Together, we can improve the lives of more individuals and the well-being of more communities.

Diffusion Associates

Innovative ideas often fail to produce effective interventions that then spread to those in need. When spread does occur, implementation may not be sustained or local adaptation renders the innovation ineffective.

We can change that. Diffusion Associates works with social innovators and sponsors committed to designing and scaling out effective interventions.

Amplifying your impact by bringing social innovations to scale.

Our Focus

Social Innovations

Drawing from expertise in developmental evaluation, implementation science, and diffusion of innovations, we work with you to develop, implement, and scale out social innovations.

Designing for Diffusion

Innovation characteristics shape how new practices are perceived by adopters. Is the innovation too costly or complex, are components are well-defined, and which aspects can be adapted?

We redesign innovations to boost adoption and accelerate scaling.

Implementation Analysis

Adapting innovations can sustain implementation but may alter program impact. What adaptations occur, and how do they affect outcomes? Why do adopters discontinue use?

We help innovators create guidance to ensure wider reach with consistent benefits.

Scaling Strategies

Scaling out requires strategic planning. Should an organization expand, franchise, or partner with networks? Does the innovation need strict fidelity, or can it be adapted? Are the organization and adopters ready?

We create scaling strategies aligned with the values and resources of all stakeholders.

Evaluation Planning

Effectiveness may change as innovations and populations evolve. Do outcomes remain consistent after scaling, or vary across groups? How can innovators and implementers share evaluation duties?

We design collaborative evaluations to monitor fidelity, adaptation, and effectiveness.

A Well-Rounded Portfolio

Projects & Clients

In addition to the selected projects and clients listed below, Diffusion Associates team members have individually worked on a variety of projects with many clients including the Bill & Melinda Gates Foundation, Robert Wood Johnson Foundation, the National Science Foundation, the National Institutes of Health, and numerous other State and Federal agencies and nonprofits.

Learn from the insights of 25 Implementation Fellows and interviews with 160 ECHO leaders and implementers across 35 ECHO hubs and 62 ECHO programs. Our FAQs provide guidance on organizing, funding, recruiting participants and experts, and designing and assessing ECHO programs. This work was funded by the Robert Wood Johnson Foundation.

Scaling what works is a crucial component of systems change. How to scale (“pathways”), whom to involve (“partnerships’), and retention of program quality (“fidelity”) are three strategic decisions that are critical to the scaling out of effective social programs. This study explores these strategic decisions, how they are related, and how they can work in concert. Funded by the Wallace Foundation.

This document presents Project ECHO (Extension for Community Healthcare Outcomes), outlining its essential elements and reviewing its impact. We conclude by proposing avenues for further evaluation and research aimed at enhancing its effectiveness as it expands its reach. Supported by the Robert Wood Johnson Foundation.

Rehumanizing Math Early ON

Supporting PK-Grade 2 teachers in creating and implementing math learning opportunities authentic to the lived experiences of young learners is the goal of Math Early On developed by Teachers Development Group (TDG). Using developmental evaluation, Diffusion Associates is working with TDG to design professional training for teachers working in rural and under resourced schools.

Learn valuable insights on implementing Project ECHO from hubs that vary in size, maturity, focus and geography. These 34 ECHO Implementation Profiles delve into the ECHO adoption decision, defining and enacting ECHO principles, factors influencing implementing, and visions for the future. This work was funded by the Robert Wood Johnson Foundation.

This multi-year $13.5 million project focused on developing nonprofit management education programs based on theory and practitioner experience. The corresponding multi-year cluster evaluation included formative evaluation of network development and innovation spread and a summative report of outcomes and impacts.

A Collaborative Approach

Our Team

Diffusion Associates takes a collaborative approach to work – you are part of our team. Diffusion Associates draws on the knowledge and expertise of colleagues across the country to ensure we have the right team to work with you. 

R. Sam Larson

Diffusion Associates is led by R. Sam Larson (Ph.D., Michigan State University). Larson builds collaborative teams drawing on the strengths of researchers and practitioners from across the country. She has led and collaborated on numerous evaluations of educational and social service programs supported by funders such as the Robert Wood Johnson Foundation, The Wallace Foundation, the W.K. Kellogg Foundation, the State of Michigan, and the U.S. Centers for Disease Control and Prevention. She was on faculty at Ohio University and the University of Denver, an internal evaluator and knowledge management director in Kaiser Permanente, and an administrator at Michigan State University.

James W. Dearing

Diffusion Associates is co-led by Jim Dearing (Ph.D., University of Southern California). Dearing is the Brandt Endowed Professor in the Department of Communication at Michigan State University. Dearing studies the strategic use of diffusion of innovation concepts to accelerate the spread of evidence-based practices, programs, and policies as a form of translational science. He has led and collaborated on multiple studies on the environment, health and education funded by the U.S. Centers for Disease Control and Prevention, the National Institutes of Health, the National Science Foundation, the Robert Wood Johnson Foundation, The Wallace Foundation, the W.K. Kellogg Foundation, and the State of Michigan.

