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

A Summary of

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

Relevance for Public Health

Public health professionals involved in development and implementation of evidence-based programs and policies could use these strategies to increase adoption and uptake of innovations, in addition to dissemination strategies. For instance, this method could assist with identifying ways to support informal knowledge sharing to support implementation of a new program among staff.


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:

Accessing the Method/Tool


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Implementing the Method/Tool

Time for Participation/Completion

Information not available

Additional Resources and/or Skills Needed for Implementation

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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.

Who is involved

Researchers, public health managers and communications staff are all potential users of this method. Participants in this method would include end-users and other potential adopters of the public health messaging being developed.

Conditions for Use

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Evaluation and Measurement Characteristics


Has not been evaluated


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Methodological Rating

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Method/Tool Development


James W. Dearing
Matthew W. Kreuter

Method of Development

A previously developed Push-Pull-Infrastructure Model was used to organize and highlight the types of activities that can be deployed during the design phase of innovations. Scientific literature about the diffusion of innovations, knowledge use, marketing, public health and experiences in working to spread effective practices, programs and policies were used for this purpose.

Release Date


Contact Person/Source

James W. Dearing
Department of Communication
Michigan State University
472 Com Arts Building
East Lansing, USA 48824
Phone: (517) 355-3470

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.


Title of Primary Resource Designing for diffusion: how can we increase uptake of cancer communication innovations?
File Attachment None
Reference 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

Type of Material Journal Article
Format Periodical
Cost to Access None.
Language English
Conditions for Use Copyright © 2010 Elsevier Ireland Ltd.

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