Why is it so hard to scale up evidence-based practices? And what can you do about it?

by: Katelyn Zilke

How do leaders with a great evidence-based practice take it to scale? The challenge of getting organizational leaders across an entire field to adopt innovations remains one of the most daunting management dilemmas of our time. New research from the Network for Nonprofit and Social Impact at Northwestern University unlocks why it’s just so hard to scale up and what leaders can do about it.  

How does scale-up actually work? The successful adoption of innovations depends on their adoption by both leaders of organizations and individuals in those organizations. Individuals don’t always adopt these innovations even if their organizations do. NNSI researchers Sophia Fu and Michelle Shumate, in collaboration with Noshir Contractor, describe this multi-layered process as complex innovation adoption. In complex innovation adoption, the various moving parts in an interorganizational system, such as individuals and organizations, influence one another. The new study examines how and how much of an influence each moving part has over one another regarding innovation adoption.

What did they do? Fu, Shumate, and Contractor conducted a study of 1,849 public health agencies in Bihar, India. They investigated the adoption of neonatal and maternal health practices promoted by the Bill and Melinda Gates Foundation (which funded the study). They examined individuals’ and organizational leaders’ intention to adopt one of the evidence-based practices. They found that the attitudes of co-workers and individuals that a leader or individual relied on for advice influence attitudes and intentions toward the evidence-based practice for both organizational leaders and individuals with no organizational decision-making authority. However, there were some surprising differences. 

First, individuals without decision-making authority were more influenced by their co-workers than advisors. Further, they were susceptible to disagreement. When their co-workers or advisors disagreed, they were unlikely to adopt the innovation. 

In contrast, organizational decision-makers were more tolerant of risk. They were less influenced by what co-workers said. Instead, they relied on advisors in other organizations to inform their opinion. And they were more tolerant of disagreement than the individuals who worked in their organization but didn’t have the authority to make a decision. 

What does this mean for your organization? This research indicates that leaders who want to scale up need to create different interventions to persuade organizational decision-makers and individuals who work for these organizations but lack decision-making authority. For example, advice networks are best used when influencing top-down organizational innovation adoption leaders. This strategy can be supported by mapping advice networks and seeking those opinion leaders’ support within advice networks. But to influence individuals’ adoption within the organization, interventions that affect the social norms in an organization work better. Social norm campaigns showing that a critical mass of individuals in the organization support the innovation and promote positive stories of innovation work better for these individuals.  

Overall, this research articulates the influences behind innovation adoption, acknowledging the differences in how organizational leaders and members adopt innovations.

Fu, S., Shumate, M. & Contractor, N. (2020). Organizational and individual innovation decisions in an interorganizational system: Social influence and decision-making authority. Journal of Communication, 70(4), 497-521.