Adoption Gap Research Articles

Trends in initiation of GLP-1 RA in patients with type 2 diabetes during 2014–2019: a US database study

Abstract Background/Introduction Evidence of cardiovascular (CV) benefit of certain glucagon-like peptide 1 receptor agonists (GLP-1 RAs) from CV outcomes trials (CVOTs) resulted in updates to international guidelines and label indications in patients with type 2 diabetes (T2D) at high CV risk. Purpose To evaluate the impact of new evidence, we investigated the incidence of new GLP-1 RA use and trends in prescriber and patient characteristics over a 5-year period encompassing key CVOT publications and an updated label indication. Methods Data from consecutive cross-sectional cohorts of patients with T2D and no GLP-1 RA prescription for ≥1 year prior to the start date, corresponding to each year between 2014 and 2019, were extracted retrospectively from US Optum's de-identified Clinformatics® Data Mart Database (2004–2020). For each year, incidence of new GLP-1 RA use, overall and according to prescriber speciality and the proportion of patients with atherosclerotic CV disease (ASCVD) among the new users were evaluated. Speciality was categorised using prescriber information within the database, while ASCVD was identified with ICD-9 CM or 10 CM codes reported prior to GLP-1 RA prescription or year-start date. Results During the study period, 2,966,970 eligible patients with T2D were identified, 108,541 of whom were new users of GLP-1 RAs. Overall incidence of new GLP-1 RA use increased each year, with a 3-fold increase in prescriptions from 727 to 2045 per 100,000 patient years between 2014 and 2019 (Figure a). Among new GLP-1 RA users, mean age was 60.1 years, increasing from 56.8 to 61.7 years. Mean HbA1c was 8.6% and was stable over time. Further analysis of new GLP-1 RA prescriptions identified family medicine as the greatest contributor to the absolute increase in incidence between 2014 and 2019, comprising nearly 40% of total prescriptions each year, whereas cardiology contributed the least, at <1% each year. The overall proportion of patients with ASCVD among those newly initiated on a GLP-1 RA and those initiated by a cardiology specialist increased after 2015, from 30.8–44.3% and 45.2–57.9% in 2019, respectively (Figure b). However, this increase in the proportion of patients with ASCVD was also observed among the total population of patients with T2D without new GLP-1 RA use (Figure b). Conclusion New use of GLP-1 RAs in patients with T2D increased in absolute terms between 2014 and 2019. Interestingly, the proportion of patients with ASCVD among those newly initiating the class has not changed relative to non-GLP-1 RA users over time, highlighting a gap in adoption of CVOT data in clinical practice by all specialities and the potential opportunity to further reduce CV risk in these patients. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Novo Nordisk

Adoption of scientifically recommended artificial insemination practices by paravets: a depiction of current scenario of four states in India.

The present investigation was done to assess the different practices followed by the AI technicians (paravets) while performing artificial insemination (AI). A total of 160 paravets were selected for the study having equal representation from 4 different states of India (Gujarat, Rajasthan, Telangana, and Odisha). Questionnaire and telephonic survey were used for collecting data. Several practices followed by paravets were assessed under three sub-groups, viz., practices followed prior to, during, and post-artificial insemination. In as many as seven practices, viz., gathering pre-AI information, storage of semen straw, time of performing AI, thawing container, wiping of semen straw, cutting of semen straw, and record keeping, the adoption gap was found to be nil. Maximum adoption gap (30.60%) was seen in "adopting basic sanitary measures," whereas about 13% of adoption gap was found in the case of "monitoring of heat post calving" followed by "checking of heat prior to AI" (8.00%). Hence, along with provision of necessary measures for water bath, apron, and gumboots by State Department of Animal Husbandry (SDAH), the paravets should be made aware about the importance of basic sanitary measures. Crystoscope availability should also be ensured as it is easy to use by paravets and farmers for heat detection.

Scaled integration of FDA approved biosimilars: Closing the knowledge and adoption gaps.

