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KEV CONGETS

  • change agent 變革者
  • clarity of results 結果清晰
  • communication channels 溝通管道
  • compatibility 相容性
  • complexity 複雜性
  • costs 費用
  • demonstrability 可證性
  • diffusion 傳播
  • homophily a innovation 同源創新
  • opinion leaders 輿論領袖
  • perceived relative advantage
    認知相對優勢
  • pervasiveness 普遍性
  • reinvention 重塑
  • reversibility 可逆性
  • time 時間
  • social networks 社群網路
  • social system 社會制度

AFTER REMING THLS CHPIER YOUSHOULD BEABLE TO
在清除這些雜質後,您應該可以

  • Describe the historical genesis of the diffusion of innovations theory.
    描述創新擴散理論的歷史起源。
" List the constructs of the diffusion of innovations theory.
"列出創新擴散理論的結構。
  • Summarize the applications of the diffusion of innovations theory in public health.
    總結創新擴散理論在公共衛生領域的應用。
  • Identify methods to modify constructs from the diffusion of innovations theory.
    確定修改創新擴散理論建構的方法。
  • Apply the diffusion of innovations theory for changing a health behavior of your choice.
    運用創新擴散理論改變你所選擇的一種健康行為。

Communication is essential
溝通至關重要
for social change. .. Social
社會變革。 ... 社會
change is the process by
變化是指
which alteration orcurs in
這些變化發生在
the structure and function
結構和功能
of a social system. National
社會制度。國家
revolution, invention of a
革命,發明了
new manufacturing 新製造technique, founding of a 技術,創立了village improvement 村莊整治council, adoption of birth
理事會,透過出生
control methods by a 控制方法family-all are examples of
家庭--都是
social change. 社會變革。

-Rogers and Shoemaker -羅傑斯和舒梅克
, p. 7)  , p. 7)
The diffusion of innovations theory is a model that has been thoroughly tested. The term diffusion refers to the process by which a new idea, object, or practice filters through various channels in a community over time (Rogers, 2003). It is a special form of communication in which the idea that is being conveyed is new. The term innovations refers to the new ideas, objects, or practices that are to be adopted. The hallmark of the diffusion of innovations theory is that it deals with the dissemination of new ideas and their adoption by people in a systematic manner. In addition, the diffusion of innovations theory is a tool for social change. Once a new idea is infused into a community, change becomes inevitable.
創新擴散理論是一個經過全面檢驗的模式。所謂擴散,是指新想法、新事物或新做法隨著時間的推移透過各種管道在社區中傳播的過程(Rogers,2003 年)。它是一種特殊的傳播形式,所傳播的思想是新的。創新一詞指的是將要採用的新想法、新事物或新做法。創新擴散理論的特點是,它涉及新想法的傳播以及人們對新想法的系統採納。此外,創新擴散理論還是社會變革的工具。新思想一旦注入社會,改變就不可避免。
This chapter begins by describing the historical aspects of the genesis of the diffusion of innovations theory. We then describe the approach taken by the diffusion of innovations theory and the various constructs that make up this theory. We discuss the applications of the diffusion of innovations theory in public health and the limitations of the theory, and then present: a skill-building application.
本章首先介紹了創新擴散理論的歷史起源。然後,我們介紹了創新擴散理論所採用的方法以及構成此理論的各種構造。我們討論了創新擴散理論在公共衛生領域的應用以及理論的局限性,然後介紹了:技能培養應用。

HISTORICAL PERSPECTIVE 歷史觀點

The diffusion of innovations theory can be traced back to the early 1900 s when Gabriel Tarde, a French sociologist and legal scholar, wrote The Laus of Imitation (Tarde, 1903/1969), which looked at factors that helped innovations spread. He used the term imitation, which is similar to the present-day term adoption (Rogers, 2003), to describe how innovations were accepted. Georg Simmel, a German philosopher and sociologist who was a contemporary of Tarde, introduced the notion of a stranger, who is a member of a system but not strongly attached to it. This concept was used later on in the diffusion of innovations theory. Tarde's and Simmel's propositions were followed by the work of anthropologist Clark Wissler (1923), who studied the diffusion of horses from Spanish explorers to Native American tribes in the Plains. Wissler found that the introduction of horses caused peaceful Native American tribes to go to war with neighboring tribes.
創新擴散理論可追溯到20 世紀初,當時法國社會學家和法律學者加布里埃爾-塔爾德(Gabriel Tarde)撰寫了《模仿之勞》(塔爾德,1903/1969 年)一書,探討了幫助創新傳播的因素。他使用了模仿一詞來描述創新是如何被接受的,該詞類似於今天的 "採納 "一詞(羅傑斯,2003 年)。與塔爾德同時代的德國哲學家和社會學家格奧爾格-西美爾(Georg Simmel)提出了 "陌生人 "的概念。這一概念後來被用於創新擴散理論。人類學家克拉克-威斯勒(Clark Wissler,1923 年)研究了馬匹從西班牙探險家向平原地區美洲土著部落傳播的過程。 Wissler 發現,馬匹的引入導致和平的美洲原住民部落與鄰近部落開戰。
Empirical work with the diffusion of innovations theory began with a hybrid seed corn study conducted by rural sociologists Bryce Ryan and Neal Gross at Iowa State University (Ryan & Gross, 1943; Valente & Rogers, 1995). Hybrid seeds were developed in 1928. Their use increases a harvest by more than , yet only a small number of farmers initially adopted the hybrid corn. Full diffusion of this innovation took almost 12 years, with the average farmer taking 7 years to progress from initial awareness to full-scale adoption of planting the whole field with hybrid seed. The main dependent variable was innovativeness (the degree to which an individual adopts early as compared with others). The cumulative number of farmers adopting the hybrid corn plotted against time formed an S-shaped curve; when plotted on a frequency basis, it formed a normal bell-shaped curve: Mass media were found to be important in the awareness stage, whereas interpersonal communication was more important at the persuasion stage (Rogers & Singhal, 1996).
創新擴散理論的實證工作始於農村社會學家布萊斯-瑞安和尼爾-格羅斯在愛荷華州立大學進行的一項雜交玉米種子研究(瑞安和格羅斯,1943 年;瓦倫特和羅傑斯,1995 年)。雜交種子開發於 1928 年。雜交種子的使用可使收成增加 ,但最初只有少數農民採用雜交玉米。這項創新的全面推廣花了近 12 年時間,農民從最初認識到全面採用雜交種子種植整塊田地平均需要 7 年時間。主要因變數是創新性(與其他人相比,個人早期採用的程度)。採用雜交玉米的農民累積人數與時間的關係形成了一條S 形曲線;如果按頻率繪製,則形成了一條正常的鐘形曲線:研究發現,大眾傳媒在認知階段非常重要,而人際傳播在說服階段更為重要(Rogers & Singhal,1996 年)。
Throughout the and , the diffusion of innovations theory was popular in rural sociology. In the 1950 s, Everett Rogers, while pursuing his doctoral studies in rural
在整個 ,創新擴散理論在農村社會學中十分流行。 1950 年代,埃弗雷特-羅傑斯(Everett Rogers)在攻讀農村社會學博士課程時,發現了創新擴散理論。

