title: Diffusion of the D.A.R.E and syringe exchange programs.
abstract: We examined the diffusion of the D.A.R.E program to reduce use of illicit drugs among school-aged children and youths and the diffusion of syringe exchange programs to reduce HIV transmission among injection drug users. The D.A.R.E program was diffused widely in the United States despite a lack of evidence for its effectiveness; there has been limited diffusion of syringe exchange in the United States, despite extensive scientific evidence for its effectiveness. Multiple possible associations between diffusion and evidence of effectiveness exist, from widespread diffusion without evidence of effectiveness to limited diffusion with strong evidence of effectiveness. The decision theory concepts of framing and loss aversion may be useful for further research on the diffusion of public health innovations.
authors.affiliation: Beth Israel Medical Center,New York, NY 10038, USA. dcdesjarla@aol.com
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Zili
authors.initials: Z
authors.lastname: Sloboda
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.forename: Courtney
authors.initials: C
authors.lastname: McKnight
authors.forename: Naomi
authors.initials: N
authors.lastname: Braine
mesh_terms: D000293:Adolescent; D002648:Child; D003659:Decision Making, Organizational; D003662:Decision Theory; D004059:Diffusion of Innovation; D004335:Drug and Narcotic Control / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D015658:HIV Infections / Q000517:prevention & control*; D006266:Health Education / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D018671:Needle-Exchange Programs / Q000600:supply & distribution*; D011634:Public Health; D012572:School Health Services / Q000458:organization & administration*; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000517:prevention & control*; D013594:Syringes / Q000600:supply & distribution* / Q000821:virology; D014481:United States