About Us

Client Centered and Socially Focused

Effective practices often fail to spread to those in need. When spread does occur, implementation may not sustained or local adaptation renders the innovation ineffective. We work with technology and program innovators and their sponsors to study how best to implement and scale innovations.  We focus on the characteristics of the innovation, the organization 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.

Highly Customized Work

Diffusion Associates works closely with clients to determine how to best spread, implement and assess innovations. Our work is theoretically based, practice focused and highly customized. Our work with clients includes:

• Readiness assessment of change agencies, delivery systems, and target populations.
• Critical assessment of innovations for diffusion.
• Network identification and partnership formation to increase the spread of innovations.
• Formative evaluation to improve the likelihood of adoption by the target population.
• Implementation monitoring to identify opportunities for sustained use and spread.
• Identification of positive reinvention by implementers and users.
• Outcome evaluation of promising practices to assess their effectiveness.

Our Team

R. Sam Larson (Ph.D., Michigan State University) is the President of Diffusion Associates (and prior to that Applied Research). In this role, she has built 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 the use of evidence in higher education decision making.  Dr. Larson was the Assistant Dean of Operations and Finance in the College of Education. Larson was also the Director of Knowledge Management and Implementation Support at Kaiser Permanente Colorado. Her work there focused on identifying member’s health needs and addressing them using evidence based treatment and prevention programs.  She has been on faculty at Michigan State University, the University of Denver, Regis University, and Ohio University.  She is also the director of River Runs North which organizes pro bono evaluation and communication consulting for nonprofits in Michigan.

James W. Dearing (Ph.D., University of Southern California) is a Senior Consultant with Diffusion Associates.  Dr. Dearing is the Brandt Endowed Professor in the Department of Communication at Michigan State University. He has been Senior Scientist with Kaiser Permanente and on the faculties of several universities. Dearing has served on the National Academy of Science/Institute of Medicine framework committee for a programmatic review of the National Institute for Occupational Safety and Health, a Centers for Disease Control and Prevention Community Guide health marketing and health communication review committee, and was scientific advisor to the coordinating committee of the NIH Science of Dissemination and Implementation Research National Conference. He 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 his is the role of health, education, and environmental policy entrepreneurs in helping to scale up pro-social innovations.


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 a training specialist skilled in instructional design, learner development and coaching, direct instruction (classroom and online), program evaluation and research, and academic/career advising. Her subject matter expertise lies in organizational communication, socialization (on-boarding), social influence processes, leadership, health communication, corporate culture and interpersonal 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.

(BA, Sonoma State University) is an independent consultant. She has worked as a curriculum writer with Pearson Education, managed the research operations for a multi-year multi-site project housed in the School of Education at the University of Pittsburgh, and has been a teacher and Peace Corps volunteer. Her specialties include planning and organizing complex projects, developing innovative learning activities, designing promotional and study materials, and writing instructions/descriptions for complex tasks and activities.

(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.

(Ph.D., Cornell University) is an independent consultant with her own firm, Scheirer Consulting. She retired from the Robert Wood Johnson Foundation where she was a Senior Program Officer for Research and Evaluation. She has focused recently on conducting, reviewing and summarizing empirical research on the sustainability of health programs. Her expertise includes process evaluation methods for assessing program implementation, evaluating the broader life cycles of programs, intervention development and effectiveness research, and broad scale implementation and sustainment.

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

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.

Collaboration for Scaling Up Social Innovations

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)

Diffusion Associates worked with the CDC to apply a Designing for Diffusion (D4D) framework to the national introduction and scale-up of a biomedical intervention, preexposure prophylaxis (PrEP) for preventing HIV.

Comprehensive Community Health Models Cluster Evaluation

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: diffusionsassociates@gmail.com

Phone: 303.907.3794