sociology at Iowa State, became interested in the diffusion theory and focused his dissertation in that area. In 1962, he wrote Diffusion of Innovations; at that time there were 405 publications on this theory (Rogers, 2004). In 2003, when the fifth edition of this book was published, more than 5,200 applications of this theory had been published in various fields (Rogers, 2003). Interested readers may consult this book for detailed information on this theory. Everett Rogers was the foremost authority on this theory and taught at the University of New Mexico. He died in 2004.
在愛荷華州立大學攻讀社會學的羅傑斯對創新擴散理論產生了濃厚的興趣,並將自己的論文重點放在了這一領域。 1962 年,他撰寫了《創新擴散》一書;當時,有關此理論的出版物有 405 種(羅傑斯,2004 年)。 2003 年,該書第五版出版時,該理論在各領域的應用已超過 5 200 篇(Rogers, 2003)。有興趣的讀者可以參閱本書,以了解這一理論的詳細資訊。埃弗雷特-羅傑斯是這一理論的權威,曾在新墨西哥大學任教。他於 2004 年去世。
The applications of the diffusion of innovations theory in public health, health promotion, and health education began with immunization campaigns and family planning programs. From the onward, the diffusion of innovations theory was used to speed up the adoption of family planning methods in Latin America, Africa, and Asia. A large impetus for applying the diffusion of innovations theory in public health was the HIV/AIDS epidemic. In the mid-1980s, the STOP AIDS intervention based on the diffusion of innovations theory was implemented and tested in San Francisco (Rogers & Shefner-Rogers, 1999). One of the components of this intervention was to identify opinion leaders who were bartenders at gay bars and to train them in HIV prevention among gay men. This approach to HIV prevention is now being evaluated in developing countries. In
創新擴散理論在公共衛生、健康促進和健康教育方面的應用始於免疫接種運動和計劃生育。從 開始,創新擴散理論被用來加速拉丁美洲、非洲和亞洲採用計劃生育方法的速度。在公共衛生領域應用創新擴散理論的一大動力是愛滋病毒/愛滋病的流行。 1980 年代中期,基於創新擴散理論的 STOP AIDS 介入措施在舊金山實施並進行了測試(Rogers & Shefner-Rogers,1999 年)。這項幹預措施的內容之一是確定同性戀酒吧調酒師中的輿論領袖,並對他們進行男同性戀者愛滋病預防方面的培訓。這種預防愛滋病的方法目前正在發展中國家進行評估。在
The diffusion model has now been around for a long time, almost 60 years. Is diffusion dead or dying? It is not declining. The number of diffusion publications completed per year continues to hold steady. Unlike most models of human behavior that begin to fade after some years of use, the diffusion model continues to attract strong interest from scholars.
擴散模型已經存在了很長時間,將近 60 年。擴散模式是死了還是正在消亡?它並沒有衰落。每年發表的擴散論文數量保持穩定。大多數人類行為模式在使用若干年後就會開始衰退,而擴散模型則不同,它繼續吸引學者的濃厚興趣。
  • Rogers , p. 19) 2000, Malcolm Gladwell wrote The Tipping Point: How Little Things Can Make a Big Difference, in which he defined the tipping point as the moment when something unique becomes common. This is the purpose of the diffusion of innovations.
    羅傑斯 ,第19 頁)2000 年,馬爾科姆-格拉德威爾(Malcolm Gladwell)撰寫了《轉折點:小事情如何產生大變化》(The Tipping Point: How Little Things Can Make a Big Difference)一書,他在書中將轉捩點定義為獨特事物變得普遍的時刻。這就是創新擴散的目的。

