Dearing James W
School of Communication Studies, Ohio University, Athens, Ohio 45701-2979, USA.
J Health Commun. 2004;9 Suppl 1:21-36. doi: 10.1080/10810730490271502.
Year by year, the gaps between what is known about behavior change and what is actually practiced in social programs grow larger, especially for community-based programs intended to help minority populations, the poor, and those living in inner-city and rural areas. Internationally, such gaps between the state of knowledge and the state of practice lead to disparities in health, education, and development among societal groups, demographic sub-populations, communities, and countries. Data about disparities are used as evidence of inequality. Here, I discuss uses of certain diffusion of innovation theory-based concepts to systematically redress problems of inequality and disparity by reducing the differences between evidence and practice in social programs that are implemented by intermediaries (practitioners) and communicated by them to needy populations. The emphasis here is on the integrated application of knowledge about innovation attributes, opinion leadership, and clustering from diffusion theory to achieve the objective of more extensive and more rapid diffusion of especially effective programs. A set of implementation steps are offered for researchers, funders of international health programs, and the intermediaries who implement health programs.
年复一年，行为改变方面已知的知识与社会项目实际实施情况之间的差距越来越大，对于旨在帮助少数群体、贫困人口以及那些生活在市中心和农村地区的人群的社区项目而言尤其如此。在国际上，知识水平与实践状况之间的这种差距导致了社会群体、人口亚群体、社区和国家之间在健康、教育和发展方面的差异。有关差异的数据被用作不平等的证据。在此，我将讨论如何运用某些基于创新扩散理论的概念，通过缩小由中介机构（从业者）实施并传达给有需要人群的社会项目中证据与实践之间的差异，来系统地纠正不平等和差异问题。这里的重点是综合运用关于创新属性、意见领袖和扩散理论中的聚类的知识，以实现特别有效的项目更广泛、更迅速地扩散这一目标。为研究人员、国际卫生项目的资助者以及实施卫生项目的中介机构提供了一套实施步骤。
