Journal of Health Communication, Volume 9: 149151, 2004 Copyright # Taylor & Francis Inc.

ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730490271601

Everett Rogers Diffusion of Innovations Theory: Its Utility and Value in Public Health
STEPHEN F. MOSELEY
President and Chief Executive Ofcer, Academy for Educational Development

AED is very pleased to be one of the sponsors of this event to celebrate the 40-year anniversary of the publication of Ev Rogers landmark book, Diffusion of Innovations, now in its fourth edition. Diffusion of Innovations has been a tremendously inuential theory for all of us working to bring about social change, as we have seen in this mornings presentations. It is hard to believe that the rst edition of this book was published in 1962. I am particularly impressed by that date because I have always thought of Ev Rogers as being eternally young, and even, on occasion, I have thought that he has got to be younger than I am. Yet in 1962, I know I was a senior in high school, and, following that logic, Ev must have started writing this book when he was a freshman in high school. Let me roll back to 1971, which is shortly after I joined AED. That year, too, was important for me for several reasons. It was the rst year that AED issued a subgrant to George Washington University to conduct a series of joint global studies on communications for development with a specic emphasis on socio-anthropological studies of behavior change. I remember very clearly, as a novice in the eld of communication, buying the second edition of Evs book then and reading it with ecstasy from cover to cover. Even more exciting for me was that a few months later I met Ev Rogers when he served as a consultant and advisor to AED on that same series of development communication studies. Those early programs in the 1970s became the foundation for AEDs emphasis and contribution to this eld during the past 30 years. One of the reasons that the Diffusion of Innovations is one of the most cited books in the social sciences is that Ev has been constantly reworking and expanding the framework, moving his thinking in different directions. One direction has been in the application of the framework. He has taken diffusion of innovations concepts and protably put them to work in international development, with fertility and family planning as one of the more prominent areas where he and his thinking have made important contributions. More recently he has been working in the applied elds of nutrition education and substance abuse. But the diffusion of innovation framework has also evolved and expanded theoretically, from early models of communication process that tended to be linear and individual, to more interactive models of communication in which participants create and share information to arrive at mutual understandings of new values, new concepts, and new practices. The diffusion of innovation framework is proving exible enough to conceptualize many kinds of social change, including change through processes of public dialogue and 149

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civic participation, change within organizations, as well as change through public agenda setting and media effects. I alluded earlier to the close interactions with Ev at the beginning of the 1970s. Those continued while he was at the University of Michigan and then later at Stanford University. Throughout the 1970s and 1980s, we drew on Evs pioneering work, applying his basic and profound observations on every continentin programs in child health, family planning, and agricultural and environmental change, and later as well in formal education for girls and women and teacher improvement. We were very fortunate to be able to interlink Ev Rogers work in our eld work, together with Wilbur Schrams leadership and that of his proteges, Emil McAnany, John Mayo, Bob Hornick, and others over the years. What we found in those early programs was that it was possiblerecognizing the transitions and phases of change by potential adopters of new technologies and innovations, coupled with the growing power then of the new broadcast media, radio and television and, of course, cassette playersto go from the village-specic experiences, one by one, to create strategies in a framework to achieve national-scale changes of behavior and adoption. Today, our opportunity to continue to draw from Evs continuing evolution of knowledge about diffusion for change is apparent in many of our current, long-range national and international scale programs. Just to cite one, they include LINKAGES, a breast-feeding and maternal nutrition program, which works in collaboration with ministries of health in some 20 countries with USAID support. More than 50 percent increases in exclusive breast feeding are being achieved after only six months of the communication intervention in countries such as Ghana. The backbone of the program is a classic diffusion of innovation model demonstrating relative advantage, proceeding through trials to achieve trial ability, ensuring that the procedures advocated are compatible with current practices or beliefs. The story is like those in Evs book, when the grandmothers in Ghana say, In the old days, we didnt give anything but breast milk until the baby started reaching for food, so we are happy to see the practice return. I could cite similar example after example from such programs as GreenCOM, the CHANGE project, the SARA project and, of course, our programs throughout the United States and developing countries in HIV/AIDS prevention and treatment. I was particularly pleased, therefore, that last year Ev chose to spend part of his sabbatical at AED, where he continued to pursue his work on agenda setting, while opening new lines of inquiry into health literacy and the role of technologies in health communication. I have been surprised and pleased to learn how many of our staff studied with Ev while he was at Stanford, Michigan, the University of New Mexico, and the other institutions where he has served on the faculty. In one seminar that Ev held for us on the India Soap Opera Ham Logue (that got the Indian public talking about the controversial topic of family planning), there must have been 1012 people who raised their hands when I asked how many had taken one of his courses. I also learned that Evs gifts as a teacher have been instrumental in attracting attention and resources to the uses of communication in development and public health. As Carol Baume, who studied communications at Stanford, recalls, He got a lot of his students interested in the topic. His classes were always full and he always had good stories to tell. He brought his examples to life. And his stories were livelier still over wine at his house. Let me give three brief anecdotes drawn from AEDs ofcers and senior program leaders who are now leading the projects I cited above, who once were Evs graduate students.