CONSTRUCTS OF THE DIFFUSION OF INNOVATIONS THEORY
創新擴散理論的構造

As noted earlier, an innovation refers to an idea, practice, or product (including services) that is perceived as new by an individual or other unit of adoption (Rogers, 2003). It does not matter how long this idea, practice, or product has been around. What matters is that the person who is adopting it perceives it as new. The newness of an innovation can be with regard to knowledge, persuasion, or the decision to adopt. Newness regarding knowledge refers to the situation in which the potential adopter was not previously aware of the product, practice, or idea. Newness regarding persuasion refers to the situation in which the potential adopter has not been previously contacted by anyone about the product, practice, or idea. Finally, newness regarding the decision to adopt pertains to the situation in which the potential adopter has not formed a positive or negative attitude about using the product, practice, or idea. Innovations are of three types: (1) incremental innovations, which reflect a relatively small improvement over previous products; (2) distinctive innovations, which represent significant improvement but do not entail any new technology or approach; and (3) breakthrough innovations, which are based on a new technology or approach (Schumann, Prestwood, Tong, Vanston, 1994).
如前所述,創新是指被個人或其他採用單位視為新的想法、做法或產品(包括服務)(Rogers,2003 年)。這種想法、做法或產品存在多久並不重要。重要的是,採用它的人認為它是新的。創新的新穎性可以是知識方面的,也可以是說服方面的,還可以是採用決定方面的。知識方面的新穎性指的是潛在採用者以前不了解產品、做法或想法的情況。說服方面的新穎性是指潛在採納者以前沒有接觸過有關產品、做法或理念的任何人。最後,決定採用的新穎性是指潛在採用者尚未對使用該產品、做法或想法形成積極或消極的態度。創新分為三種:(1) 漸進式創新,即與以前的產品相比有相對較小的改進;(2) 獨特式創新,即有重大改進,但不涉及任何新技術或新方法; (3) 突破式創新,即基於新技術或新方法的創新(Schumann, Prestwood, Tong, Vanston, 1994)。
Innovations have several attributes (Frerichs, 1994; Greenhalgh, Robert, Bate; Macfarlane, 8 . Kyriakidou, 2005; Rogers, 2003; Tornatzky & Klein, 1982). See Table 9-1 for additional information on the attributes described here:
創新具有多種屬性(Frerichs, 1994; Greenhalgh, Robert, Bate; Macfarlane, 8 .Kyriakidou, 2005; Rogers, 2003; Tornatzky & Klein, 1982)。有關本文所述屬性的更多信息,請參見表 9-1:
  • Perceived relative advantage: Perception regarding how much better the new product, idea, or practice is than the orie it will replace.
    感知相對優勢:關於新產品、新概念或新做法比其替代品好多少的看法。
  • Compatibility: Perception of the innovation's consistency with the values, past experiences, and needs of potential adopters.
    相容性:對創新與潛在採用者的價值觀、以往經驗和需求是否一致的看法。
  • Complexity: Perception of the degree of difficulty in understanding and using the new idea, practice, or product.
    複雜性:對理解和使用新想法、新做法或新產品的困難程度的感知。
  • Demonstrability: The degree to which an innovation may be experimented with on a limited basis.
    可示範性:創新可進行有限試驗的程度。
  • Clarity of results: The degree to which outcomes of an innovation are clearly visible.
    成果的清晰度:創新成果清晰可見的程度。
  • Costs: The tangible and intangible expenses incurred in the adoption of a new idea, practice, or product.
    成本:採用新理念、新做法或新產品所產生的有形和無形費用。
Atribute Definition How to Modiy? 如何 Modiy?
Perceived
relative
advantage
The perception regarding how much better the new
關於新
product, dea; or practice is than the one it will
產品、技術或實踐比它將
replace,
Increase the perception that
提高人們對
the innovation is advantageous
創新具有優勢
in monetary terms, social
在貨幣方面,社會
terms, or in other respects.
或其他方面。
Compatibility
The perception of the innovation's consistency with
對創新與以下方面一致性的看法
the values, past experiences, and needs of potential
潛在使用者的價值觀、過去的經驗和需求
adopters.
Make the idea consistent with
使想法與
the prevalent norms and
流行的規範和
values.
Complexity
The perception of the degree of difficulty in under:
對困難程度的認知:
standing and using the new idea, practice, or product:
使用新想法、新做法或新產品:
Simplify the idea, practice, or
簡化想法、做法或
product.
Demonstrability
The degree to which an innovation may be
創新的程度
experimented with on a limited basis.
在有限的基礎上進行試驗。
Provide an opportunity to try
提供嘗試機會
the idea, practice, or product
理念、實踐或產品
either in small units or in total.
無論是小單元或是總單元。
Clarity of results 結果清晰
The degree to which outcomes of an innovation are
創新成果在多大程度上
clearly visible. 清晰可見。
Disseminate information on
傳播以下訊息
the results of the innovation
創新成果
and makeit more visible.
並使其更加引人注目。
Costs
The tangible and intangible expenses incurred in
有形和無形開支
the tacoption of anew idea; practice, or product.
採用新的想法、做法或產品。
Minimize costs as much as
盡可能降低成本
possible.
Reversibility
The ability and degree to which the status quo can
維持現狀的能力和程度
be reinstated by ceasing to use the innovation.
透過停止使用創新來恢復。
Make innovations reversible:
使創新具有可逆性:
Pervasiveness
The degree to which an innovation requires changes
創新需要改變的程度
or adjustments by other elements in the social
或社會中其他因素的調整
system.
Minimize changes in other
盡量減少其他
parts of the social system.
社會系統的組成部分。
Reinvention
The degree to which a potential adopter can adapt,
潛在採用者的適應程度、
refine, or modify the innovation to suit his or her
完善或修改創新成果,使其適合自己
needs.
Allow for modification(s) by the
允許修改
user:
  • Reversibility: The ability and degree to which the status quo can be reinstated by ceasing to use the innovation.
    可逆性:可逆性:停止使用創新成果後恢復原狀的能力與程度。
  • Pervasiveness: The degree to which an innovation requires changes or adjustments by other elements in the social system.
    普遍性:創新在多大程度上需要社會系統中的其他要素做出改變或調整。
  • Reinvention: The degree to which a potential adopter can adapt, refine, or modify the innovation to suit his or her needs.
    再創新:潛在採用者根據自身需求對創新進行調整、改進或修改的程度。
These characteristics of innovations usually serve as independent variables in studies using this theory (Wolfe, 1994).
在使用此理論進行的研究中,創新的這些特徵通常是自變數(Wolfe,1994 年)。
The second construct of the diffusion of innovations theory is communication channels (Rogers, 2003). These are the links between those who possess know-how regarding the innovation and those who have not yet adopted that innovation. They are the means by which messages are transferred between individuals. Communication channels are of three kinds: (1) mass media channels, such as television, radio, and newspapers; (2) interpersonal channels, which require face-to-face interaction between two or more individuals; and (3) interactive communicafion channels, such as the Internet. Mass media channels are the fastest at spreading information, reach a large number of people, and are especially advantageous in building awareness or knowledge about the innovation. Interpersonal channels are especially helpful in persuading a potential adopter. Therefore, in the initial stages of adoption one should use mass media channels, followed by interpersonal and interactive channels to reinforce the message and persuade the potential adopter.
創新擴散理論的第二個概念是溝通管道(羅傑斯,2003 年)。這些管道是那些掌握創新技術訣竅的人與尚未採用創新技術的人之間的聯繫。它們是個人之間傳遞訊息的手段。傳播管道有三種:(1) 大眾媒體管道,如電視、廣播和報紙;(2) 人際管道,需要兩個或兩個以上的人面對面交流;(3) 互動式傳播管道,如網路。大眾媒體管道在傳播訊息方面速度最快,覆蓋人數眾多,在建立對創新的認識或了解方面尤為有利。人際管道尤其有助於說服潛在的採用者。因此,在採用創新的最初階段,應使用大眾媒體管道,然後使用人際和互動管道來強化訊息並說服潛在採用者。
The third construct of the diffusion of innovations theory is time (Rogers, 2003), which refers to the interval between becoming aware of an idea and adopting the idea. This can take from days to years, depending on the innovation. The time construct is involved with diffusion of innovations in three ways: (1) the innovation-decision process, (2) adopter categories, and (3) rate of adoption (Rogers, 2003). The innovation-decision process is a five-step process:
創新擴散理論的第三個概念是時間(Rogers,2003 年),指從意識到一個想法到採用該想法之間的間隔時間。根據創新的不同,這可能需要幾天到幾年的時間。時間結構在三個方面與創新擴散有關:(1) 創新決策過程,(2) 採用者類別,(3) 採用率(羅傑斯,2003 年)。創新決策過程分為五個步驟:
  1. Gaining knowledge about the innovation
    獲得有關創新的知識
  2. Being persuaded about the innovation
    說服創新
  3. Deciding whether to adopt or reject the innovation
    決定採用或拒絕創新
  4. Implementing the innovation (putting it to use)
    實施創新(投入使用)
  5. Confirming step: either reversing the decision or adopting the innovation
    確認步驟:要麼推翻決定,要麼採用創新成果
Adopter categories indicate people's willingness to adopt an innovation and have a bell-shaped distribution (Rogers, 2003). The initial adopters are the innovators ( ), people who adopt quickly. Innovators by nature are adventurous and cosmopolitan, have geographically dispersed contacts, are high risk takers, and have a high tolerance for uncertainty and failure. The second category consists of the early adopters . Early adopters are well-respected opinion leaders and well-integrated and judicious individuals. The early majority category ( ) consists of people who are deliberate, highly connected within a peer system, and are ahead of the average. These adopters are followed by the late majority (34%). Late-majority adopters are skeptical, responsive to economic necessity, responsive to social norms, have limited economic resources, and have a low tolerance for uncertainty. The final group are the laggards (16%). Laggards are more traditional in their disposition, are relatively isolated, have precarious economic situations, and are suspicious of change (Rogers, 2003). Figure 9-1 depicts the distribution of adopter categories on a normal curve. Table 9-2 summarizes the characteristics of the five types of adopters and strategies that can be used to appeal to them.
