8). The report claims this process “empowers individualsand communities, it engages people in making decisions that enhancetheir lives” (1999, p. 18). Yet the report poses questions couched clearlyin diffusion terms:

[C]an we create a “transfer of knowledge” or type of curriculum that can be exportedworldwide easily and economically? What’s in such a curriculum? Who are the trainers?. . . How do we reach people in those areas of the world most in need of this knowledgebut who have the smallest number of resources to access such training? (RockefellerFoundation, 1999, p. 24)

A researcher involved in a South African health project described theexpansion of community participation and the consequent reduction ininvolvement of researchers and other outsiders in terms that suggest thediffusion model: “The amount and level of activity of the two groups var-ied inversely as expertise and organizational abilities of the outside peoplewere transferred to the community people” (Hildebrant, 1994, p. 284).

Another evocation of diffusion principles appears in a summary ofcommunity-based participatory efforts at malaria control: “Health edu-cation plays an important role in predisposing a community to interven-tion,” says the researcher. Communities whose understanding of thecauses and prevention of disease are not “in concordance with biomedicalunderstanding” need “new information about disease transmission andvector control prior to the introduction of an intervention” (Manderson,1992, p. 13). Related to the perceived need for the transmission of knowl-edge, even in participatory campaigns, is recognition of the role that out-side experts can play: “The analysis also . . . shows that successful commu-nity-based programs require a substantial, sustained input from properly-trained external collaborators in the planning, execution and operationphases of a project” (Eng et al., 1990, p. 1358).

Participatory communication activist and scholar Servaes (1999, p.157) echoes this point:

Participation does not imply that there is no longer a role for development specialists,planners, and institutional leaders. It only means that the viewpoint of the local public


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groups is considered before the resources for development projects are allocated anddistributed and that suggestions for changes in the policy are taken into consideration.

Such comments and examination of the studies reviewed here suggestthat, like the claim made by Reardon and Rogers (1988) about the spu-rious distinction between interpersonal and mass communication, thedistinction between participatory and diffusion approaches may be jus-tifiably described as a false dichotomy.

Campaign ReplicabilityThis analysis has reviewed development communication projects forevidence of successful outcomes linked to the goals of diffusion and par-ticipatory approaches. Examination of many studies shows that manytypes of interventions produce at least some of the desired results, butunder different conditions, they produce different results, some moresuccessfully than others.

One reason that it is difficult to discover a pattern of successful tech-niques is that most campaigns use some combination of strategies, butthey do not use the same combination. Strategies vary depending onlocal needs, resources, politics, and program aims, which are themselveslikely to be shaped by funding agencies’ priorities. It can be difficult,then, to sort through and attribute change to one or another piece of anoverall campaign or even to a certain combination of factors.

The Rockefeller Foundation (1999) report on communication for so-cial change made this case in terms of participatory projects: “Becausedialogue and debate are the immediate objectives and are difficult tomeasure or attribute to any particular intervention, and because it isrecognized that social change is likely to take a long time, this work isvery difficult to assess and evaluate” (p. 19). Concerning projects basedon diffusion principles, Storey et al. (1999) similarly stated: “the causesof any given health behavior change can be highly complex, so it is un-likely that any one message or act of communication will consistentlyproduce action” (p. 272).

Certainly, the foregoing has revealed no clear pattern of success indevelopment communication interventions. Interventions based on dif-ferent theoretical models, communication strategies, measurement tools,and goals have met varying degrees of success at different times and indifferent places. This raises the question of why it is difficult to general-ize about what sorts of communication campaigns are most effective or,stated in terms of the scientific method, which campaign strategies canbe replicated.

The prospect of generalizability and replicability of development com-munication campaigns seemingly remains out of reach. It is not pos-

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sible, maintains one scholar, “to identify a single solution to a complexset of problems which do not share a common history of creation” (Rifkin,1996, p. 90). This recognition that local contexts differ and that com-munication strategies must be based on research into the specificities oflocal cultures echoes one of the basic discoveries of the global market-ers: Blanket multinational strategies for selling products are ineffective(Maxwell, 1997). Development communication researchers, like theirmarketing counterparts, have argued that foreign models and assump-tions don’t work (Brunt et al., 1997; McDivitt, 1991; Ogundimu, 1994;Starosta, 1994) and that successful campaigns owe their success, at leastin part, to their incorporation of local norms, vocabulary, and under-standings, not to mention participation (Marmo da Silva & ChagasGuimarães, 2000; Wright et al., 1997).

“Community participation,” states one researcher, “can be seen as aset of views and activities which reflect a solution to a specific set ofcircumstances. The process under which solutions develop might havesome universal characteristics but the solution itself will be local” (Rifkin,1996, p. 89). Even in the developed world, argued Hancock et al. (1997),interventions must be localized: “Standard interventions may not beacceptable within the community setting. A standardized approach thatincludes flexibility to individual community variability may be moreappropriate” (p. 236).

Servaes (1990) made a virtue of this lack of replicability: “Each soci-ety must attempt to delineate its own strategy to development, based onits own ecology and culture. Therefore, it should not attempt to blindlyimitate programs and strategies of other countries with a totally differ-ent historical and cultural background” (p. 38). This may seem discour-aging to campaign planners seeking a globally efficacious interventiontemplate, but addressing the unique characteristics and expectations oflocal communities can only enhance the effectiveness of developmentprograms.