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During 19721974, while teaching at the School of Public Health at the University of Michigan, Ev was an extremely popular professor. In those days, he wore his long hair in a pony tail or with a leather headband. He was also prone to wearing fringed vests and Indian khadi shirts to class. It was sometimes hard to tell Ev from the other students, but never hard to distinguish Ev from the other faculty, who were considerably more conservative dressers. Ev was a practitioner of his own theories. In one undergraduate class, he introduced an innovation to see how many students would initially adopt the practice of eating a new food previously unknown to them, and then how the innovation would spread when the early adopter students described the new food to their classmates. It made for an extremely lively and entertaining class. This educational tool only worked once during a semester, however, when at the end of the class, Ev told the students that the new food they had tried was actually chocolate-covered ants brought back from one of Evs many globe-trotting excursions. Evs classes in those days were clearly an early version of what was later to become one of his books, Entertainment Education. Ev was a showman, stand-up comedian, and circus barker all rolled into one college professor. He entertained as he educated. One famous prop was a ag, a piece of green felt with large white letters spelling N E E D, that he would whip out of his pocket at the opportune time to make his point, felt need, about an individuals motivation for behavior change.

Back in the 1970s, Ev was central to creating a Development Communication program at Stanford that was the rst of its kind and spawned graduates who began applying and expanding his ideas under AEDs HEALTHCOM project. HEALTHCOM itself was a rst of its kind of demonstration project that documented the impact that well-conceived communication research and strategies can have on health. In some ways it is hard to be very specic about Evs conceptual contributions, mainly because they have become such an essential and now taken-for-granted part of our thought and practice. It is also hard to pin down exactly where Evs contributions have had the greatest impact: in the discipline of communication, of course, but also in geography, sociology, marketing, political science, and economic development. Ev, as this suggests, is a master at spanning boundaries . . . a creator and a promoter of a way of thought that has become a paradigm in its own right. We are all very fortunate to have had Ev Rogers for the last 40 years, and I hope for 40 years to come. Let me just nish by saying that for the last 10 days I have been trooping around upper Egypt and southern Ethiopia looking at diffusions of innovation in education programs for rural girls and youth. Knowing I would be making this brief talk, I carried with me the fourth edition of Evs great book, which was easy to nd the afternoon before I left by just walking down AEDs halls and stopping in various ofces. There was always the second, third, or fourth edition, and you could probably tell from that right away which person on our staff had been Ev Rogers graduate student or protege from Michigan, Stanford, New Mexico, or wherever. But I have to say in ending that it is amazing to me that anyone has read this book, if you are a traveler in developing countries, given that its weight for traveling around the world could be a major barrier to reading and adoption.