Innovation, diffusion and the dancing guy
Over the last couple of months, we have been in deep thinking mode as we work on designing an innovation project that we are pretty excited about it. We’ll share plenty more about this as we go but as a quick teaser for what it’s all about – In the US 8% of children born have of low birthweight, however this small cohort represents 47% of the immediate hospital inpatient costs and 27% of first year medical costs for all children. Birthweight is a predictor of future chronic disease, mental health, academic performance, employment and incarceration. Again, in the US - an increase of 250 grams in birth weight saves an average of $12,000 to $16,000 in first year medical expenses. While these are American figures, it’s still pretty staggering stuff. We'll leave you with some questions to think about this one:
We seem to have the money to foot the bill for downstream care, but reluctant to invest that upstream, why is this so?
Can we prevent low birth weight? If so, how do we do this?
Who is effected most by low birth weight? Can we target an intervention in a suitable setting?
Is preventing low birth weight the key to unlocking social and economical mobility across generations?
This post isn’t about that project.... but we will keep you updated with our progress as we move forward. As we’ve been trawling through the evidence of what has worked, what hasn’t and the theories to help explain why, we’ve been thinking a lot about how we can best make things change – especially, when so much of it relies on people, their behaviour and context.
In 1962, a guy named Everett Rogers came up with what he coined the Diffusion of Innovation Theory. In short, the theory attempts to explain how an ‘innovation’ is adopted amongst members of a social system. Ever been told you’re an early adopter? Or not? These are terms coined by Rogers in his work and a lot of the elements of this theory are just as relevant today, over 50 years later.
Innovations can be anything. They may be a novel idea to change people’s behaviour or a new product or service. For the purposes of this post, let’s use a fairly simple scenario. One of the key challenges faced by the health system is that people that need to access certain health services face a range of barriers in doing so, despite them often being ‘free’ – lack of transport to make appointments, lack of family support, stigma, poor previous experience with health services. These barriers push them to present ‘downstream’ often when a condition could have been better treated or prevented earlier. This is one of the reasons why introducing token fees for people to enter the health system is a bit scary. Discouraging those that already face significant access barriers further is counterintuitive.
Anyway, let’s imagine that the ‘innovation’ in this scenario is health services being offered in a person’s home. I should point out that many community organisation already offer this so it isn’t particularly innovative, nor is it anything we are actually proposing – just for the sake of a scenario.
The theory explains that there are five stages someone needs to go through to adopt an innovation. In this instance, that means a person utilising in-home health services. These include:
Knowledge – the person becomes aware of the service and how it works
Persuasion – they form an attitude towards using the service in the future
Decision – they choose to adopt or reject the service
Implementation – they utilise the service
Confirmation – they form an opinion on the results of their decision to adopt the innovation.
One of the most important things to consider is that adoption is not the same as diffusion. We think of adoption being an individual process, whereby a person adopts an innovation as they move through the stages above. However, diffusion is the group-level process, where adoption of the innovation happens throughout a connected group of people. Diffusion of new ideas or behaviours depends on:
The innovation itself, and whether it:
is seen as a better option
fits with the person’s values
is achievable
can be trialled first
is observed to be of benefit
Communication channels that enable diffusion to occur between people
The period of time required for innovation to be diffused and reach a critical mass
The social system, including the roles that other people play (e.g. leaders, early adopters) in influencing decisions of those within the system
In creating social impact that is big enough to really make a difference, diffusion is what we need. This requires big-picture thinking about the context, not just the innovation itself. Most importantly, it means being authentic and genuine, finding a role for those people who are vital for diffusion to take place – the innovators and early adopters.
To illustrate the diffusion of innovation in action in a very amusing and human way, check out this great video by Derek Sivers titled ‘Leadership lessons from Dancing Guy’. It’s a must-watch (with sound on) - enjoy!