15 Background: Biosimilars are clinically equivalent and highly similar to brand yet cost significantly less. Financial savings are shared by patients, practices and payers, ranging anywhere from 21-24% based on 10/01/20 ASP data from CMS. The effective conversion to biosimilar products is vitally important to total cost-of-care savings and can be achieved without negatively affecting patient outcomes. Physician understanding and confidence in biosimilar products is seen as a major conversion barrier. Methods: Interchangeability is an FDA designation that allows generic drugs to be substituted for reference drugs at the pharmacy, without a physician’s consent. Currently no biosimilar has that FDA approval for interchangeability. Building on previous pharmacy auto-substitution processes with therapeutic interchange, a formalized biosimilar policy and SOP was developed to automate conversion from the reference biologic product to the P&T/Physician approved biosimilar. Workflow changes were instituted to alleviate the provider burden of patient-by-patient decisions and placed them with the pharmacy review team. Full staff support and understanding on biosimilar usage was endorsed through mandatory biosimilar education of physicians, advanced practice providers, pharmacists, nurses, financial navigators and prior authorization team members and tracked using meeting attendance and the online E-learning system. Patient education was verified using established teaching visits by tracking documentation in the electronic health record (EHR). Quantitative metrics and reports were developed to assist in tracking the number of unique patients receiving the brand or biosimilar agents. Billed product units per month were also tracked to facilitate auditing and assure accuracy. Baseline brand/biosimilar utilization data for Rituximab, Trastuzumab, and Bevacizumab was collected from July 1, 2019 through December 31, 2020. Results: During the baseline period of 7/01/19 – 12/31/19, biosimilar conversion ranged from 0% (trastuzumab) to 8.4% (rituximab). Following full staff education and physician consent, systematic auto-conversion to biosimilar products was initiated on January 1, 2020. Conversion rates based upon billed biosimilar units likewise improved from 11.7% (baseline) to 90.2% (2021 Q1) for rituximab, 8.4% to 87.4% for trastuzumab, and 0% to 90.0% for bevacizumab. Conclusions: Rapid and near-complete conversion from brand product to FDA approved biosimilar is feasible, measurable and can be scaled.[Table: see text]

ADOPTION BEHAVIOUR OF FARMERS TOWARDS WHEAT VARIETY SHUATS W-6, IN HOLAGARH BLOCK OF PRAYAGRAJ DISTRICT, UTTAR PRADESH

India is an agrarian based country with two third of population as farming community. Wheat, ‘King of cereals’ also the second most cultivated food crop has technological gap in adoption of improved variety, hence the present study aims to understand the socio-economic profile, knowledge, attitude and adoption level of respondents to identify the technological gap and increase the adoption rate. The present study is carried out with 120 respondents from ten villages of Holgarh block of Prayagraj district of Uttar Pradesh. Primary data collected with the help of semi-structured interview schedule and subjected to statistical analysis. The results indicated that majority of the wheat growers had medium level of knowledge, attitude and adoption towards SHUATS W-6 variety. Further, it was recommended for timely availability of seeds, fertilizer, proper marketing facility and reducing the cost of critical inputs.

Right information at the right time: Reevaluating the attitude–behavior gap in environmental technology adoption

This paper examines the impact of information on sustainable technology adoption behavior and decisions. Data from a sample of current and potential clients of a large retailer of photovoltaics (PV) systems is used to study how different information sources and different information channels affect both the intention to adopt and the actual purchasing decision of the customers. This research challenges the notion that providing more information always supports the adoption of environmental technologies. Drawing upon innovation diffusion theories and the theory of sustainable consumer behavior change, this analysis indicates that different information types and different channels have different effects. This research also finds that the impact of information changes throughout the adoption process, as potential technology adopters move from being indifferent to developing sustainable attitude, and then from displaying sustainable attitude to actually making an adoption decision. Generic information facilitates the development of sustainable attitude, but it is relatively ineffective in supporting adoption. Likewise, information obtained from commercial channels supports sustainable attitude, but it does not increase the likelihood of displaying sustainable behavior. Only information obtained from unbiased third party sources favors adoption. This research contributes to clarifying the “attitude–behavior gap” in the context of environmental technology adoption; while the findings have critical implications for policymakers and technology providers in optimizing their marketing strategies and information campaigns to promote new environmental technologies.

Managerial challenges to promoting competency-based intellectual capital in emerging market economies – developing a framework for implications

PurposeThis study aims to explore the challenges experienced by managers in adopting competency modeling (CM) and recommends an approach to overcome these challenges in promoting competency-based intellectual capital in organizations.Design/methodology/approachUsing in-depth interviews with organizational practitioners in India, this study identifies the challenges of competency modeling in emerging market economies.FindingsThis study identified nine contextual and eight non-contextual challenges in implementing CM practices in organizations. The framework addresses the CM challenges using direction setting, negotiation and selling, and monitoring and control dimension of implementation with behavioral, operational and change alignment aspects of CM. The framework proposes a checklist for stakeholders to help them diagnose and analyze the gaps in effective CM implementation.Research limitations/implicationsThis article contributes in the concept of competency-based intellectual capital and adoption of CM practices.Practical implicationsThis framework will assist the change management practitioners, human resources leaders, organizational development consultants and practitioners as a toolkit to address the challenges in the people management intervention.Originality/valueThe framework suggests a checklist for stakeholders to help diagnose and analyze the gaps in effective CM adoption.

