About Us

Scaling Social Innovations

Effective practices often fail to spread to those in need. When spread does occur, implementation may not be sustained or local adaptation renders the innovation ineffective. We work with program innovators and their sponsors to study how best to implement and scale innovations. We focus on the characteristics of the innovation, the organizational context, and the implementation process to identify which adaptations are helpful and which are not and recommend how to successfully cross the research-to-practice-to-scale chasm.

Evaluating Processes, Outcomes, and Impacts

Diffusion Associates works closely with clients to assess how programs are implemented and to what effect. We conduct formative evaluation to improve the likelihood of adoption, we monitor implementation to identify opportunities for sustained use and spread, assess the effectiveness of promising practices, and focus on how a best practice spreads to new problems and populations. Our work is theoretically based, practice focused, and highly customized.

Our Team

R. Sam Larson (Ph.D., Michigan State University) is the President of Diffusion Associates (and prior to that Applied Research). Sam builds collaborative teams drawing on the strengths of researchers and practitioners from across the country. She has led and collaborated on numerous evaluations of educational and social service programs. At present, her primary areas of inquiry include the analysis of innovation implementation, collaboration strategies used to scale-up social innovations, and adult and continuing education. Sam is also the director of River Runs North which organizes pro bono evaluation and communication consulting for nonprofits serving rural areas in Michigan.

James W. Dearing (Ph.D., University of Southern California) is the Brandt Endowed Professor in the Department of Communication at Michigan State University and a Senior Consultant with Diffusion Associates. He has been Senior Scientist with Kaiser Permanente and on the faculties of several universities. Dearing studies the strategic use of diffusion of innovation concepts to accelerate the spread of evidence-based practices, programs, and policies as a form of translational science. At present, a primary interest of Jim’s is the role of health, education, and environmental policy entrepreneurs in helping to scale up pro-social innovations.

Nagesh Rao (Ph.D., Michigan State University) is a Professor and Chair of the Department of Social Medicine, Heritage College of Osteopathic Medicine, at Ohio University.  His scholarly work focuses on cultural competence, diversity, and inclusion in health care.  He is currently focused on the strategic role of intercultural communication in creating healthy individuals and healthy communities. 

Caryn Medved (Ph.D., University of Kansas) is a Professor and Graduate Program Director at Baruch College with the City University of New York.  Caryn has expertise in qualitative methods and offer workshops in qualitative analysis. She has conducted in-depth interview-based research for the last two decades on issues of gender, work, and family.  Currently, Caryn is focusing on employment in the gig economy.

Collaborators

We’ve worked with a diverse group of professionals throughout our catalog of projects.

(Ph.D., University of California Los Angeles) is Senior Research Fellow, Center for Southern California Studies at California State University Northridge, where he also is Executive Director of Valley Nonprofit Resources, a service center for the more than 4,500 nonprofits in the San Fernando Valley Region in Los Angeles. He was President and directed research at the nonprofit Human Interaction Research Institute. His subject matter expertise includes studying and working with people, organizations, and communities to help them meet the challenges of innovation and change. He concentrates on improving health and human services for vulnerable populations, enhancing nonprofit arts and culture programs, and helping highly creative people deal with the challenges of creative work.

(Ph.D., Northwestern University) is Associate Professor in the Department of Communication and James Madison College at Michigan State University. He specializes in public opinion and experimental work on advocacy campaigns. His expertise includes field experimental design, political attitudes, and the sources of partisan polarization in the public.

(Ph.D., Michigan State University) is an Assistant Professor in communication Studies at Albion College.  Jeff studies risk communication, social media, health literacy and environmental communication.  

(Ph.D. Michigan State University) is Visiting Assistant Professor in Speech Communication at Oregon State University. She specializes in the application of quantitative methods to understand how social influence processes impact attitudes and behavior in environmental, health, and risk contexts.

(Ph.D. The University of Texas at Austin) is Associate Professor in the School of Communication at Chapman University. His research explores the diffusion and implementation of innovations in the scientific, health, environmental, and organizational contexts.

(Ph.D., Michigan State University) is Senior Vice Provost for Faculty Affairs at Marquette University where is also a professor in the Department of Communication. His research expertise includes the diffusion of innovations, effective health risk message design, evaluation, and corporate communications.

(Ph.D., University of Connecticut) is a Health Scientist Administrator at the National Cancer Center and previously on faculty at the University of Alabama at Birmingham. Her subject matter expertise includes the science of implementation of evidence-based health practices and interventions in health care and public health settings as well as scaling-up effective health practices and programs.

(Ph.D., University of Colorado Denver) is an investigator/assistant professor at Geisinger Health System Genomic Medicine Institute. Her work focuses on the integration of family history collection tools and genetic tests into clinical practice and electronic health records. Her subject matter expertise includes qualitative research, health information, research design and genetic testing.

Selected Projects & Clients

A Well-Rounded Portfolio

In addition to the selected projects and clients listed below, Diffusion Associates team members have individually worked on a variety of projects with many clients including the Bill & Melinda Gates Foundation, Robert Wood Johnson Foundation, the National Science Foundation, the National Institutes of Health, and numerous other State and Federal agencies and nonprofits.

Project ECHO: Implementation Collaboration

Robert Wood Johnson Foundation

This paper introduces Project ECHO (Extension for Community Healthcare Outcomes), describes its core components as an intervention, and briefly recount its ascent as a way to bring specialty health care to underserved rural populations. We conclude with suggestions for future evaluation and research to improve its performance in the field as it scales out.

