H571 – Week 8

1. 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

2. 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)

3. 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.

4. PNRC framework for Creating Nurturing Environments DISTAL INFLUENCES PROXIMAL INFLUENCES PRIMARY OUTCOMES • Poverty • Neighborhood poverty • Family poverty • Access to dental and health care • Relative deprivation and inequality • Family • Involved in learning-related activities • Involved monitoring • Non-harsh limit setting • Reinforcing interactions • Positive role modeling • Health maintenance, hygiene • Involvement in positive activities Cognitive Development Social/ Emotional Competence • Social Cohesion • Pro-social norms, informal social control • Connectedness, social capital • Healthy community norms • Social exclusion, discrimination • School • High-quality early childhood education • Effective instruction • Positive school climate • Positive behavior support • School attendance • Health education and prevention • After-school education and activities Absence of Psychological and Behavioral Problems • Physical Environment • Decay: abandoned buildings, substandard housing • Neighborhood design, land use • Access to alcohol, tobacco, other drugs, firearms • Access to nutritious foods • Toxic exposures • Media • Peer • Pro-social peers, role models • Exposure to alcohol, tobacco and other drug use, violence and crime • Social networking technology Physical Health

5. 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/

6. Discussion Questions • 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?