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H571 – Week 8
• Diffusion of Innovations Theory• Tara
• Community-Based Research– Intro (NCI)
• Alexandra
– Israel et al paper • Coral, Kathryn and Alexandra
– Parker et al paper• Connie and Jennifer
• Discussion Questions
DSC: Chapter 10
Diffusion of Innovations Theory
“The process by which an innovation is communicated through certain
channels over time among members of a social system” (Rogers, 1995, p. 10)
Community-Level Theory of Change
• Community, as one level embedded in the social ecological model, is a complex and dynamic system.
• While we have multiple theories of individual change and organizational change, we have very few theories of community change.
• This is one of the least understood processes in public health, but perhaps the one with greatest potential to impact population health.
Cognitive Development
Social/Emotional
Competence
Absence of Psychological
and Behavioral Problems
Physical Health
PRIMARY OUTCOMES
PROXIMAL INFLUENCES
DISTAL INFLUENCES
PovertyNeighborhood poverty
Family povertyAccess to dental and health
careRelative deprivation and
inequality
SchoolHigh-quality early childhood education
Effective instruction Positive school climate
Positive behavior supportSchool attendance
Health education and preventionAfter-school education and activities
PeerPro-social peers, role models
Exposure to alcohol, tobacco and other drug use, violence and crime
Social networking technology
FamilyInvolved in learning-related activities
Involved monitoring Non-harsh limit settingReinforcing interactionsPositive role modeling
Health maintenance, hygieneInvolvement in positive activities
PNRC framework for Creating Nurturing Environments
Social CohesionPro-social norms,
informal social controlConnectedness, social capital
Healthy community normsSocial exclusion,
discrimination
Physical Environment Decay: abandoned buildings,
substandard housingNeighborhood design,
land useAccess to alcohol, tobacco,
other drugs, firearmsAccess to nutritious foods
Toxic exposuresMedia
Implications of Community-Based Approaches for Health Promotion Practice
• Communities are increasingly key settings for health promotion
• Building community capacity is increasingly a focal outcome of health promotion
• Different approaches to community-based health promotion interventions reflect differing conceptualizations of community (e.g., worksites, media, schools, neighborhoods)
• A whole CBPR course online: http://www.cbprcurriculum.info/
1. What concepts are common between DIT and CBPR? How do the principles of CBPR relate to the elements of DIT?
2. What is the role of community-based action in diffusion of an innovative intervention? Under what conditions is reinvention of an intervention appropriate?
3. How can interventions be both disseminated through multiple communities and community-developed?
4. How can the conflicting roles (and power) of researchers and community members be reconciled? Does CBPR bias researchers’ objectivity? Does this matter? How can it be avoided or minimized?
5. How can CBPR help professionals facilitate the diffusion of appropriate, effective innovations through already existing or strengthened social systems and communication channels?
6. How could you integrate the DIT and principles of CBPR to address the varying agendas of groups involved in childhood obesity prevention?
7. What barriers do outsiders (researchers or public health practitioners) face when entering a new community? How can they be overcome?
8. How can DIT and CBPR be used together to build coalitions, and then disseminate interventions -- among underserved populations?
Discussion Questions