A Multi-Level Approach to Evaluating Coordinated Communication Initiatives: Reframing Injury and Violence Prevention and Response

Theoretical Background and research questions/hypothesis: The Centers for Disease Control and Prevention’s (CDC’s) National Center for Injury Prevention and Control (NCIPC) recognized a need to increase awareness of the prevalence and preventability of injury and move audiences to behavior change. NCIPC began a collaborative initiative to identify a new approach to communicating about injury. NCIPC conducted message-testing research through public and injury professional focus groups and in-depth policymaker interviews to identify a new frame for communicating about injury. The Framing Guide, Adding Power to Our Voices, was developed to help injury professionals apply the new frame and coordinate communication across the injury field. NCIPC conducted a framing training session to educate staff and partners about the new frame and coordinating messaging. Additional activities were undertaken to support the implementation of the frame including quarterly calls and a collaborative online workspace. Diffusion of Innovations Theory served as a guiding theoretical framework to plan and evaluate the initiative. The evaluation sought to answer how NCIPC staff and partners changed over time in their use of the frame and guide and how their perceptions of the guide and frame influenced their adoption and continued use.

Methods: NCIPC’s framing initiative was evaluated using a multi-tier research approach incorporating both quantitative and qualitative methods. Methods included: (1) Quantitative baseline and follow-up assessments completed by NCIPC staff and partners  prior to and eight months after the training, (2) In-depth interviews with staff and partners eight months post training, and (3) Baseline and follow-up content analysis of NCIPC and partner organizations’ websites.

Results: Assessment findings revealed statistically significant increases in individuals’ use and positive perceptions of the framing guide and frame. Significantly more individuals post training were in the confirmation stage of adoption and reported regular use of the frame. Regular use was correlated with perceptions of innovation attributes as theorized in Diffusion of Innovations Theory—relative advantage, compatability, observability, complexity, and trialability, significantly predicted use of the frame and guide, accounting for nearly 40% of the variance. “Compatibility” had the strongest relationship to regular use. Interviews revealed that individuals perceived the guide and frame positively, although use and adoption varied greatly. Findings suggested that other structural and social factors, as identified by the Diffusion of Innovations Theory, affected adoption of the guide and frame. Factors hindering adoption included internal political organizational factors, organizational tensions, and lack of communication and strategic coordination. The “type of innovation decision” (i.e., mandated decisions and decisions from a collective of individuals) and the “extent of change agent’s promotion efforts” also influenced greater adoption. The content analysis indicated about half of the Web pages included the frame and coordinated communication messaging points.

Conclusions: Participants perceived the frame and coordinated communication positively and significantly more were coordinating communication in the post-training analysis. The Diffusion of Innovations attributes were significantly related to innovation adoption.  

Implications for research and/or practice: Diffusion of Innovations Theory provides a good framework for planning and evaluating communication innovations. An evaluation of this type is best enhanced by a multi-method, multi-phase approach that can explore additional structural and social factors affecting innovation adoption.