161 Supplementary files Appendix B: Innovation-Decision Framework, extended version, including rationale for each theme. Based on work from E.M. Rogers, 2003 [1] ‘Prior conditions’ Phase 1: Knowledge; Influenced by ‘Characteristics of the decision-making unit’ Phase 2: Persuasion; Determined by ‘Perceived characteristics of the innovation’ - Refer to the contextual factors within a social system that shape the status quo when introducing an innovation. - Refer to the attributes, traits, and dynamics of the potential adopters. - Refer to the subjective perceptions and evaluations of an innovation formed by potential adopters. ‘Previous practice’ - Refers to the established behaviors, routines, and methods individuals or social systems use before introducing an innovation. It is essential to assess how an innovation, like Shared Decision Making (SDM), deviates from or aligns with previous practice. This understanding helps determine the compatibility and potential challenges of implementing SDM within existing routines and facilitates tailored strategies for adoption. ‘Socioeconomic characteristics’ - Refer to the demographic and economic factors that shape individuals’ societal positions and roles. These characteristics include income, education level, occupation, and social status. Understanding socioeconomic characteristics helps identify potential patterns of adoption and diffusion of innovations, as they can influence access to resources, information, and the ability to adopt and sustain new practices. ‘Relative advantage’ - Refers to the perceived benefits and advantages of adopting an innovation compared to the existing alternatives or practices. It assesses the extent to which potential adopters perceive an innovation as superior, advantageous, or beneficial. Understanding the relative advantage is crucial in predicting and explaining the adoption decisions, as individuals are more likely to adopt innovations that offer clear advantages over the status quo. ‘Felt needs/problems’ - Refer to the perceived gaps or challenges individuals or social systems recognize and desire to address. These subjective needs or problems play a crucial role in driving the adoption of innovations, as people are more receptive to solutions that address their perceived issues. Understanding and aligning innovations with these felt needs/problems increases the likelihood of acceptance and adoption. ‘Personality variables’ - Refer to individual traits, attitudes, and psychological characteristics that influence the adoption and diffusion of innovations. These variables encompass factors such as openness to change, risk tolerance, adaptability, and the willingness to try new things. Understanding personality variables helps predict and explain individual differences in accepting and adopting innovations, as they shape individuals’ receptiveness and readiness to embrace new ideas or practices. ‘Compatibility’ - Refers to the degree to which an innovation is perceived as consistent, harmonious, and compatible with potential adopters’ existing values, beliefs, needs, and experiences. It assesses the fit between the innovation and the sociocultural context in which it is introduced. Understanding compatibility helps predict and explain the adoption of innovations, as individuals are more likely to adopt innovations that align with their existing practices and do not require significant changes or disruptions. [continued on next page] A
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