Collaborators

Professor and Graduate Program Director at Baruch College with the City University of New York. Medved has expertise in qualitative methods and offers workshops in qualitative analysis. She has conducted in-depth interview-based research for the last two decades on issues of gender, work, and family.

Caryn Medved

Health Communication Specialist at The MITRE Corporation. Walling’s work explores mental health communication via mixed methodologies using quantitative and qualitative data analysis.

Brandon Walling

Professor and Chair of the Department of Social Medicine, Heritage College of Osteopathic Medicine, at Ohio University. Rao’s scholarly work focuses on cultural competence, diversity, inclusion in health care, and the strategic role of intercultural communication in creating healthy individuals and communities.

Nagesh Rao

Executive Director, Greater Well-Being. Ellis focuses on the role that relationships play in helping individuals and communities lead happier, healthier, more satisfied lives. Ellis specializes in coaching and effective relationship development and created myIPRM (My Important Personal Relationships Manager), an app that promotes intentional relationship building.

Linton Ellis

Informing Practitioners, Researchers & Policy Makers

Resources

Selecting and Implementing a Telemonitoring Program: Case Studies of Project ECHO

Extension for Community Healthcare Outcomes (Project ECHO) is a telementoring program for health professionals that uses adult learning techniques and interactive video technology to connect distal community providers with specialist and multidisciplinary teams in real-time collaborative sessions. Larson and Medved examine the adoption, implementation, and sustainability of ECHO programs at four academic medical centers in the journal Metropolitan Universities.

Project ECHO: Review and Research Agenda

This paper introduces Project ECHO (Extension for Community Healthcare Outcomes), describes its core components as an intervention, and briefly recount its ascent as a way to bring specialty health care to underserved rural populations. We conclude with suggestions for future evaluation and research to improve its performance in the field as it scales out. 

Strategies to Scale Up Social Programs: Pathways, Partnerships and Fidelity
This study funded by the Wallace Foundation and conducted by Larson, Dearing and Baker, assesses the conditions and circumstances that favor one scaling-up strategy over others. The primary focus is on collaboration and partnerships found in 45 social innovations that scaled up using different strategies.

An Agenda for Research on the Sustainability of Public Health Programs
In this American Journal of Public Health publication, Scheirer and Dearing provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection.

Design Research and the Diffusion of Innovations
This chapter in The Handbook of Design Research Methods in Education: Innovations in Science, Technology, Engineering and Mathematics Learning and Teaching by Larson and Dearing introduces the diffusion of innovation paradigm and explicates how, in the case of consequential innovations such as design research, diffusion operates. It poses questions that can facilitate a purposive diffusion strategy for accelerating the spread of design research as a new and effective methodology for use by educational researchers.

Designing for Diffusion of a Biomedical Intervention
In this American Journal of Preventive Medicine publication, Dearing, Larson and others apply what is known about diffusion to the general case of biomedical interventions and specifically pre-exposure prophylaxis (PrEP). It defines designing for diffusion as the taking of strategic steps early in the process of creating and refining an evidence-based intervention to increase its chances of being noticed, positively perceived, accessed, and tried and then adopted, implemented, and sustained in practice.

Diffusing STEM Pedagogies: The Role of Opinion Leaders
Larson and Meyer use literature and exploratory data to contrast awareness and persuasion and suggest that opinion leaders in academic departments can play a critical role in the diffusion of STEM pedagogies in this article from Metropolitan Universities.

Disseminating Proven Approaches to Physical Activity Promotion
Approaches from diffusion of innovations and social marketing are used to propose efficient means to promote and enhance the dissemination of evidence-based physical activity programs in this article by Dearing, Maibach and Buller published in the American Journal of Preventive Medicine .

How Centers Work: Building and Sustaining Academic Nonprofit Centers
In this publication from the W. K. Kellogg Foundation, Larson and Barnes share findings about the development and sustainability of academic nonprofit centers. They describe how these centers work – how they were created, who leads them, how they are lead, and how they gain academic credibility and institutional stability.

Local Reinvention of the CDC HIV Prevention Community Planning Initiative
In the Journal of Community Health, Larson, Dearing and others conclude that to fully achieve the potential of HIV prevention community planning a distinction should be drawn so that information-seeking tasks are centrally coordinated and decision-making tasks are decentralized.

Next Steps in Designing for Diffusion of Pre-Exposure Prophylaxis
Dearing, Norton and Larson suggest that pre-exposure prophylaxis, a biomedical intervention with potential to be highly effective if well implemented and used, appears well suited to sequential demonstration, first for experimental purposes with the objective of assessment of feasible delivery methods, and second for exemplary purposes with the objective of promoting its effective implementation in this article in the American Journal of Preventive Medicine.

Contact Us

Let’s Be Thought Partners

If you’re seeking to improve the lives of more individuals and help more communities by scaling out an intervention(s), we are ready to talk.

Phone

303.907.3794