After dissemination: Diffusion principles to increase uptake and adoption of innovations

Dearing, J. W. & Kreuter, M. W. (2010). Designing for diffusion: How can we increase uptake of cancer communication innovations? Patient Educ Couns, 81 Suppl, S100-110. doi: 10.1016/j.pec.2010.10.013


This resource outlines principles to increase uptake and adoption of evidence-based programs and policies by potential users. In contrast to dissemination, where program designers and researchers "push" information about an innovation to intended audiences, diffusion involves communication among users through a network or groups. Diffusion is a social process among potential users where social influence is a key precursor to generating interest, forming attitudes and changing behaviour to support the adoption of innovations.

In contrast to dissemination, diffusion is a social process that may or may not occur after the dissemination of information has occurred. Diffusion involves the activation of influence among potential adopters. Some principles that support diffusion of innovations include (for the complete list, see p. S102):

  • Disseminated information about an innovation is necessary but often not sufficient for subsequent diffusion and uptake of an innovation.
  • Evidence about intervention effectiveness is only one of many attributes that can influence adoption decisions.
  • Audience segmentation allows for design of dissemination products that are perceived as more relevant by intended audiences.
  • Most people are highly attuned to social norms regarding the use of an innovation, where people adopt an innovation when they perceive that their peers and/or social groups support adoption.
  • Social influence is often held by a small group of people, where the majority look to this small group of influential people for cues to action or inaction.
  • Establishing a decentralized support system for implementers to share tacit information and solutions to issues improves implementation quality.

Other related resources include:

Steps for Using Method/Tool

Four activities can be applied in developing innovations to increase dissemination and diffusion among users:

  1. Have a user-oriented approach to identifying groups of potential adopters and their needs, actively engaging them in the development process, shaping the innovation around their needs and interests, and adapting and improving the innovation based on user experiences.
  2. Share control in the creation and implementation of interventions among developers and users. This is positively related to adoption, implementation and sustainability of change.
  3. Collect data on the social structure or patterns of relationships among users, such as by asking "who do you look to for new ideas or advice concerning better ways of providing services?," to understand who influences whom, and which organizations and individuals to recruit to champion the innovation.
  4. Conduct frequent and iterative testing of prototype versions of innovations with users. This is a key component of designing for diffusion through formative evaluation of the innovation.

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.

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