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Diffusion of Innovations Theory in Public Health

Prevention Intervention and Selected Article

The selected injury prevention intervention chosen for this paper is alcohol and drug addiction education, an innovation that can combine several steps of intervention and different programs. Various programs that focused on alcohol, tobacco, and drug addiction education has been already implemented in the United States. Sharma and Kanekar (2008) described these programs and strategies in their article Diffusion of innovations theory for alcohol, tobacco, and drugs; while some of the programs were efficient, other required a careful plan and use of several communication channels. The authors also pointed out that the theory produces particular issues, namely pro-innovation biases. These biases are linked to the expectation that innovations are adopted rapidly and by all members of the community, which is often not possible (Sharma & Kanekar, 2008). Therefore, the innovations need to be examined during their adoption.

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Diffusion of Innovations Theory

Diffusion of innovations theory was developed more than a century ago; nevertheless, it remains to be an effective and useful tool for implementation of changes at different levels. Diffusion of innovations theory implies that innovations can be adopted in a systematic manner and with the help of particular steps and key concepts (Sharma & Kanekar, 2008). Diffusion is “the overall spread of an innovation” where the innovation is transmitted through social channels in a community or area (Oldenburg & Glanz, 2008). This theory can apply to the intervention (alcohol and drug addiction education) by engaging lessons and lectures on addiction in school curricula; teachers and administration staff of schools that participate in the intervention also need to engage social channels in disseminating the idea, i.e. speak to students about drug addiction, discuss recent news, and provide advice if needed.

Characteristics and Setting

The five main characteristics of innovations that can influence the diffusion of intervention are “relative advantage, compatibility, complexity, trialability, and observability” (Oldenburg & Glanz, 2008). Presuming that schools chosen for this intervention have not developed any similar program before, the relative advantage of innovations is clear, because they present a new approach to the problem. The innovation does fit with the audience, as many of them have not yet tried drinking or using drugs; if they did try, this program could remind them what consequences they might face. As for complexity, it depends on how deeply it will be woven into curricula; however, it is easier to combine the alcohol and drug addiction education with education programs rather than address each student individually. The innovation can be trialed in the form of an experimental study in different school districts (Sharma & Kanekar, 2008). However, to observe the results of this intervention, a significant period of time is needed (from two to eight months at least).

There are “five adopter categories: innovators, early adopters, early majority adopters, late majority adopters, and laggards” (Oldenburg & Glanz, 2008). It is expected that most of the freshmen and elementary students will be either innovators or early majority adopters. However, seniors and those of the freshmen who have already tried alcohol and/or drugs and did not quit might show skepticism towards the intervention. Moreover, settings and environment also need to be considered when implementing innovations, especially those that concern alcohol and drug addiction. Lack of resources, lack of support, and lack of authority are the factors that can have an adverse impact on the efficiency of implemented innovations (Oldenburg & Glanz, 2008). Moreover, some types of students are more strongly linked to substance abuse: as studies show, “sports participation is positively correlated with alcohol use” (Lisha & Sussman, 2010, p. 403). It is also possible to assume that substance addiction rates can be higher for those students who live in communities with high criminal rates or families with a history of addiction, abuse, and violence.

As it was mentioned, pro-innovation bias is one of the most obvious disadvantages of this theory. It would be incorrect to assume that all students who take part in the program will eventually adopt the proposed innovation (Oldenburg & Glanz, 2008). Individuals’ blame bias also needs to be avoided during the implementation, because the assumption that a particular person is responsible for their problem can lead to biased conclusions; the system can also contribute to the problems a person is experiencing (Oldenburg & Glanz, 2008). Therefore, if some of the participants refuse to adopt the innovations, it might be due to issues in the system and policies that determine their life.

Insights and Example

Behavioral changes are often hard to trigger, especially in those who do not accept the new program or innovation. The students who will take part in the program need to believe that advantages of this intervention outweigh the disadvantages, have a positive emotional attitude towards it, and face no environmental barriers that will hinder the adoption (Doll, Bonzo, Mercy, & Sleet, 2008). The program Smart Choices combined two theories, as well as engagement of teachers, to provide effective intervention (Sharma & Kanekar, 2008). Organizational factors also influenced the outcomes.


Diffusion of innovations theory can be a useful tool in the implementation of intervention programs and ensure that its adoption is made through various channels. Nevertheless, the setting needs to be carefully assessed to understand how it can contribute to or interfere with the intervention. What environments can be regarded as unsuitable for the proposed intervention?

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Doll, L. S., Bonzo, S. E., Mercy, J. A., & Sleet, D. A. (2008). Handbook of injury and violence prevention. New York, NY: Springer.

Lisha, N. E., & Sussman, S. (2010). Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: A review. Addictive Behaviors, 35(5), 399-407.

Oldenburg, B., & Glanz, K. (2008). The diffusion of innovations. In K. Glanz, B. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 335-361). San Francisco, CA: Jossey-Bass.

Sharma, M., & Kanekar, A. (2008). Diffusion of Innovations theory for alcohol, tobacco, and drugs. Journal of Alcohol and Drug Education, 52(1), 3–7.

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