Diffusion of Innovations: An HC3 Research Primer

"This model highlights the uncertainties associated with new behaviors and helps public health program implementers consider ways to resolve these uncertainties."

This research brief describes the Diffusion of Innovations research model (click here for a full explanation) and when it should be used in designing social and behaviour change communication (SBCC) programmes. In brief, this research model "describes how a new idea, product or positive health behavior spreads through a community or social structure." It identifies factors that can influence how quickly an idea or behaviour is adopted.

Figure 1 in the resource (also shown above) represents the diffusion S-curve, which illustrates how people are initially slow to adopt new behaviours. However, as the behaviour becomes better known and accepted, more people quickly start to practice it. According to this research brief, the adoption of a new idea depends on characteristics of the innovation, communication channels, time, and the social system. "Implementers can track the progress of their social and behavior change communication campaigns and other interventions by creating similar graphs as results of the program reach are evaluated."

In terms of when this model should be used, the brief recommends it for interventions that have a limited amount of time to make an impact on entire communities. Also, "Diffusion of Innovations approaches work best when applied to issues that can be influenced by prominent members of society or spread through traditional methods of communication."

The next section of the resource outlines what implementers should know. Figure 2 describes the main characteristics of an innovation, as well as their meaning for programme implementation. One key lesson: "Finding ways to connect early adopters to the rest of the community can promote diffusion."

The brief concludes with a case study of the model in action. Launched in 2009, Brothers for Life (BFL) is an ongoing South African health communication programme that uses a variety of approaches to diffuse the principles of positive behaviour among South African men. The focus is on promoting HIV testing, voluntary medical male circumcision (VMMC), male involvement in the prevention of mother-to-child transmission of HIV (PMTCT), and prevention of gender-based violence. "For VMMC, BFL used the Diffusion of Innovations principles of Observability and Trialibility by interviewing men who underwent the VMMC procedure and publicising the interviews through a national campaign using TV and radio. Through storytelling, BFL connected other men to the experiences of their peers and encouraged them to make a decision to go forward with the procedure. In support of these activities, BFL also created an SMS [text messaging] number that men and women could text to get answers to their questions about VMMC and directions to the nearest clinic." As reported here, as a result of these efforts, BFL successfully increased knowledge of VMMC from 8% in 2009 to 47% in 2012. BFL used the same principles to promote positive HIV testing behaviour by creating 1,000 Twitter accounts for World AIDS Day 2011 and recruiting HIV-positive volunteers to tweet about HIV stigma and to promote HIV testing using the hashtag #HIVarmy. This case study claims that, within hours, this hashtag was "trending" in South Africa and then globally. Then, local celebrities reportedly picked up the hashtag and joined the conversation.