Strategies to Scale Up Social Innovation 

Wallace Foundation

This study assesses the conditions and circumstances that favor one scaling-up strategy over others. The primary focus is on collaboration and partnerships found in 45 social innovations that scaled up using different strategies.

Dissemination & Implementation Planning for PrEP

Centers for Disease Control and Prevention (CDC)

In this American Journal of Preventive Medicine publication, Dearing, Larson, and others apply what is known about diffusion to the general case of biomedical interventions and specifically pre-exposure prophylaxis (PrEP). It defines designing for diffusion as the taking of strategic steps early in the process of creating and refining an evidence-based intervention to increase its chances of being noticed, positively perceived, accessed, and tried and then adopted, implemented, and sustained in practice.

Comprehensive Community Health Models

W.K. Kellogg Foundation

A three-year cluster evaluation of a $28 million effort to affect the redesign of health systems in three Michigan counties. This multi-method theoretically-based evaluation framed from the perspective of diffusion of innovations included longitudinal surveys, interviews, archival data, cost analysis, participant observation, and quantitative modeling.

Advise Seeking Network Identification

Rocky Mountain Health Plans

Working with the client, we helped to conceptualize, design and collect survey responses from among 450 family practice clinics. Once mapped, we identified an influence network that could be activated for the spread of best practices in health care.

Building Bridges Initiative Evaluation

W.K. Kellogg Foundation

This multi-year $13.5 million project focused on developing nonprofit management education programs based on theory and practitioner experience. The corresponding multi-year cluster evaluation included formative evaluation of network development and innovation spread and a summative report of outcomes and impacts.

Selected Publications

Informing Practitioners, Researchers & Policy Makers

• Project ECHO for Robert Wood Johnson Foundation
This paper introduces Project ECHO (Extension for Community Healthcare Outcomes), describes its core components as an intervention, and briefly recount its ascent as a way to bring specialty health care to underserved rural populations. We conclude with suggestions for future evaluation and research to improve its performance in the field as it scales out. 

Strategies to Scale Up Social Programs: Pathways, Partnerships and Fidelity
This study funded by the Wallace Foundation and conducted by Larson, Dearing and Baker, assesses the conditions and circumstances that favor one scaling-up strategy over others. The primary focus is on collaboration and partnerships found in 45 social innovations that scaled up using different strategies.

• An Agenda for Research on the Sustainability of Public Health Programs
In this American Journal of Public Health publication, Scheirer and Dearing provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection.

• Design Research and the Diffusion of Innovations
This chapter in The Handbook of Design Research Methods in Education: Innovations in Science, Technology, Engineering and Mathematics Learning and Teaching by Larson and Dearing introduces the diffusion of innovation paradigm and explicates how, in the case of consequential innovations such as design research, diffusion operates. It poses questions that can facilitate a purposive diffusion strategy for accelerating the spread of design research as a new and effective methodology for use by educational researchers.

• Designing for Diffusion of a Biomedical Intervention
In this American Journal of Preventive Medicine publication, Dearing and others apply what is known about diffusion to the general case of biomedical interventions and specifıcally pre-exposure prophylaxis (PrEP). It defines designing for diffusion as the taking of strategic steps early in the process of creating and refıning an evidence-based intervention to increase its chances of being noticed, positively perceived, accessed, and tried and then adopted, implemented, and sustained in practice.

• Designing for Diffusion: How Can We Increase Uptake of Cancer Communication Innovations?
Dearing and Kreuter conclude that augmenting current dissemination practices with evidence-based concepts from diffusion science, marketing science, and knowledge utilization hold promise for improving results by eliciting greater market pull in this journal article from Patient Education and Counseling.

• Diffusing STEM Pedagogies: The Role of Opinion Leaders
Larson and Meyer use literature and exploratory data to contrast awareness and persuasion and suggest that opinion leaders in academic departments can play a critical role in the diffusion of STEM pedagogies in this article from Metropolitan Universities.

• Disseminating Proven Approaches to Physical Activity Promotion
Approaches from diffusion of innovations and social marketing are used to propose efficient means to promote and enhance the dissemination of evidence-based physical activity programs in this article by Dearing, Maibach and Buller published in the American Journal of Preventive Medicine .

• How Centers Work: Building and Sustaining Academic Nonprofit Centers
In this publication from the W. K. Kellogg Foundation, Larson and Barnes share findings about the development and sustainability of academic nonprofit centers. They describe how these centers work – how they were created, who leads them, how they are lead, and how they gain academic credibility and institutional stability.

• Local Reinvention of the CDC HIV Prevention Community Planning Initiative
In the Journal of Community Health, Larson, Dearing and others conclude that to fully achieve the potential of HIV prevention community planning a distinction should be drawn so that information-seeking tasks are centrally coordinated and decision-making tasks are decentralized.

• Next Steps in Designing for Diffusion of Pre-Exposure Prophylaxis
Dearing, Norton and Larson suggest that pre-exposure prophylaxis, a biomedical intervention with potential to be highly effective if well implemented and used, appears well suited to sequential demonstration, fırst for experimental purposes with the objective of assessment of feasible delivery methods, and second for exemplary purposes with the objective of promoting its effective implementation in this article in the American Journal of Preventive Medicine.

Contact Us

Email: rsamlarson@diffusionassociates.com

Phone: 303.907.3794