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Network News ExcerptsEDITION OF THE NETWORK NEWS) From the Director Practice-Based Research: The Diffusion of an Innovation Are you familiar with the book, The Diffusion of Innovations,1 by sociologist
Everett Rogers? This overview of research on planned and unplanned social
change is now in its fifth edition. I've never seen this work on a required
reading list for pediatric practitioners, but I think it would appeal
to many PROS practitioners. Everett Rogers defines an innovation as any idea, practice, or object
perceived as new by a potential adopter. Rogers' review makes it clear
that better ideas and practices often are adopted very, very slowly. For
example, the use of citrus to prevent scurvy on long sea voyages was first
shown to be effective in 1601 by James Lancaster. Many decades passed
and a heavy scorbutic toll was extracted from British sailors until regular
citrus rations were made policy by the British navy (1795) and merchant
marine (1865). Happily, in the 21st century, much is known about what
makes innovations more or less likely to be adopted. What has the diffusion of innovations to do with PROS? I would argue
that the entire PROS enterprise can be understood as the diffusion of
a series of innovations. The idea that research should and can be done
on care in practice settings, the notion that practitioners can make meaningful
additions to the research enterprise, and the very techniques used by
practice-based research networks in developing and executing studies all
have been innovations. Finally, the network is in the process of testing
innovations - the violence prevention intervention of the Safety Check
study and the distance quality improvement intervention of the Translating
Immunization Research Into Practice study exemplify using the innovation
of practice-based research to test other innovations. Rogers' book has many lessons for practice-based research - some that
we already have applied and others that we are beginning to put into operation.
One lesson is that all innovations diffuse best within existing communications
channels. The AAP with its chapter structure and network of interpersonal
relationships has proven a great place to diffuse the PROS innovation
of practice-based research, and now PROS itself has created communications
channels through which to spread innovative studies. Other lessons can
be drawn from Rogers' list of the characteristics of innovations that
make them more or less likely to be adopted. These characteristics are relative advantage (the degree to which an
innovation is perceived as better than the idea it supersedes), compatibility
(the degree to which an innovation is perceived as being consistent with
the existing values, past experiences, and needs of potential adopters),
complexity (the degree to which an innovation is perceived as difficult
to understand and use), trialability (the degree to which an innovation
may be experimented with on a limited basis), and observability (the degree
to which the results of an innovation are visible to others). With respect to relative advantage, we are constantly challenged to provide
for PROS members the benefits, which make participating in practice-based
research a great experience (i.e., better than not participating!). The
principle of compatibility has stimulated us to use similar forms and
procedures from one PROS study to the next. To reduce complexity, we work
with PROS Chapter Coordinators to make protocols as simple as possible.
The principle of trialability has encouraged us to persist in descriptive
"starter studies" like the Child Abuse Recognition Experience
Study. Finally, the principle of observability has inspired us to make
PROS participation more visible to the outside world, both with the time-honored
"This is a PROS Practice" wall certificate and with the new
PROS Honor Roll of participants published in the AAP News. These examples are only a few of the dozens that I could have mentioned.
The overall message is that PROS is a case study for the diffusion of
innovations, and you, whose participation makes PROS possible, are both
the innovators and the inspiration for innovation. Reference
From The Steering Committee Chair So, how do you take the time, make the time to contribute to pediatric
knowledge and practice through participation in PROS. You're altruistic
and love intellectual stimulation... but you need to get through each
day.
About PROS | Study
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News Excerpts
Pediatric Research in Office Settings (PROS)
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