ConclusionThis review of development communication campaigns has indicatedthat there is growing awareness of the potential for the existing diffu-sion and participatory approaches to inform one another. Campaignevaluators’ comments have illustrated the folly of rigidly separating theseapproaches. Laverack et al. (1997), noting that participatory and diffu-sion methods “are often presented as mutually exclusive,” make a casefor combining them: “A suitable strategy for many programmes willprobably be a pragmatic mix of both approaches,” a combination theyterm “semi-participatory” (p. 26). Singhal and Rogers, leading propo-nents of entertainment-education, a diffusion-based campaign strategy,


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suggested recently, “In the future, E-E interventions are likely to see moreintegration with participatory communication” (2002, p. 133).

Along those lines, communication theorists working on alternativemodels have proposed mixes of both approaches whose very labels—“convergence,” “triadic,” “multiplicity”—suggest that integration istaking place at the theoretical level.

Everett Rogers himself, across 20 years of revisions of Diffusion ofInnovations, moved away from a definition of diffusion as solely a one-way process of message transmission toward a definition that incorpo-rates participatory aspects: “Other types of diffusion are more accu-rately described by a convergence model, in which communication isdefined as a process in which the participants create and share informa-tion with one another to reach a mutual understanding” (Rogers, 1983,p. xviii).

In 1994, Ascroft and Agunga proposed a “triadic model for partici-patory decision-making” that moves the diffusion model toward theparticipatory model. Their model replaces Rogers’s “traditional changeagent”—typically a government representative such as an agriculturalextension agent or a health care worker —with a “professional commu-nicator” whose task, unlike that of the change agent, is not to influencereceivers’ behavior but rather to serve as a neutral communication chan-nel between citizens and government or funding agencies. With the ad-dition of a neutral go-between, the communication changes from dyadicto “triadic.” The key here is that this “trained communicator” transmitsinformation to receivers and also feeds back information from receiversto funding agencies, rather than acting as a partisan for the governmentor the funding agency. This intermediary must be able to “create thesituational and psychological conditions in which development benefac-tors and their intended beneficiaries can participate together in mutualcoequality in making development decisions” (1994, p. 310).

If the participatory and diffusion models are seen as lying on a con-tinuum rather than as fenced off from one another, Servaes starts muchfurther along the continuum toward the participatory model. Arguingthat “there is no universal path to development” (1996, p. 83), Servaesfavors a “multiplicity paradigm” that draws on “a new political praxis. . . a more dialectic and multi-centered perception of power and cul-tural factors” (1996, p. 106). Whereas Ascroft and Agunga propose ahuman interlocutor to improve dialogue between the public and devel-opment agencies, Servaes suggests the use of mass media to diffuse mes-sages in two directions: Not only, he says, can media carry useful informa-tion to the public, but the public should also have access to media channelsin order to “make its information needs known” (1996, p. 105).

These examples of new theorizing across diffusion and participatorymodels represent conscious attempts to bridge these approaches. In ad-

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dition to these deliberate efforts at cross-pollination, many projects re-viewed in this analysis show practitioners and evaluators unexpectedlydiscovering the usefulness of elements of the other approach. Thus, for-mally and informally, knowingly or unknowingly, advocates of bothmodels are borrowing elements from one another.

To advance development communication theorizing, researchers havesuggested looking to other branches of communication scholarship, suchas organizational communication (Jacobson, 1996, p. 274), and otherbodies of social theory, such as new social movements (Huesca, 2000;Servaes, 1996). Additional calls have come for widening the scope ofdevelopment communication theorizing to give greater consideration tosocial structural analysis (Mody, 2000) and, crucially, to the distribu-tion of power in society (Wilkins, 2000). To varying degrees, these pos-sible directions imply the recognition of the pivotal significance of thelocal context to any campaign. The acknowledgment from both partici-patory and diffusion schools of thought that solid research into commu-nity norms and values and its skilled application can enhance the abilityof campaign planners to achieve their ends provides a shared founda-tion for further theorizing about development communication.

Nancy Morris (PhD, University of Pennsylvania) is an associate professor in the Department ofBroadcasting, Telecommunications, and Mass Media at Temple University. This article was madepossible through support provided by the Global Office of Health and Nutrition G/PHN, Bureaufor Global Programs, Field Support and Research, U.S. Agency for International Development,under the terms of Cooperative Agreement No. HRN-A-00–98–00044–00 (the CHANGE Project),with the Academy for Educational Development and its subcontractor, the Manoff Group, Inc. Theopinions expressed herein are those of the author and do not necessarily reflect the views of the U.S.Agency for International Development. The author would like to acknowledge the invaluable con-tributions of Betty Davidson, Robert Hornik, Sandy Kyrish, Judith A. McDivitt, Langdon Morris,Tom Polcari, Silvio Waisbord, and Karin Wilkins. Correspondence concerning this article shouldbe addressed to Nancy Morris, Annenberg Hall, Room 6, Temple University, Philadelphia, PA19122 or email: [email protected].

1 Although Eisele, Macintyre, Eckert, Beier, & Killeen (2000) argue that there is a distinctionbetween the meanings of “intervention” and “program,” the terms will be used interchangeablyhere.2 For critiques of development communication research, see McKillip (1989); Servaes (1999, pp.95–117); Sherry (1997); and Yoder, Hornik, & Chirwa (1996). Freedman’s (1997) critique dis-cusses selection bias; Westoff and Rodríguez (1995) discuss problems of inferring causal direction.3 As noted, some other interventions that bill themselves as participatory projects are similarlylacking in grassroots input (e.g., Antunes et al., 1997; Díaz et al., 1999; Pribadi et al., 1986).

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A Comparative Analysis of the Diffusion and Participatory Models in Development Communication