Diffusion of clean indoor air ordinances in the southwestern United States.

The authors investigate the process through which clean indoor air ordinances were considered in 10 communities in the southwestern United States and key factors that influenced diffusion and adoption. Clean indoor air ordinances, which ban smoking in public places, were adopted in approximately 1,409 U.S. communities from 1986 to April 2004. The authors gathered data from 10 communities in New Mexico and Texas by means of face-to-face interview, e-mail, and telephone interviews and by analyzing archival materials. Important influences on the adoption or rejection of clean indoor air ordinances were (a) personal experiences of policy champions, (b) local framing of the ordinance as a public health issue versus as an economic/ business or an individual rights issue, and (c) interpersonal networks connecting a community to previously adopting communities. The policies that were adopted ranged in comprehensiveness, with each community of study reinventing model policies obtained from other communities.

A framework for research utilization applied to seven case studies.

BACKGROUND: It is widely acknowledged that prevention research often is not fully or adequately used in health practice and/or policies. This study sought to answer two main questions: (1) Are there characteristics of research utilization in communities that suggest stages in a process? (2) What factors, including barriers and facilitators, are associated with the use of prevention research in community-based programs, policies, and practices? METHODS: Researchers used a multiple case study design to retrospectively describe the research-utilization process. A conceptual framework modified from Rogers's diffusion of innovations model and Green's theory of participation were used. Data were gathered from archival sources and interviews with key people related to any one of seven community-based practices, programs, or policies. Fifty-two semistructured interviews were conducted with program or project staff members, funding agency project managers, community administrators and leaders, community project liaisons, innovation champions, and other members of the research user system. RESULTS: Participation in the process of research utilization was described by using characteristics of collaborative efforts among stakeholders. Program champions or agents linking research resources to the community moved the research-utilization process forward. Practices, programs, or policies characterized by greater community participation generally resulted in more advanced stages of research utilization. CONCLUSIONS: Investigating the interactions among and contributions of linking agents and resource and user systems can illuminate the potential paths of prevention research utilization in community settings. Because community participation is a critical factor in research utilization, prevention researchers must take into account the context and needs of communities throughout the research process.

Small-area variations in conviction rates for DWI: the significance of contextual variables in a Southwestern state.

Average annual conviction rates (1990-2000) of people arrested for driving under the influence of alcohol in each of New Mexico's 33 counties are described. Conviction rates vary from 58 to 95%. Rates are correlated with political conservatism, being higher where a higher proportion of voters voted for the republican presidential candidates, and with measures of crowding in the courts. Conviction rates are higher in rural than urban areas and are correlated with a low prevalence of alcohol-related problems in the population. The variance in conviction rates is higher in rural than urban areas, and higher where measures of court crowding are low. The results suggest that political culture and the efficiency of court functioning are each independently associated with conviction rates for DWI and may also be associated in a reciprocal fashion with both low DWI arrest rates and alcohol-involved crash rates.

A prospective and retrospective look at the diffusion model.

In this article we discuss how the diffusion model originally was created, some of the most important ways in which it has evolved over the past 30 years, and its future prospects.

Effectiveness of customized Victim Impact Panels on first-time DWI offender inmates.

This study investigates the effectiveness of a customized Victim Impact Panel (VIP) on reducing 'driving while impaired' recidivism, alcohol consumption and drinking and driving behavior. The study was conducted at a 28-day Detention/Treatment Program in a largely rural county in northwestern New Mexico. Study participants were randomly assigned to attend or not attend a VIP while participating in the program for court-defined first-time driving while intoxicated (DWI) offenders. There were no significant differences between the two groups on alcohol consumption, drinking and driving behavior, or recidivism within 2 years. These findings support the findings of other studies that VIPs do not produce a differential benefit with regards to recidivism of those convicted as a first-time DWI offenders.

Diffusion of preventive innovations.

The present paper draws on the diffusion of innovations model to derive a series of strategies for speeding up the spread and implementation of new ideas in preventing addiction. Preventive innovations usually require an action at one point in time in order to avoid an unwanted future condition. Hence, preventive innovations diffuse rather slowly, in part due to delayed rewards from adoption. Here we suggest five strategies, based on diffusion theory, for speeding up the diffusion of preventive innovations.

Patient oriented activities in Dutch community pharmacy: diffusion of innovations.

OBJECTIVES: To explore the implementation of patient oriented activities, the perception of an innovation aimed at implementation of patient education and the preconditions for implementation of this innovation among Dutch pharmacists. METHOD: A survey, based on Roger's theory of diffusion of innovations, was carried out among a random sample (n = 300) of Dutch managing pharmacists. MAIN OUTCOME MEASURES: Reported activities regarding patient education, medication surveillance and drug therapy meetings, as well as perception of the innovation and its perceived compatibility with pharmacy practice. RESULTS: The response rate was 49.3%. Hundred (84.7%) respondents reported to provide extra written and verbal information with first prescription medication. Medication surveillance (100% check by computer, and check of the lists by the pharmacist) was reported by 43 (36.4%), and complete participation in drug therapy meetings was reported by 57 (48.3%) respondents. Observability (or results to others) of the new strategy was perceived as important by 90 (77.6%), compatibility (perceived consistency with existing values, past experiences and needs of potential adopters) by 87 (76.4%) and trialability (degree to which an innovation may be experimented with) by 81 (69.8%) respondents. Relative advantages (perception of the innovation as being better) and complexity (relatively difficult to understand and use) of the innovation were perceived as important by less respondents. The preconditions that were met by most pharmacists were 'financial resources' (n = 70; 59.8%), 'enough workspace' (n = 61; 53.1%) and 'enough time' (n = 58; 50%). Fifty-eight (49.2%) respondents intend to adopt the innovation, but this intention would be higher when more time and money and technicians are available, as well as less situations that are experienced as barriers (rush hours, lack of support, illness of employees). CONCLUSION: Based on the definitions used, we conclude that the implementation of medication surveillance and drug therapy meetings is relatively low compared to patient education. The development of an implementation tool is justified, but should deal with the experienced preconditions, barriers and needs of pharmacists. Combined, comprehensive pharmacy interventions promise to be a good way to change pharmacy practice.

Mass media estimates of a disaster's severity : The 1989 Loma Prieta earthquake

One of the most important aspects of a disaster reported by the mass media is its severity, usually by the number of deaths, injuries, and the amount of property damage. This article analyses the accuracy with which the news media reported the 1989 Loma Prieta earthquake in Northern California, USA.(AU)