Diffusion of innovations in the long-term care sector: The role of motivation

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MacEachern, Lauren
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Mount Saint Vincent University
As Canada continues to experience an advancing need for long-term care (LTC) services and an increasing complexity of residents, dissemination of best practices and innovations that improve the quality of care within the LTC sector is paramount. The presence or absence of decision-maker motivation greatly influences the implementation of innovative practices. Research investigating the motivational characteristics of opinion leaders (OL) within the Canadian LTC sector would lead to an increased ability to tailor implementation strategies and achieve care quality improvements within this sector. My research focused on characteristics of motivation, capability, and opportunity from the perspective of OLs identified within the social network analysis study titled, Advice Seeking Networks in Long Term Care (Dearing et al., 2017). The aim of this study was to determine how the presence or absence of opinion leader motivation, with consideration for associated factors of capability and opportunity, impacts the diffusion and/or implementation of advice within the Canadian long-term care sector. To determine this impact, the following questions were addressed: What are the drivers of capability, opportunity, and motivation for opinion leaders within the interpersonal adviceseeking networks of this sector? What are the potential outcomes of having motivated opinion leaders within the long-term care sector with respect to the diffusion and implementation of innovations? Data for this secondary analysis research were collected through semi-structured qualitative telephone interviews with 13 OLs and 13 advice-seekers of OLs. The theoretical frameworks used to guide this research were diffusion of innovation theory and the COM-B (capability, opportunity, motivation, and behavior) framework. While previous research identified motivation as one of the characteristics of an OL in the long-term care sector, it was unclear from where this motivation was derived. Findings suggest that OLs in this sector are motivated by a combination of factors, including: obligations of the position, value of education, ‘systemness’, relationships, supportiveness, passion, and caring nature. While these themes were identified from interviews with OLs, statements from advice-seekers supported these findings from an alternative perspective. Motivational factors were presented on a sliding motivational scale ranging from professional motivators to prosocial motivators. Obligation of the position was the dominant motivator for OLs in this sector, however a desire to improve care quality was found to be intertwined within many themes across the scale. Prosocial motivation was represented most clearly in the factors of supportiveness, passion, and caring nature. This research confirmed that OLs in the long-term care sector are motivated individuals, and that they are using this motivation as a driver to create change and improve care practices. Specific outcomes associated with this motivational presence includes the diffusion and implementation of innovations, an increased sense of community within the network, and increased readiness for the future of the long-term care sector. This research has important implications for policy and practice due to the nature of resource availability in the long-term care sector and the challenges for implementation of innovations that arise from this issue. OLs play a key role in ensuring resources are used efficiently and effectively, as they are invested in seeking out and sharing information pertaining to innovations that are evidence-based and will improve care quality.
Long-term care, motivation, Canada