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A Practice-Based View of Innovation Adoption  

Rangapriya Kannan and Paola Perez-Aleman

Innovation adoption is challenging at both intra-organizational and interorganizational levels. Several decades of innovation adoption research have identified various barriers at both levels. Intra-organizational barriers are often related to the characteristics of the innovation, adopters, managers, environment, and ecosystem but can also include an incompatibility with an organization’s strategy, structural impediments, organizational resource constraints, a lack of fit of the innovation with an organizational culture and climate, decision making challenges, a lack of integration with an organization’s knowledge management, human resource management practices, dynamic capabilities, and active innovation resistance from customers. Interorganizational barriers include uncertainty with learning and implementation, the distributed nature of the innovation process, differences in production systems, disparities in regulatory systems, variation within local contexts, and the nature of embedded knowledge adopted in diverse organizational contexts. One of the key missing aspects in understanding innovation adoption is how extant practices within an organizational or interorganizational context enhance or hinder innovation adoption. Although the practices of innovation adoption emerge and evolve dynamically, existing research does not highlight fine-grained practices that lead to its success or failure. A practice lens focuses on people’s recurrent actions and helps to understand social life as an ongoing production that results from these actions. The durability of practices results from the reciprocal interactions between agents and structures that are embedded within daily routines. A practice lens allows us to study practices from three different perspectives. The first perspective, empirically explores how people act in organizational contexts. The second, a theoretical focus investigates the structure of organizational life. This perspective also delves into the relations between the actions that people take over time and in varying contexts. Finally, the third perspective which is a philosophical one focuses on how practices reproduce organizational reality. By focusing on the unfolding of constellations of everyday activities in relation to other practices within and across time and space, a practice lens hones in on everyday actions. Everyday actions are consequential in producing the structural contours of social life. A practice lens emphasizes what people do repeatedly and how those repetitive actions impact the social world. A practice theory lens also challenges the assumption that things are separable and independent. Instead, it focuses on relationality of mutual constitution to understand how one aspect of the issue creates another aspect. Relationality of mutual constitution is the notion that things such as identities, ideas, institutions, power, and material goods take on meaning only when they are enacted through practices instead of these being innate features of these things Focusing on duality forces us to address the assumptions that underlie the separation. A practice perspective on innovation adoption highlights the concepts of duality, dynamics, reciprocal interactions, relationality, and distributed agency to inform both the theory and practice of innovation adoption. Understanding these concepts enables a practice lens for successful adoption of innovations that impact organizational and societal outcomes, such as economic development, productivity enhancement, entrepreneurship, sustainability, equity, health, and other economic, social, and environmental changes.


Diffusion Theory in Integrative Approaches  

Gary L. Kreps

Diffusion is the process through which new ideas, technologies, products, or processes are spread through communication among members of a social system via communication channels over time. Diffusion is a specialized form of communication that focuses on disseminating information about new ideas, products, technologies, services, or regulations. It is an especially important form of communication because it promotes social progress in the evaluation and adoption of important new ideas to address social issues. Diffusion helps to reduce uncertainty about how to address difficult issues and provides direction for achieving social goals. A large body of research has been conducted from many disciplines on the diffusion of innovations since the original publication of Everett M. Rogers’ seminal book The Diffusion of Innovations in 1962, which is now in its fifth edition (2003). In this book, he introduced the Diffusion of Innovations (DOI) model, which describes a general process of adopting new ideas across multiple populations, cultures, and applications. This research has examined innovations in fields such as agriculture, engineering, sales, education, architecture, technology, public policy, and health care, and has been applied to a range of different issues, such as the adoption of new technologies, consumer purchasing behaviors, and public support for political issues and candidates, but has been especially influential in guiding strategic health promotion. The DOI model has contributed to a greater understanding of health behavior change, including adoption of health promotion recommendations. The model has led to a broad scope of practical applications for promoting public health.


Variations in the Adoption of Healthcare Innovation: A Literature Review  

Marisa Miraldo, Katharina Hauck, Antoine Vernet, and Ana Wheelock

Major medical innovations have greatly increased the efficacy of treatments, improved patient outcomes, and often reduced the cost of medical care. However, innovations do not diffuse uniformly across and within health systems. Due to the high complexity of medical treatment decisions, variations in clinical practice are inherent to healthcare delivery, regardless of technological advances, new ways of working, funding, and burden of disease. In this article we conduct a narrative literature review to identify and discuss peer-reviewed articles presenting a theoretical framework or empirical evidence of the factors associated with the adoption of innovation and clinical practice. We find that variation in innovation adoption and medical practice is associated with multiple factors. First, patients’ characteristics, including medical needs and genetic factors, can crucially affect clinical outcomes and the efficacy of treatments. Moreover, differences in patients’ preferences can be an important source of variation. Medical treatments may need to take such patient characteristics into account if they are to deliver optimal outcomes, and consequently, resulting practice variations should be considered warranted and in the best interests of patients. However, socioeconomic or demographic characteristics, such as ethnicity, income, or gender are often not considered legitimate grounds for differential treatment. Second, physician characteristics—such as socioeconomic profile, training, and work-related characteristics—are equally an influential component of practice variation. In particular, so-called “practice style” and physicians’ attitudes toward risk and innovation adoption are considered a major source of practice variation, but have proven difficult to investigate empirically. Lastly, features of healthcare systems—notably, public coverage of healthcare expenditure, cost-based reimbursement of providers, and service-delivery organization, are generally associated with higher utilization rates and adoption of innovation. Research shows some successful strategies aimed at reducing variation in medical decision-making, such as the use of decision aids, data feedback, benchmarking, clinical practice guidelines, blinded report cards, and pay for performance. But despite these advances, there is uneven diffusion of new technologies and procedures, with potentially severe adverse efficiency and equity implications.


Adopting the Internet in Urban China  

Jianbin Jin, Xiaoxiao Cheng, Jing Yang, and Hui Wang

This century is marked by a burgeoning information society around the globe; accordingly, the adoption and use of information and communication technologies (ICTs) in general and the Internet in particular have been one of the most fruitful domains in the broader field of communication sciences. The observed persistent academic interest can, to a large extent, be attributed to the polymorphic nature of ICTs of various modalities, functioning as ICTs technology clusters and/or meta operating systems that accommodate numerous technologies, functions and applications. Beyond that, ICTs or Internet adoption is reflective of a social process of development, during which the informational mode of development is interwoven with other social systems and varies across diverse social settings. Most existing empirical research and theoretical approaches have overwhelmingly focused on the Internet adoption in developed economies, but in-depth investigations on the developing economies such as China are scarce, if any. Compared to most developed countries, China’s informatization-urbanization model marks a unique path of modernization, which further provides a huge opportunity to build momentum for the rapid and large-scale Internet adoption in urban China. In order to present a whole-range holistic portrait of China’s Internet development, the intrinsic logics and social outcomes of China’s informatization-urbanization model necessitate in-depth investigations.