title: Diffusion and dissemination of a family peer-education program on mental disorders: a case study of the Omotenashi--Family Experiences Learning Program.
abstract: The families of people with mental illnesses need sufficient opportunities to learn about such illnesses. Therefore, a family peer-education program about mental disorders, the Omotenashi - Family Experiences Learning Program, has been developed in Japan following the design of similar programs in the U.S. and Hong Kong. We aimed to clarify the factors related to the diffusion and dissemination of the program and to identify areas for improvement in its dissemination strategies.
  
  
  
  This report was a case study based on the conceptual framework of the diffusion and dissemination of innovation in a health-care organization. The conceptual framework incorporates the adoption and routinization of the innovations by individuals and organizations in the external context. Interview data from fifteen family members in three family groups that had adopted the program were analyzed. They were interviewed about their backgrounds, the adoption of the program, and their experiences with the program implementation. We extracted descriptions based on the conceptual framework from the transcribed interview data and classified them into the framework components. We also compared the processes of adoption and routinization employed by the three family groups.
  
  
  
  Adoption processes were affected by the sense of crisis caused by decreased membership, member aging, and the necessity of policy change in family groups as well as the anticipation that the program may solve problems and the strength of the leader's intention to change and sustain the family group. Cooperative families and sufficient funding were necessary for the adoption of the program. Support from relevant organizational staff encouraged the family groups to adopt the program. Adopters encountered difficulties in gaining program participants but continued to take part in the program after realizing their anticipated positive results and receiving positive feedback from program participants.
  
  
  
  Our results suggest that the following may be effective for further dissemination of the program: an explanation about the ripple effects of the program on family groups and obtaining assistance from the relevant organizational staff in consulting for funding of the program and referring program participants.
authors.affiliation: Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo.
authors.forename: Masako
authors.initials: M
authors.lastname: Kageyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Yukako
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Iwao
authors.initials: I
authors.lastname: Oshima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005190:Family; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged