| The recent rise in the number of public health research investigations of knowledge diffusion and program transfer is indicative of the search for cost-effective mechanisms for lowering the trends in American disease and disability outcomes. Researchers acknowledge that competition for resources and environmental turbulence require methods and interventions that reduce the barriers to organizational and end user adoption, implementation and ownership of health promotion technology. This is a study of program transfer methods and capacity-building interventions. Through this examination, I aim to integrate public health knowledge of communication and transactional processes with best practices to enhance health promotion program implementation and ownership in a voluntary cancer control agency.; The case study methodology was chosen because it allows the researcher to capture the richness of person-environment-situation interactions. The investigator accessed multiple sources of data, including conducting real-time observations of meetings, conducting 10 interviews and collating archival records dating from 1991–1996.; The stakeholders demonstrated that a loosely-coupled collaboration among diverse partners in academia, private industry, state government, and a voluntary health organization could share resources to diffuse a public health program. The research personnel of the Texas Cancer Awareness and Prevention Project (T-CAPP), the default team leaders, served as the “super expert” volunteers of the initiative. The T-CAPP staff developed materials and designed a multi-level model that demonstrated the feasibility of replicating and conducting a low-cost worksite health promotion. The transfer of the Top Priority program occurred (as designed or as modified) throughout the state. When the funding interruption changed the involvement of T-CAPP as a partner, the relational characteristics of non-disclosive intimacy introduced a breakdown in communication, coordination, and understanding that introduced complexity and discontinuity to the Top Priority program implementation process.; The case history of the transfer of Top Priority is a complex constellation of exchange management tasks: the exchange and coordination of resources, data/information, agendas, the rules of performance, and the management of understanding. The study found that disconnects can occur in a public health collaboration. Health promotion programs developers often neither sense nor understand the social meaning and consequences of the programs they introduce to organizational or community members. The sensemaking approach illustrated how the Top Priority collaboration was constrained by institutional identity, unanticipated events, and unexamined frames of reference for convening the multi-agency partnership. |