採用者類別顯示人們採用創新的意願,呈鐘形分佈(羅傑斯,2003 年)。最初的採用者是創新者( ),他們採用得很快。創新者天生具有冒險精神和世界主義情結,他們的連結地域分散,敢於承擔高風險,對不確定性和失敗有很高的容忍度。第二類是早期採用者 。早期採用者是備受尊敬的意見領袖,是具有良好整合能力和判斷力的個人。早期多數人( )由深思熟慮、在同儕系統中關係密切、領先於平均水準的人組成。緊隨其後的是後期多數(34%)。後多數採納者持懷疑態度,對經濟需求作出反應,對社會規範作出反應,經濟資源有限,對不確定性的容忍度低。最後一類是落後者(16%)。落後者的性格較為傳統,相對孤立,經濟狀況不穩定,對變革持懷疑態度(羅傑斯,2003 年)。圖 9-1 描述了採用者類別在常態曲線上的分佈。表 9-2 總結了五類採用者的特徵以及吸引他們的策略。
FIGURE 9-1 Distribution of adopter categories according to diffusion of innovations theory.
圖 9-1 根據創新擴散理論劃分的採用者類別分佈。
FIGURE 9-2 The S-shaped curve of diffusion of innovation.
圖 9-2 創新擴散的 S 型曲線。
The rate of adoption refers to the speed with which an innovation is adopted. If the cumulative frequency is plotted against time, an S-shaped curve is obtained, which is the rate of adoption (Figure 9-2). The diffusion rate usually serves as the dependent variable in studies using the diffusion of innovations theory (Wolfe, 1994).
採用率是指創新被採用的速度。如果將累積頻率與時間相對對照,就會得到一條 S 形曲線,這就是採用率(圖 9-2)。在使用創新擴散理論進行的研究中,擴散率通常是因變數(Wolfe,1994 年)。
The fourth construct of the diffusion of innovations theory is the social system (Berwick, 2003; Rogers, 2003). A social system implies that people are part of society that is composed of individuals, groups, organizations, or communities, and that people are connected by common goals. An important aspect of the social system is how similar the group members are. Similarity among group members is called homophily. Innovations spread faster among homophilous groups (Rogers, 2003). Thus, to enhance the rate of diffusion of an innovation, identify the degree of homophily in the target audience and use homophilous agents to spread the message.
創新擴散理論的第四個概念是社會系統(Berwick, 2003; Rogers, 2003)。社會系統意味著人們是由個人、群體、組織或社區組成的社會的一部分,人們因共同的目標而聯繫在一起。社會系統的一個重要面向是群體成員的相似程度。群體成員之間的相似性稱為同親性。創新在同親群體中傳播得更快(羅傑斯,2003 年)。因此,要提高創新的傳播速度,就要確定目標受眾的同親程度,並利用同親媒介傳播訊息。
Another aspect of the social system is the use of social networks, which are person-centered webs of social relationships that provide friendship, advice, communication, and support (Valente, 1996, 2015). Social networks can be physical or virtual (i.e., online). The configuration of social networks through which innovations diffuse governs the pace and extent of diffusion. For example, in facilitating adoption and diffusion of contraceptive use among women in Korea, it was found that denser social networks led to faster diffusion (Valente, 2015). To hasten diffusion, identify and utilize physical and virtual networks and create new networks.
社會系統的另一個面向是社交網絡的使用,社交網絡是以人為中心的社會關係網,提供友誼、建議、交流和支持(Valente,1996 年,2015 年)。社交網路可以是實體的,也可以是虛擬的(即線上的)。創新傳播所通過的社會網絡配置決定了創新傳播的速度和範圍。例如,在促進韓國婦女採用和推廣避孕藥具的過程中,人們發現,社交網絡越密集,推廣速度越快(Valente,2015 年)。為加快傳播速度,應識別和利用實體和虛擬網絡,並建立新的網路。
The third aspect of the social system is the change agent, an individual who influences a potential adopter's decision about innovation in a favorable way (Haider & Kreps, 2004). An example of a change agent might be a health educator at a health department. The change agent must be used to favorably influence the decision.
社會系統的第三個面向是變革推動者,即以有利方式影響潛在採用者對創新做出決定的人(Haider & Kreps, 2004)。衛生部門的健康教育工作者就是變革推動者的一個例子。變革推動者必須對決策產生有利影響。
The fourth aspect of social systems is opinion leaders, individuals who are influential in a community and sway the beliefs and actions of their colleagues in either a positive or negative direction (Locock, Dopson, Chambers, & Gabbay, 2001). These are individuals who have greater exposure to new ideas through the media, have greater social participation, have higher social status, and are more innovative (Rogers & Shoemaker, 1971). To hasten diffusion, identify true opinion leaders and involve them in the campaign. Opinion leaders were used in some of the classic heart health trials, such as the Stanford Five-City Project (Farquhar et al., 1990) and the North Karelia Project (Puska et al., 1986).
社會系統的第四個面向是意見領袖,即在社區中具有影響力並能左右同事的信念和行動的個人,他們的方向可以是積極的,也可以是消極的(Locock, Dopson, Chambers, & Gabbay, 2001)。這些人透過媒體接觸新想法的機會更多,社會參與度更高,社會地位更高,創新能力更強(Rogers & Shoemaker, 1971)。為了加速傳播,應確定真正的意見領袖並讓他們參與活動。在一些經典的心臟健康試驗中,如史丹佛五城計畫(Farquhar 等人,1990 年)和北卡累利阿計畫(Puska 等人,1986 年),都使用了意見領袖。
FIGURE 9-3 Depiction of the constructs of the diffusion of innovations theory.
圖 9-3 創新擴散理論的結構描述。
These characteristics of the social system usually serve as independent variables in studies using this theory (Wolfe, 1994). Figure 9-3 depicts the constructs of the diffusion of innovations theory in a diagram. Table 9-3 summarizes the key constructs of the diffusion of innovations. theory, along with ways to modify them.
在使用此理論進行研究時,社會系統的這些特徵通常作為自變數(Wolfe,1994 年)。圖 9-3 以圖表的形式描述了創新擴散理論的建構。表 9-3 總結了創新擴散理論的主要結構以及修改這些結構的方法。
To apply these constructs of the diffusion of innovations theory for health programming, Dearing (2004) has suggested a nine-step process. The first step is selecting the topic, in which the area of concern with high societal need and fewer previous programs is selected. Next is identifying the program population, in which the target population is selected. The third step is deriving a sample of best practices, in which the best existing products pertaining to the topic are identified. The fourth step is identifying intermediary networks. In this step, potential adopters are identified; there must be existing communication within this network. The fifth step is identifying opinion leaders in the intermediary network. Opinion leaders, as.we have seen, are individuals who are influential in a community. They can be identified by sociometric questionnaires in which respondents characterize their relations with others in the network, participant observation, expert interviews, or selfreports. Opinion leaders typically consist of to of the network membership. The sixth step is collecting pretest data, such as characteristics of members of the community and pretest opinions about the product. The next step is creation of a decision support tool, in which potential adopters can assess alternative best-practice products. The eighth step is to set up research design conditions
為了將創新擴散理論的這些建構應用於衛生計畫編制,Dearing(2004 年)提出了一個九步驟流程。第一步是選擇主題,即選擇社會需求量大、以往計畫較少的關注領域。其次是確定計劃人群,即選擇目標人群。第三步是獲得最佳實踐樣本,即確定與該主題相關的現有最佳產品。第四步是確定中介網絡。在這一步驟中,要確定潛在的採用者;在這一網絡中必須有現有的交流。第五步是確定中介網絡中的意見領袖。正如我們所見,意見領袖是指在社區中有影響力的個人。他們可以透過社會測量問卷、參與觀察、專家訪談或自我報告來確定,在社會測量問卷中,受訪者可以描述他們與網路中其他人的關係。意見領袖通常由 的網絡成員組成。第六步是收集預測試數據,如社區成員的特徵和對產品的預測試意見。下一步是建立決策支援工具,潛在採用者可透過該工具對備選最佳實踐產品進行評估。第八步是設定研究設計條件
Improving the application of the Diffusion of Innovations model in the field of public health can lead to advances in health promotion and disease prevention on a global level.
改進創新擴散模型在公共衛生領域的應用,可以在全球範圍內促進健康和預防疾病。
  • Haider and Kreps 海德爾和克雷普斯
, p. 3 ) in which network members can be assigned to different conditions and the variables manipulated. The final step is postest measurement, in which a posttest similar to the pretest can be administered and the rate of adoption in different conditions calculated. Table summarizes these steps.
第 3 頁),在此過程中,網路成員可被指派到不同的條件下,並對變數進行操作。最後一步是後測,即進行與前測類似的後測,並計算不同條件下的採用率。表 總結了這些步驟。
A similar model for the diffusion of innovations theory in public health organizations, FOMENT, has been suggested by Muhiuddin Haider of George Washington University (Haider & Kreps, 2004). FOMENT is an acronym in which stands for focus on a specific behavior change; for organization of the behavior change program; for management, which supports and approves the behavior change program; for an environment that is conducive to behavior change; for a network to diffuse innovations at the individual and organizational levels; and for the technology available to diffuse innovations.
喬治-華盛頓大學的 Muhiuddin Haider(Haider & Kreps,2004 年)提出了一個類似的公共衛生組織創新理論傳播模型 FOMENT。 FOMENT 是一個首字母縮寫詞,其中 代表對特定行為改變的關注; 代表行為改變計劃的組織; 代表支持和批准行為改變計畫的管理階層; 代表有利於行為改變的環境; 代表在個人和組織層面擴散創新的網絡; 可用於擴散創新的技術。
Construct Definition How to Solitw, 如何 Solitw、
Innovation
An idea, practice, or
思想、實踐或
product (including senvices)
產品
that is perceived as new by
an individual or other unit
個人或其他單位
of adoption.
- Increase the perception that innovation is
- 提高人們對創新的認識
advantageous in monetary terms, social terms, or in
在金錢上、社會上或
other respects. 其他方面。
- Make the idea consistent with the prevalent norms
- 使想法符合流行規範
and values.
- Simplify the idea, practice, or product.
- 簡化想法、做法或產品。
- Provide opportunity to try the idea, practice, or
- 提供嘗試想法、做法或
product either in small units or in total.
產品可以是小件,也可以是整件。
- Disseminate information on results of the innovation
- 傳播有關創新成果的訊息
and make it more visble.
並使其更加醒目。
- Minimize costs as much as possible.
- 盡可能降低成本。
- Make innovations reversible.
- 使創新具有可逆性。
- Minimize changes in other parts of the social system.
- 盡量減少社會系統其他部分的改變。
- Allow for modification(s) by the user.
- 允許使用者進行修改。
Communication
channels
The link between those
它們之間的聯繫
who have know-how 懂行的人
regarding the innovation
關於創新
and those who have not
和那些沒有
yet adopted the innovation.
尚未採用創新。
- Use mass media for building awareness.
- 利用大眾媒體提高認識。
- Use interpersonal channels for persuasion.
- 利用人際管道進行說服。
Time
The interval between 之間的間隔時間
becoming aware of an idea
覺悟
and adopting the idea.
並採納這個想法。
- Facilitate adoption over time.
- 促進長期採用。
Social system 社會系統
People in a society
社會中的人
connected by a common
由一個共同的
goal.
- Facilitate adoption from person to person.
- 促進人與人之間的收養。
Use homophilous agents to spread the message.
利用同親媒介傳播訊息。
- Use social networks.
- 利用社交網路。
- Use change agents.
- 利用變革推動者。
- Use opinion leaders.
- 利用輿論領袖。

