Communication Strategies for Spreading Changes

​Communication is at the heart of all spread initiatives, and it is the central activity of the spread agents and the key messengers. Because of its importance, organizations need a communication campaign to organize and carry out spread activities over the course of the spread initiative (Hirschorn, 2002).


The purposes of the communication campaign are to build awareness of the new ideas and provide technical support to those ready to adopt the ideas. The purposes should be matched with the appropriate methods of communication (Fraser, 2002). For example, large meetings may help to build awareness while one-to-one conversations may be more effective to move people closer to the decision to adopt or to provide the detail about how to make the improvements.



Changes for Improvement


Select Appropriate Communication Methods to Provide Technical Information 

Individuals who are experienced in implementing the improvements to be spread (or "better ideas") must communicate technical information (i.e., concepts, specific changes, and tips) to potential adopters in the target population. Technical information focuses on the "how to" implementation details of the changes to be spread.

While broad-based communication methods, such as presentations at general meetings, or broad-based publications are useful for building awareness of the improvements, other methods have been shown to be best suited for the transfer of technical knowledge. These include the following:
  • Care team or unit-level meetings
  • Person-to-person contact (Avorn, 1983)
  • Visits to high-performing sites (Szulanski, 2002)
  • Groups of individuals with similar jobs and interests who form communities of practice (Brown, 2000; Dixon, 2002)
  • Small group conference calls
  • Online chat or discussion groups
  • Telephone "hotlines" that connect experts with adopters


These communication methods provide an opportunity for adopters to ask questions, explore solutions among colleagues, share learning, and deepen their understanding of the changes they are making.
  • Utilize multiple methods of communication for transferring technical information since individual adopters may differ in their learning styles. While face-to-face sessions may work best for some, others may prefer the opportunity for small group interaction.



Use Appropriate Communication Methods and Messages to Build Awareness About the Improvements


Individuals in the target population must recognize that there is a problem before they will be willing to change behavior (Prochaska, 1995) or even listen to the experiences of a site that has successfully implemented the changes to be spread. Communication messages to build awareness about improvements should address the extent of the problem and the benefits of the changes (Attewell, 1992) for those in the target population.

An awareness campaign should identify individuals in the target population who are either interested in hearing more about the improvements or ready to actually try them in their own setting. An effective strategy for attracting potential adopters is to tailor the communication messages to the concerns, questions, problems, and interests of the target population. For example, data showing the gap between ideal and actual performance for the sites in the target population helps to focus attention on the actual opportunities for improvement among this group. Using examples and messengers from the successful site to "make the case" to the target population is another way to tailor the communication message since the potential adopters can see that someone "like them" has made the improvements and benefited from the results.


Appropriate methods or channels of communication for building awareness about the improvements in the target population include: general meetings, internal publications, messages on the website, email broadcasts, posters, and videos.



  • Utilize a number of different methods or channels of communication for building awareness since there is often variation in learning styles within the target population. Some individuals respond to written communication while others learn best from more visual messages such as videos.
  • Continue building awareness until the improvements have been adopted throughout the target population. In any population, there is variation in the willingness of people to adopt improvements — in the beginning, some are more willing than others (Rogers, 1995). Building awareness is therefore a continuous process of drawing more and more adopters to the improvements, a process that becomes easier as the improvements spread in the target population.

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