Designing for diffusion of a biomedical intervention.

Diffusion is a social process that occurs among people in response to learning about an innovation such as a new evidence-based intervention. Researchers have conceptualized diffusion either at the macro-sociologic level of societal sector or systemand the importance of norms and associations, the communicaive level of relationships and how those patterned linkges affect adoption over time, or the psychological level f how individuals perceive innovations in the form of a odifıed set of pros and cons. Diffusion is well explained y three factors of adopters’ perception of the innovation n question, adopters’ perception of others’ reactions and he contextual timing and framing of the innovation’s ntroduction to its potential adopters. The present article applies some of what is known about diffusion to the general case of biomedical interventions and specifıcally pre-exposure prophylaxis (PrEP). Designing for diffusion is the taking of strategic steps early in the process of creating and refıning an evidence-based intervention to increase its chances of being noticed, positively perceived, accessed, and tried and then adopted, implemented, and sustained in practice. For PrEP, the focus in the current paper is on healthcare providers such as physicians and nurses in primary care units, staff in sexually transmitted disease clinics and community and rural health centers, and staff in allied community-based organizations and pharmacies who serve individuals at high risk for HIV, such as young African-American men who have sex with men. Pre-exposure prophylaxis must fırst be adopted by healthcare providers before it in turn can be prescribed to and tried by high-risk individuals. Many high-risk indi-