Table 9-4. Steps for Applying the Diffusion of Innovation Theoty for Health Programing
表 9-4.在衛生計畫編製中應用創新擴散理論的步驟

  1. Select the topic. 選擇主題。
  2. Identify the program population.
    確定計劃人群。
  3. Derive a sample of best practices.
    得出最佳做法樣本。
  4. Identify intermediary networks.
    確定中介網絡。
  5. Identify opinion leaders in the intermediary network.
    確定中介網絡中的意見領袖。
  6. Collect pretest data. 收集預測試資料。
  7. Create a decision support tool.
    建立決策支援工具。
  8. Set up research design conditions.
    設定研究設計條件。
  9. Measure the rate of adoption and participants' opinions posttest.
    測量採用率和參與者的意見。

APPLICATIONS OF THE DIFFUSION OF INNOVATIONS THEORY
創新擴散理論的應用

The diffusion of innovations theory has been used in a variety of applications in public health, health promotion, and health education. Most of the published studies on the diffusion of innovations theory use cross-sectional surveys of adopters done after they have adopted the innovation and pertain to a single innovation (Meyer, 2004). The diffusion of innovations theory has been used in public health to promote adoption of a picture archiving communication system (PACS) in hospitals (Cranfield et al., 2015; Pare & Trudel, 2007), novel medication regimes for diabetes management (De Civita & Dasgupta, 2007; Miake-Lye et al., 2017; Pugh, Anderson, Pogach, & Berlowitz, 2003), and telemedicine in rural areas (Helitzer, Heath, Maltrud, Sullivan, & Alverson, 2003; Sugarhood, Wherton, Procter, Hinder, & Greenhalgh, 2014). The theory was used in designiing Students Together Against Negative Decisions (STAND), a peer educator training curriculum for sexual risk reduction (Smith, Dane, Archer, Devereaux, & Katner, 2000; Smith & DiClemente, 2000); in enriching a gerontology curriculum (Dorfman & Murty, 2005); in health coaching for people with diabetes (Liddy, Johnston, Nash, Ward, & Irving, 2014); and in impacting patient acceptance and use of consumer e-health innovations (Zhang, Yu, Yan, Ton & Spil, 2015). It has been used to implement a change strategy for primary care treatment of depression (Dietrich et al., 2004); computerized provider order entry (CPOE) in the outpatient setting (Ash et al., 2007; Rahimi, Timpka, Vimarlund, Uppugunduri, & Svensson, 2009); use of electronic health care records (Lin et al., 2016); family planning in developing countries (Murphy, 2004; Vaughan & Rogers, 2000); a health counseling intervention in a cardiology outpatient clinic (Harting et al., 2005); the National Quality Measurement and Reporting System (NQMRS) (McGlynn, 2003); patient education in community pharmacies (Pronk, Blom, Jonkers, & Van Burg, 2001); a sun protection program (Buller et al., 2005); a technology system to promote patient safety (Karsh, 2004); and telehomecare technology in community care (Hebert & Korabek, 2004). The diffusion of innovations theory has also been applied to incorporating genomic medicine
創新擴散理論廣泛應用於公共衛生、健康促進和健康教育等領域。大多數已發表的創新擴散理論研究都是在採用者採用創新後對其進行的橫斷面調查,並且只涉及一項創新(Meyer,2004 年)。創新擴散理論已被用於公共衛生領域,以促進醫院採用圖片存檔通訊系統(PACS)(Cranfield 等人,2015 年;Pare & Trudel,2007 年)、糖尿病管理的新型藥物療法(De Civita & Dasgupta, 2007 年;Miake-Lye et al、2017; Pugh, Anderson, Pogach, & Berlowitz, 2003),以及農村地區的遠距醫療(Helitzer, Heath, Maltrud, Sullivan, & Alverson, 2003; Sugarhood, Wherton, Procter, Hinder , & Greenhalgh, 2014)。該理論被用於設計"學生共同反對消極決定"(STAND)--一種減少性風險的同儕教育培訓課程(Smith、Dane、Archer、Devereaux 和Katner,2000 年;Smith 和DiClemente,2000 年);豐富老年學課程(Dorfman & Murty, 2005);糖尿病患者健康指導(Liddy, Johnston, Nash, Ward, & Irving, 2014);以及影響患者接受和使用消費者電子健康創新(Zhang, Yu, Yan, Ton & Spil, 2015)。它已被用於實施憂鬱症初級保健治療的變革策略(Dietrich 等人,2004 年);門診環境中的電腦化醫囑輸入(CPOE)(Ash 等人,2007 年;Rahimi、Timpka、Vimarlund、Uppugunduri 和Svensson,2009 年);電子醫療記錄的使用(Lin 等人,2016 年);發展中國家的計劃生育(Murphy,2004 年;Vaughan 和Rogers,2000 年);心臟病學門診中的健康諮詢幹預( Harting 等人,2005 年);國家品質測量(National Quality Measurement,2005 年)、2005);國家品質測量與報告系統(NQMRS)(McGlynn,2003);社區藥局的病患教育(Pronk、Blom、Jonkers 和Van Burg,2001);防曬計畫(Buller 等人,2005);促進病人安全的技術系統(Karsh,2004);以及社區照護中的遠距家庭照護技術(Hebert 和Korabek,2004)。創新擴散理論也被應用於將基因組醫學納入醫療領域。
Examples of potentially constructive innovations in health care can be as simple as ensuring that an improved drug regimen published in a refereed journal article immediately becomes the norm in a practice group, or as complex as redesigning an entire scheduling system to better conform to sound principles from queuing theory.
醫療保健領域潛在的建設性創新的例子可以很簡單,例如確保發表在期刊論文中的改進藥物方案立即成為實踐小組的規範,也可以很複雜,例如重新設計整個調度系統,使其更好地符合排隊理論的合理原則。
-Berwick (2003, p. 1969) into primary care (Suther & Goodson, 2004), increasing Internet use by family physicians (Chew, Grant, & Tote, 2004), interpreting primary care physicians' attitudes regarding rotavirus immunization (Agyeman et al., 2009), predicting smoking cessation (Deprey et al., 2009; Kuntsche & Gmel, 2005), recruiting in intervention trials (McMullen, Griffiths, Leber, & Greenhalgh, 2015), and reducing the spread of sexually transmitted diseases and HIV infection (Bertrand, 2004; Swendeman & Rotheram-Borus, 2010; Valente & Fosados, 2006). It has been used to promote safety promotion in sports (Poulos & Donaldson, 2015) and a social media-based health intervention (Young, Belin, Klausner, & Valente, 2015). It has been applied to translating research on diabetes self-management interventions into practice (Leeman, Jackson, & Sandelowski, 2006). It has been used to promote use of acetylcholinesterase inhibitors in Alzheimer's disease (Ruof, Mittendorf, Pirk, & von der Schulenburg, 2002), decision support systems (DSS) by child welfare workers (Foster & Stiffman, 2009), and patient-driven computers in primary care services (Shakeshaft & Frankish, 2003). It has also been applied to the use of voodoo practitioners in Haiti to educate people about HIV/AIDS (Barker, 2004). Table 9-5 summarizes these applications.
-Berwick,2003 年,第1969 頁),增加家庭醫生對網路的使用(Chew、Grant 和Tote,2004 年),解釋初級保健醫生對輪狀病毒免疫接種的態度(Agyeman 等人,2009 年),預測戒菸率(Deprey 等人,2009 年;Kuntsche 和Gmel,2005 年),進行幹預試驗招募(McMullen、Griffiths、Leber 和Greenhalgh,2015 年),以及減少性傳染病和愛滋病毒的傳播、2009;Kuntsche & Gmel,2005)、幹預試驗招募(McMullen、Griffiths、Leber & Greenhalgh,2015)以及減少性傳染病和HIV 感染的傳播(Bertrand,2004;Swendeman & Rotheram-Borus,2010;Valente & Fosados,2006)。它也被用於促進體育運動中的安全宣傳(Poulos & Donaldson, 2015)和基於社交媒體的健康幹預(Young, Belin, Klausner, & Valente, 2015)。它也被用於將糖尿病自我管理幹預研究轉化為實踐(Leeman、Jackson 和 Sandelowski,2006 年)。它也被用於促進乙醯膽鹼酯酶抑制劑在阿茲海默症中的使用(Ruof、Mittendorf、Pirk 和von der Schulenburg,2002 年)、兒童福利工作者的決策支援系統(DSS)(Foster 和Stiffman ,2009 年)以及初級醫療服務中以病人為導向的電腦(Shakeshaft 和Frankish,2003 年)。它也被應用於海地使用伏都教巫師對人們進行愛滋病毒/愛滋病教育(Barker,2004 年)。表 9-5 總結了這些應用。

Table 95 Applications of the Diffusion of Innovations Theory in Public Health
表 95 創新擴散理論在公共衛生領域的應用

