title: Diffusion of innovations theory applied to global tobacco control treaty ratification.
abstract: This study applies diffusion of innovations theory to understand network influences on country ratification of an international health treaty, the Framework Convention for Tobacco Control (FCTC). From 2003 to 2014 approximately 90% of United Nations member countries ratified the FCTC. We hypothesized that communication between tobacco control advocates on GLOBALink, a 7000-member online communication forum in existence from 1992 to 2012, would be associated with the timing of treaty ratification. We further hypothesized dynamic network influences such that external influence decreased over time, internal influence increased over time, and the role of opinion leader countries varied over time. In addition we develop two concepts: Susceptibility and influence that uncover the micro-level dynamics of network influence. Statistical analyses lend support to the influence of co-subscriptions on GLOBALink providing a conduit for inter-country influences on treaty ratification and some support for the dynamic hypotheses. Analyses of susceptibility and infection indicated particularly influential countries. These results have implications for the study of policy diffusion as well as dynamic models of behavior change.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA. Electronic address: tvalente@usc.edu.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Valente
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Dyal
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA.
authors.forename: Kar-Hai
authors.initials: KH
authors.lastname: Chu
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Wipfli
authors.affiliation: Center for Health Promotion and Prevention Research, School of Public Health, University of Texas, Health Science Center at Houston, USA.
authors.forename: Kayo
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D004059:Diffusion of Innovation; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007391:International Cooperation / Q000331:legislation & jurisprudence*; D015233:Models, Statistical; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D060756:Social Networking; D019460:Tobacco Industry / Q000191:economics; D014944:World Health Organization; D062789:Tobacco Products
keywords: Behavior change; Diffusion of innovations; Health; Policy; Social network analysis