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Innovation Adoption: A Review of Theories and Constructs

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Abstract

Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations.

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Acknowledgments

This manuscript was created with support from the National Institute on Mental Health (P30 MH090322, PI: Hoagwood). Dr. Wisdom’s work on this manuscript was conducted while she was at Columbia University.

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Correspondence to Jennifer P. Wisdom.

Appendix 1

Appendix 1

Databases and Search Strategy

Ovid Medline, PsycInfo, and Web of Science were the major electronic databases used for Medical Subject Heading (MeSH) and article keyword searches.

  1. 1.

    Ovid Medline provided the first and primary source of literature. First, exploratory searches were conducted using these individual MeSH terms:

    • Diffusion of innovation (13,774 hits);

    • Evidence-based practice (51,940 hits);

    • Evidence-based medicine (47,305 hits) a subset of evidence-based practice;

    • Models, theoretical (1,120,350 hits).

Next, guided by the goal of this review, the following MeSH terms were combined with the and Boolean operator:

  • Diffusion of innovation and evidence-based practice (1,781 hits); diffusion of innovation and models, theoretical (1,299 hits);

  • Diffusion of innovation and evidence-based practice (1,397 hits).

Considering theoretical frameworks are the focus of this review, further combinations of the following MeSH terms were conducted using the and Boolean operator:

  • Diffusion of innovation and evidence-based practice and models, theoretical (320 hits);

  • Diffusion of innovation and evidence-based medicine and models, theoretical (237 hits).

Since evidence-based medicine is a subset of evidence-based practice in the MeSH grouping, the search narrowed down to diffusion of innovation and evidence-based practice and models, theoretical.

  1. 2.

    We used PsycInfo to supplement the original pool of literature using a similar search logic of MeSH:

    • Adoption (15,535 hits);

    • Evidence based practice (8,940 hits);

    • Innovation (3,995 hits);

    • Models (65,923 hits);

    • Theories (91,148 hits).

Since adoption as a MeSH in PsycInfo is quite broad and often refers to the child welfare taxonomy, we used the and Boolean operator for the following combinations:

  • Adoption and evidence based practice (291 hits);

  • Adoption and innovation (339 hits).

Next, to add a theoretical focus to this pool, we used the and Boolean operator for the following combinations:

  • Adoption and evidence based practice and innovation (10 hits);

  • Adoption and evidence based practice and models (11 hits);

  • Adoption and evidence based practice and theories (9 hits);

  • Adoption and innovation and models (18 hits);

  • Adoption and innovation and theories (6 hits).

All articles from these last searches in PsycInfo were screened for overlaps.

  1. 3.

    To gain a broader perspective on other fields, we used Web of Science to expand the pool of literature obtained from Ovid Medline and PsycInfo, using the following topic searches:

    • Adoption (45,440 hits);

    • Diffusion (425,401 hits);

    • Evidence-base (47,294 hits);

    • Innovation (76,818 hits);

    • Model (3,894,846 hits);

    • Theory (1,172,347).

Given these large yields, we used the and Boolean operator to combine the following topic searches:

  • Adoption and evidence-base (899 hits);

  • Adoption and innovation (4,209 hits);

  • Adoption and diffusion (3,059 hits);

  • Adoption and evidence-base and innovation (135 hits).

To narrow the focus on theoretical models, further search combinations were produced using the and Boolean operator:

  • Adoption and innovation and model (48 hits);

  • Adoption and innovation and theory (194 hits);

  • Adoption and evidence-base and model (23 hits);

  • Adoption and evidence-base and theory (80 hits);

  • Adoption and innovation and model and theory (439 hits);

  • Adoption and evidence-base and model and theory (42 hits);

The last step searches from these three databases formed the preliminary pool of literature. All articles were searched for overlaps within and between databases, which yielded 332 unique hits. To systematically zero into specific adoption theories, we screened article keywords so at least one of the following keywords were included:

  • Adoption;

  • Adoption of innovation;

  • Conceptual model;

  • Diffusion;

  • Evidence-based interventions;

  • Evidence-based practice;

  • Framework;

  • Innovation;

  • Theory.

In addition, article titles were screened so that at least one of the following words were included:

  • Adoption;

  • Diffusion;

  • Diffusion of innovation;

  • Diffusion of innovations;

  • Evidence-based interventions;

  • Evidence-based mental health treatments;

  • Evidence-based practice;

  • Framework;

  • Innovation;

  • Innovation adoption;

  • Model;

  • Multilevel;

  • Research-based practice;

  • Theoretical models.

Finally, we screened the actual titles of the adoption theories within the texts of the articles so that at least one the following words were included:

  • Adoption;

  • Diffusion;

  • Evidence-based;

  • Evidence-based practice;

  • Framework;

  • Innovation;

  • Model.

Appendix 2

See Table 3.

Table 3 Theoretical frameworks of innovation adoption and adoption within the context of implementation

Appendix 3

See Table 4.

Table 4 Adoption constructs based on theories of adoption and adoption within the context of implementation

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Wisdom, J.P., Chor, K.H.B., Hoagwood, K.E. et al. Innovation Adoption: A Review of Theories and Constructs. Adm Policy Ment Health 41, 480–502 (2014). https://doi.org/10.1007/s10488-013-0486-4

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