Adopting and implementing a picture archiving communication system. (PACS) in hospitals
在醫院採用和實施圖片存檔通訊系統。 (PACS)
Adopting novel medication regimens for diabetes management
採用新的藥物療法治療糖尿病
Adopting telemedicine in rural areas Designing Students Together Against Negative Decisions (STAND), a peer educator training curriculum
在農村地區採用遠距醫療 設計 "學生共同反對負面決定"(STAND)--同儕教育者培訓課程

for sexual risk reduction
減少性風險
Enriching a gerontology curriculum
豐富老年學課程
Health coaching for diabetes
糖尿病健康指導
Impacting patient acceptance and use of consumer e-health innovations
影響病人接受與使用消費性電子醫療創新的因素
Implementing change strategy for primary care treatment of depression
為憂鬱症的初級保健治療實施變革策略
Implementing computerized provider order entry (CPOE) in the outpatient setting
在門診環境中實施電腦化醫囑輸入(CPOE)
Implementing electronic health care records
實施電子醫療紀錄
Implementing family planning in developing countries
在開發中國家實施計劃生育
Implementing health counseling intervention in the cardiology outpatient clinic
在心臟科門診實施健康諮詢介入措施
Implementing a National Quality Measurement and Reporting System (NQMRS).
實施國家品質測量和報告系統 (NQMRS)。
Implementing patient education in community pharmacies
在社區藥局進行病患教育
Implementing a sun protection program
實施防曬計劃
Implementing technology implementation systems to promote patient safety
實施技術實施系統,促進病人安全
Implementing telehomecare technology in community care
在社區護理中實施遠距家庭護理技術
Incorporating genomic medicine into primary care
將基因組醫學納入初級保健
Increasing Internet use by family physicians
家庭醫生越來越多地使用互聯網
Interpreting primary care physicians attitude regarding rotavirus immunization
解讀初級保健醫師對輪狀病毒免疫接種的態度
Predicting smoking cessation
戒菸預測
Recruiting in intervention trials
幹預試驗的招募
Reducing the spread of sexullly transmitted diseases and HIV infection
減少性傳染病和愛滋病毒的傳播
Safety promotion in sports
體育運動中的安全宣傳
Social media-based health intervention
基於社群媒體的健康幹預
Translating research on diabetes self-management interventions into practice
將糖尿病自我管理介入研究轉化為實踐
Using acetylcholinesterase inhibitors in Alzheimer's disease
在阿茲海默症中使用乙醯膽鹼酯酶抑制劑
Using decision support systems (DSS) by child welfare workers
兒童福利工作者使用決策支援系統(DSS)
Using patient-driven computers in primary care services
在初級保健服務中使用由患者驅動的計算機
Using voodoo practitioners in Haiti to educate people about HIV/AIDS
利用海地的伏都教巫師對人們進行愛滋病毒/愛滋病教育

LIMITATIONS OF THE DIFFUSION OF INNOVATIONS THEORY
創新擴散理論的局限性

The diffusion of innovations theory has been in existence for quite some time and has been tested empirically and refined. It offers several advantages in guiding the adoption of something that is novel or new. However, like all other models and theories, this approach has some limitations. In health promotion and education, there are few real innovations (Tornatzky & Fleischer, 1990). People often know about the issues and may have tried the behavior. For example, almost all smokers know that smoking is injurious to their health, and many have tried to quit. So quitting is not an innovation for them. Use of the diffusion of innovations theory is challenging in these circumstances.
創新擴散理論已經存在了相當長的一段時間,並且經過了實證檢驗和改進。該理論在指導創新或新事物的採用方面具有一些優勢。然而,與所有其他模式和理論一樣,這種方法也有一些限制。在健康促進和教育領域,真正的創新很少(Tornatzky & Fleischer, 1990)。人們通常知道這些問題,並且可能已經嘗試過這種行為。例如,幾乎所有吸菸者都知道吸菸有害健康,而且很多人都嘗試過戒菸。因此,戒菸對他們來說並不是一種創新。在這種情況下,使用創新擴散理論就具有挑戰性。
Public health interventions are preventive in nature, whereby the individual has to adopt the new idea today to avoid the likelihood of a negative consequence occurring at a later date. For example, a smoker would need to quit smoking today to prevent development of lung, cancer 20 or so years later. Such a long interval poses special challenges, and diffusion occurs more slowly (Rogers, 2002). It needs to be kept in mind that diffusion of innovations in health is a complex process that occurs at multiple levels, across many
公共衛生幹預措施具有預防性質,即個人必須在今天採用新觀念,以避免日後可能出現的負面後果。例如,吸菸者需要在今天戒菸,以防止 20 多年後罹患肺癌。如此長的時間間隔會帶來特殊的挑戰,而且傳播速度會更慢(羅傑斯,2002 年)。需要牢記的是,衛生領域創新的傳播是一個複雜的過程,它發生在多個層面,橫跨多個領域
Diffusion is a multifaceted perspective about social change. Scholars dating at least to Georg Simmel and Gabriel Tarde 100 years ago theorized about imitative behavior at the level of small groups and within communities, and the relation between these micro-level processes to macro-level social change in which sectors, networks, and cities change.
擴散是關於社會變革的多層面視角。至少從100 年前喬治-西美爾(Georg Simmel)和加布里埃爾-塔爾德(Gabriel Tarde)開始,學者們就對小團體和社區內的模仿行為以及這些微觀層面的過程與宏觀層面的社會變遷之間的關係進行了理論研究,這些宏觀層面的社會變革包括部門、網絡和城市的變化。
-Dearing , p. 24 different settings, and utilizes different strategies (Brownson, Tabak, Stamatakis, & Glanz, 2015; Parcel, Perry, & Taylor, 1990).
-Dearing , 第 24 頁 不同的環境,使用不同的策略(Brownson, Tabak, Stamatakis, & Glanz, 2015; Parcel, Perry, & Taylor, 1990)。
Oftentimes in health promotion and health education, the interventions are designed for lower socioeconomic groups, people with low literacy levels, and other vulnerable community members. The adoption and diffusion process is easier and smoother in the wealthier and more highly educated populations than in the vulnerable populations, which present a number of challenges and barriers. As a consequence, the gap between the haves and the have-nots widens even further.
在健康促進和健康教育中,幹預措施往往是為社會經濟地位較低的群體、文化水平較低的人以及其他弱勢社區成員設計的。在富裕和教育程度較高的人群中,幹預措施的採用和推廣過程比在弱勢群體中容易和順利得多,因為弱勢群體面臨許多挑戰和障礙。因此,富人與窮人之間的差距進一步拉大。
Another issue with the diffusion of innovations theory is proinnovation bias (Rogers, 2003). This refers to the preconception that an innovation should be diffused and adopted by all members of society in a rapid manner without rejection or reinvention. This is often not possible with many health promotion and education objectives. For example, it is virtually impossible at present to think that no one will smoke or that everyone will engage in 30 minutes of physical activity every day. Rogers (2003) suggested conducting research while the innovation is still being adopted rather than waiting for it to be completely adopted, studying unsuccessful innovations and examining the broader context in which an innovation diffuses.
創新擴散理論的另一個問題是支持創新的偏見(羅傑斯,2003 年)。這指的是一種先入為主的觀念,即創新應迅速傳播並被所有社會成員所採用,而不應遭到排斥或重新發明。許多健康促進和教育目標往往無法做到這一點。例如,要想讓所有人都不吸煙或每天進行 30 分鐘的體能鍛煉,目前幾乎是不可能的。羅傑斯(Rogers,2003 年)建議在創新仍在被採用時進行研究,而不是等待創新完全被採用,研究不成功的創新,並檢視創新傳播的更廣泛背景。
Finally, focusing on linear-stage models of decision making with the diffusion of innovations theory can be problematic. Seldom does the adoption of innovation follow a linear path as suggested in the theory. Often the path is uneven, and results that fit the S-shaped curve are not achieved (Mohr, 1987; Rosegger, 1996). Hence, a nonlinear, dynamic process that pays more attention to systemic context and norms may be more beneficial. In this regard, Westarp (2003) has suggested relational and structural models. Relational models analyze how direct
最後,將創新擴散理論的重點放在決策的線性階段模型上可能會產生問題。創新的採用很少像理論認為的那樣遵循線性路徑。通常情況下,採用創新的路徑是不平坦的,也不會出現符合 S 型曲線的結果(Mohr,1987 年;Rosegger,1996 年)。因此,一個非線性的、動態的、更關注系統環境和規範的過程可能更有益處。在這方面,Westarp(2003 年)提出了關係模型和結構模型。關係模型分析直接

contacts between participants in networks influence the decision to adopt or not adopt an innovation, whereas structural models focus on the pattern of all relationships and show how the structural characteristics of a social system determine the diffusion process.
網路參與者之間的連結會影響採用或不採用創新的決定,而結構模型則著重於所有關係的模式,並說明社會系統的結構特徵如何決定傳播過程。

