Using diffusion of innovations theory to guide diabetes management program development: an illustrative example.
BACKGROUND
Optimal management of type 2 diabetes requires achievement of optimal glucose, blood pressure and lipid targets through promotion of prudent diet, regular physical activity and adherence to necessary medication. This may require the development of new programs for the coordination of required multidisciplinary services. Diffusion of innovations theory offers a conceptual framework that may facilitate the implementation of such programs.


METHODS
To illustrate this, we have re-examined the implementation experiences previously reported by the developers of an actual diabetes management pilot program in Montreal, with an eye toward identifying potentially important process factors that could effectively increase adoption and sustainability.


RESULTS
Physician participation in the program appeared to be influenced by perceived advantages of participation, compatibility of the program with own perspective and perceived barriers to participation. Organizational features that may have influenced participation included the extent of the program's integration within the existing health care system.


CONCLUSIONS
A thorough consideration of process factors that impact system and team integration must equally include a focus on ensuring ongoing partnerships among the producers of the model, governments, nongovernmental organizations, private industry, user professionals and patients. This can only be achieved when a knowledge transfer action plan is developed to guide program development, implementation and sustainability.
De Civita
Mirella
M
Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, 687 Pine Avenue West, V Building, Montreal, Quebec, Canada H3A 1A1.
Dasgupta
Kaberi
K
D000488:Allied Health Personnel; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018672:Community Health Planning; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D004059:Diffusion of Innovation; D019468:Disease Management; D005194:Family Practice / Q000379:methods*; D019983:Guideline Adherence; D006801:Humans; D019359:Knowledge; D010348:Patient Care Team; D010865:Pilot Projects; D011321:Primary Nursing; D016730:Program Development / Q000379:methods*; D011792:Quebec; D012984:Software