SKILL-BUILDING ACTIVITY 技能培養活動

Let us see how we can apply the diffusion of innovations theory in health education and health promotion. The National Commission for Health Education Credentialing (NCHEC) provides a certification system for professionals working in health education and health promotion. Other professions, such as physicians, nurses, and dietitians, are registered practitioners. Let us assume we want to start the innovation of "registered health educators."
讓我們看看如何將創新擴散理論應用於健康教育和健康促進。國家健康教育認證委員會(NCHEC)為從事健康教育和健康促進工作的專業人員提供了一個認證系統。其他職業,如醫生、護士和營養師,都是註冊從業人員。讓我們假設要開始 "註冊健康教育工作者 "的創新。
In applying the diffusion of innovations theory, we would first look at the construct of innovation and its attributes. The first attribute is perceived relative advantage. For all existing and prospective health educators, this innovation should seem advantageous. Employers could be convinced to give a nominal raise to those who become registered health educators, thus providing a monetary advantage. The social status that comes with being a registered member of the profession would need to be underscored. The ability to write the credential "RHEd" with one's name would need to be marketed. The second attribute is compatibility. This innovation is in direct synchrony with the previous innovation of Certified Health Education Specialist (CHES) and should build on that to be successful. The third attribute is that of complexity. The process should be similar to that of becoming a CHES, and thus not very complex. The simpler the process, the better its chances of adoption. The fourth attribute, demonstrability, would not be possible with this innovation. The fifth attribute is that of clarity of results. The results of several years of success with CHES and with registration in other disciplines could be shared. The sixth attribute is costs, which would have to be kept at a nominal rate similar to that involved with CHES. The seventh attribute of reversibility would be easy: A person who does not want to be registered would simply abstain from paying the annual dues. The eighth attribute is that of pervasiveness. To influence this attribute, employers would need to make adjustments by endorsing the idea of registered health educators and mandating that only such individuals be hired in health education jobs. The ninth attribute, reinvention, does not apply to this innovation.
在應用創新擴散理論時,我們首先要研究創新的概念及其屬性。第一個屬性是可感知的相對優勢。對於所有現有的和未來的健康教育工作者來說,這種創新應該是有利的。可以說服雇主給那些成為註冊健康教育者的人名義上加薪,從而提供金錢上的優勢。需要強調的是,成為註冊健康教育工作者所帶來的社會地位。需要宣傳在自己的名字上寫上 "RHEd "這張證書的能力。第二個特點是相容性。這項創新與先前的認證健康教育專家(CHES)創新直接同步,應在此基礎上取得成功。第三個屬性是複雜性。這個過程應與成為註冊健康教育專家(CHES)的過程類似,因此不會非常複雜。程序越簡單,採用的機會就越大。第四個特性是可示範性,這種創新是不可能實現的。第五個特點是結果明確。可以共享 CHES 和其他學科註冊幾年來的成功結果。第六個特點是成本問題,成本必須保持在與 CHES 類似的名目水準上。第七個特點是可逆性:不想註冊的人只需放棄繳納年度會費即可。第八個特性是普遍性。為影響此屬性,雇主需要做出調整,認可註冊健康教育工作者的理念,並規定只僱用此類人員從事健康教育工作。第九個屬性是再創新,不適用於這種創新。
The second construct is that of communication channels. Mass mailing of information about the innovation (registration for health educators) would need to be sent to existing CHES practitioners, the 258 institutions of higher education that award degrees in health education, and all major employers who hire health educators (e.g., county health departments, state health departments, major hospitals, major school systems, and large companies with health and wellness units). Interpersonal communication using people who have adopted the innovation would also need to be done. A website detailing the innovation would need to be set up.
第二個構想是傳播管道。需要向現有的CHES 從業人員、授予健康教育學位的258 所高等院校以及僱用健康教育工作者的所有主要雇主(例如,縣衛生部門、州衛生部門、大型醫院、大型學校系統以及設有衛生和健康部門的大型公司)群發有關創新(健康教育工作者註冊)的資訊。也需要與採用創新方法的人員進行人際交流。還需要建立一個詳細介紹創新的網站。
The third construct is that of time. The flow of time would involve the five-step process of providing knowledge about the innovation, persuading health educators about the innovation, helping health educators decide about the innovation, starting the first batch of registered
第三個結構是時間結構。時間流程包括五個步驟,即提供有關創新的知識、說服健康教育工作者了解創新、幫助健康教育工作者決定創新、啟動第一批註冊的健康教育工作者、向健康教育工作者提供有關創新的知識、幫助健康教育工作者決定創新、啟動第一批註冊的健康教育工作者、提供健康教育工作者有關創新的知識。

health educators, and then confirming their continuation as registered health educators. A count of people adopting the innovation could be kept so that a rate of adoption curve could be plotted.
健康教育工作者,然後確認他們繼續成為註冊健康教育工作者。可以對採用創新方法的人數進行統計,以便繪製採用率曲線。
The fourth construct is that of the social system. The first aspect of the social system is homophily. Health educators comprise diverse groups. Thus, the first task would be to decrease the diversity and make the innovation appeal to the common attributes of all health educators. The second aspect is social networks. Health educators who have adopted the innovation could be used to spread the message to other health educators. The electronic network of health educators (HEDIR) could also be used in this process. The third aspect of the social system is the change agent. The leadership at the National Commission for Health Education Credentialing should take up the task of coordinating and sending the necessary information and becoming change agents. The fourth aspect of the social system is opinion leaders, who would be composed of supervisors at workplaces and department chairs at the various institutions of higher education.
第四個結構是社會系統結構。社會系統的第一個面向是同質性。健康教育工作者由不同的群體組成。因此,首要任務是減少多樣性,使創新符合所有衛生教育工作者的共同屬性。第二個面向是社會網絡。可以利用已採用創新方法的健康教育工作者向其他健康教育工作者傳播訊息。在這過程中,還可以利用健康教育工作者電子網路(HEDIR)。社會系統的第三個面向是變革推動者。國家健康教育認證委員會的領導應承擔起協調和發送必要資訊的任務,並成為變革的推動者。社會系統的第四個面向是意見領袖,他們將由工作場所的主管和各高等教育機構的系主任組成。
Using this approach, you can plan to work on spreading any innovation using the diffusion of innovations theory. Table 9-6 provides a set of questions to consider when setting up your plan.
使用這種方法,你可以利用創新擴散理論,制定推廣任何創新的計畫。表 9-6 提供了一系列在製定計劃時需要考慮的問題。

Table Shaping Constructs of the Diffusion of hnovatuons Theory for Health Edueation Program Planning
創新擴散理論在健康教育計畫規劃中的塑造結構

  1. What should be considered while developing the in novation?
    在製定新約時應考慮哪些因素?
  • Increase perceived relative advantage.
    增加可感知的相對優勢。
  • Increase compatibility. 提高相容性。
  • Decrease complexity. 降低複雜性。
  • Give opportunity for demonstrability:
    提供展示的機會:
  • Show clarity of results.
    顯示清晰的結果。
  • Minimize costs. 成本最小化。
  • Allow for reversibility.
    允許可逆性。
  • Work on factors affecting pervasiveness:
    研究影響普遍性的因素:
  • Allow for reinvention. 允許重塑。
  1. What should be considered while developing the communication channels?
    在開發傳播管道時應考慮哪些因素?
  • Mass media 大眾媒體
  • Interpersonal 人際關係
  • Interactive 互動式
  1. What should be considered while developing the time?
    在製定時間時應考慮哪些因素?
  • Innovation-decision process
    創新決策過程
  • Rate of adoption 採用率
  • Adopter categories 採用者類別
  1. What should be considered while developing the social system?
    在製定社會制度時應考慮哪些因素?
  • Homophily 同源性
  • Social networks 社群網路
  • Change agents 變革推動者
  • Opinion leaders 意見領袖

CASE STUDY:MOLY NEEDS HELP APPLYING THE DIFEUSION OF INNOVTIONS THEORY
案例研究:莫里公司在應用創新理論時需要協助

Molly is a health promotion student at a large university in the northwestern United States. She is a member of Eta Sigma Gamma (the health education honorary), and they have been working with the wellness center at the university promoting health and wellness programs. One of the programs she facilitates is yoga and meditation. Recently, a virtual reality (VR) asset has come to market that helps yoga practitioners perform meditation. VR entails computer-generated simulations and provides a totally immersive experience that can help participants concentrate on the experience provided while shutting out other stimult. The gaming headset used to play the VR ranges from for one used with a cell phone to for a stand-alone headset. The cost of the meditation VR asset itself is . Molly wants to use the diffusion of innovations theory to promote the use of this meditation VR among students at her university, but she has some doubts about that she needs help with. Her doubts are presented as questions for discussion.
莫莉是美國西北部一所大型大學的健康促進專業學生。她是 Eta Sigma Gamma(健康教育榮譽組織)的成員,她們一直與大學的健康中心合作,推廣健康和保健計畫。她主持的項目之一是瑜伽和冥想。最近,市場上出現了一種虛擬實境(VR)資產,可以幫助瑜珈練習者進行冥想。 VR 包含電腦生成的模擬,提供了一種完全身臨其境的體驗,可以幫助參與者專注於所提供的體驗,同時屏蔽其他刺激。玩 VR 所用的遊戲頭盔從 (與手機一起使用)到 (獨立頭盔)不等。冥想 VR 資產本身的成本為 。莫莉希望利用創新擴散理論在她所在大學的學生中推廣使用這款冥想 VR,但她有一些疑惑需要幫助。她的疑慮將以問題的形式呈現,供大家討論。

QUESTIONS FOR DISCUSSION
討論問題

  1. Does the meditation VR present a perceived relative advantage of the innovation to the user? Why or why not?
    冥想 VR 是否向使用者展示了創新的相對優勢?為什麼?
  2. What attributes of the meditation VR innovation can Molly use to promote its use among students, faculty, and staff at her university?
    Molly 可以利用冥想 VR 創新的哪些特質在她大學的學生、教職員中推廣使用?
  3. What strategies can she use to entice early adopters and the early majority in adopting the innovation of meditation VR?
    她可以使用哪些策略來吸引早期使用者和早期大多數人採用冥想 VR 這項創新技術?
  4. What communication channels can she employ in promoting the meditation VR at her university?
    她可以透過哪些傳播管道在大學推廣冥想 VR?
  5. What social neiworks can she use to promote the meditation VR at her university?
    她可以利用哪些社群網路在大學推廣冥想 VR?
  6. Which opinion leaders can she tap into in helping her promote the meditation VR at her university?
    她可以利用哪些意見領袖來幫助她在大學推廣冥想 VR?
  7. Which change agents can she utilize in helping her promote the meditation VR at her university?
    她可以利用哪些變革推動者來幫助她在大學推廣冥想 VR?
  8. How would she go about designing a program based on the diffusion of innovations theory to promote this meditation VR at gyms and wellness centers in her city?
    她將如何根據創新擴散理論設計一項計劃,在她所在城市的健身房和健康中心推廣這種冥想 VR?

SUMMARI 蘇馬裡

The diffusion of innovations theory explains the adoption of a new idea, practice, or object over a period of time. The origins of this theory are almost 100 years old, but the first empirical study was done by Bryce Ryan and Neal Gross at lowa State University with hybrid corn seed in the 1940 s. They studied the adoption process and the characteristics of the farmers who adopted the hybrid corn seed. Their work had implications not only in agriculture, but also for a variety of disciplines, including health promotion and health education.
創新擴散理論解釋了新想法、新做法或新事物在一段時間內被採納的過程。這個理論的起源已有近 100 年的歷史,但第一項實證研究是由布萊斯-瑞安和尼爾-格羅斯於 20 世紀 40 年代在美國 Lowa 州立大學針對雜交玉米種子所做的。他們的工作不僅對農業有影響,而且對包括健康促進和健康教育在內的多個學科也有影響。
The four main constructs of the diffusion of innovations theory are innovation, communication channels, time, and social system. Several attributes of innovation are perceived relative advantage (perception about how much better the new product, idea, or practice is than the one it will replace), compatibility (the perception regarding the innovation's consistency with the values,
創新擴散理論的四個主要概念是創新、傳播管道、時間和社會制度。創新的幾個屬性是感知相對優勢(感知新產品、新概念或新做法比它將取代的產品、理念或做法好多少)、相容性(感知創新與價值觀的一致性)、傳播管道(感知創新與傳播管道的一致性)與社會系統(感知創新與社會系統的一致性)、

past experiences, and needs of potential adopters), complexity (the perception of the degree of difficulty in understanding and using the new idea, practice, or product), demonstrability (the degree to which an innovation may be experimented with on a limited basis), clarity of results (the degree to which the outcomes of an innovation are clearly visible), costs (the tangible and intangible expenses incurred in the adoption of a new idea, practice, or product), reversibility (the ability and degree to which the status quo can be reinstated by ceasing to use the innovation), pervasiveness (the degree to which an innovation requires changes or adjustments by other elements in the social system), and reinivention (the degree to which a potential adopter can adapt, refine, or modify the innovation to suit his or her needs).
複雜性(對理解和使用新理念、新做法或新產品的困難程度的認識)、可示範性(可在有限的基礎上對創新進行試驗的程度)、結果的明確性(創新成果清晰可見的程度)、成本(在採用新理念、新做法或新產品過程中產生的有形和無形支出)、可逆性(停止使用創新成果後可恢復原狀的能力和程度)、普遍性(創新成果要求其他方面做出改變或調整的程度)、可逆性(停止使用創新後可恢復原狀的能力和程度)、普遍性(創新要求社會系統中其他要素做出改變或調整的程度)和再創造性(潛在採用者可依自身需求調整、完善或修改創新的程度)。
The communication channels are of three kinds: (1) mass media channels, such as television, radio, and newspapers; (2) interpersonal channels, which require face-to-face interaction between two or more individuals; and (3) interactive communication channels, such as those available online.
傳播管道有三種:(1) 大眾媒體管道,如電視、廣播和報紙;(2) 人際傳播管道,需要兩個或兩個以上的人面對面交流;(3) 互動傳播管道,如網路傳播管道。
The time construct is involved with the diffusion of innovations in three ways: (1) the innovation-decision process, (2) adopter categories, and (3) rate of adoption. The social system construct comprises homophily (similarity among group members), social networks (person-centered webs. of social relationships); change agents (people who influence a potential adopter's decision about innovation in a favorable way), and opinion leaders (influential individuals in a community who sway the beliefs and actions of their colleagues in either a positive or negative direction). The diffusion of innovations theory has been widely applied in public health.
時間結構在三個方面與創新的傳播有關:(1) 創新決策過程,(2) 採用者類別,(3) 採用率。社會系統結構包括同質性(群體成員之間的相似性)、社會網絡(以人為中心的社會關係網)、變革推動者(以有利的方式影響潛在採用者對創新做出決定的人)和意見領袖(在社區中有影響力的個人,他們以積極或消極的方式影響同事的信念和行動)。創新擴散理論已廣泛應用於公共衛生領域。

IMPORTANT TERMS 重要術語

change agent 變革者

clarity of results 結果清晰
communication channels 溝通管道
compatibility 相容性
complexity 複雜性
costs 費用
demonstrability 可證性
diffusion 傳播
homophily innovation 同親創新
opinion leaders 輿論領袖
perceived relative advantage
認知相對優勢
pervasiveness 普遍性
reinvention 重塑
reversibility 可逆性
social networks 社群網路
social system 社會制度
time 時間

REVIEW QUESTIONS 複習題

  1. Describe the historical genesis of the diffusion of innovations theory.
    描述創新擴散理論的歷史起源。
  2. Discuss the five attributes of innovations.
    討論創新的五個屬性。
  3. What does the acronym FOMENT mean in the context of the diffusion of innovations?
    在創新傳播方面,縮寫 FOMENT 是什麼意思?
  4. Describe the four constructs of the diffusion of innovations theory.
    描述創新擴散理論的四個結構。
  5. Discuss the limitations of the diffusion of innovations theory.
    討論創新擴散理論的限制。
  6. Apply the diffusion of innovations theory for spreading any innovation of your choice.
    運用創新擴散理論來傳播你所選擇的任何創新。
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