Awareness and adoption of positive selection technology among yam farmers in West Africa

PurposeThis paper aims to investigate how awareness influences the adoption of positive selection (PS) technology among smallholder yam farmers in West Africa. PS has the potential of increasing yield and reducing disease incidence and severity in yam production.Design/methodology/approachThis paper applies the average treatment effect (ATE) methodology to estimate the rates of awareness and adoption of the PS technology and associated factors using data from 678 smallholder seed yam farmers in Ghana and Nigeria.FindingsThe results indicate that the actual adoption rates of PS technology are 58 and 55%, while the potential adoption rates are estimated at 89.5 and 79.3% for Ghana and Nigeria, respectively, if the PS technology was fully disseminated. This leads to adoption gaps of 31.7 and 24.8%, respectively, for Ghana and Nigeria stemming from incomplete awareness of the PS among the population of yam growing farmers. The PS adoption is high among the educated young farmers who are members of farmer based organizations and participate in demonstrations.Practical implicationsPromotional efforts for enhancing awareness and adoption of PS should target educated youth willing to participate in field demonstrations and should focus on scaling up of PS technology to ensure quality farmer saved seed yams and enhance yam productivity in West Africa.Originality/valueThe introduction of PS in seed yam production is quite recent also its introduction to seed yam farmers in West Africa. Subsequently, a better understanding of what the adoption status would be should everyone in the population of yam farmers are aware of PS is vital for policy, research and development.

Adoption Gaps of Environmental Adaptation Technologies with Public Effects

As the Intergovernmental Panel on Climate Change (2018) testifies, the world is a long way from halting climate change, let alone reverting it. The existence of adaptation and mitigation technologies did not prove sufficient, their adoption being respectively faulted or hindered by the presence of externalities. In this work, we study how externalities, whether positive or negative, lead the system away from Pareto-dominant (social optimum) states, towards Pareto-dominated ones. We show that adoption gaps, i.e. differences between socially optimum vs current adoption shares, of both (mal)adaptation and mitigation technologies are caused by the externalities emitted. In particular, over-adoption may occur for maladaptive technologies, whereas under-adoption may occur in case of mitigation. We employ a model with two regions at different stages of development and also derive relevant considerations on possible counterproductive effects of green policies and environmental dumping.

Legal Mechanisms for Energy Efficiency Adoption in Telecommunications Operations in Nigeria

This study reviews the poor adoption of energy efficiency in Nigeria against the backdrop of its enormous socio-economic benefits globally. The study adopted the exploratory research design. It appraised existing literature to determine the potency of law as a tool for addressing the energy efficiency adoption gap in Nigeria. Law is presented as a veritable tool for the promotion of energy efficiency in Nigeria while the telecommunications sector was chosen as the test environment due to the energy intensity of telecommunications operations. The Social Engineering Theory of Law propounded by Roscoe Pound provided the framework for this study. The study revealed that energy efficiency adoption in Nigeria has been very low, especially in energy intensive sector such as telecommunications. Although there exist policies and plans on energy efficiency adoption in Nigeria, these policies are merely of persuasive authority without any force of law. They are at best statements showing the intention of governments on the subject of energy efficiency. The study therefore recommends the codification of energy efficiency standards and requirements and specifically makes a case for the use of sector specific regulations as an effective means of energy efficiency adoption within the telecommunications sector in Nigeria. Keywords: Energy Efficiency, Legislation, Social Engineering, Telecommunications DOI: 10.7176/JLPG/81-05 Publication date: June 30 th 2021

Adoption of dual-purpose sweetpotato varieties under partial population exposure in Rwanda: Insights from an African plant breeding programme

As part of the Green Revolution, plant breeding programmes such as the African Centre for Crop Improvement have trained scientists to breed crop varieties in Africa to address the challenges of low productivity. However, exposure to and adoption of these varieties is somewhat modest, and there is also a scarcity of empirical studies on the drivers of exposure and adoption. Using data from Rwanda, the counterfactual treatment effect framework was used to estimate observed and potential adoption rates, as well as the drivers of exposure and adoption of dual-purpose sweetpotato varieties bred for both food and feed, under partial exposure to information. The results show that if the entire target farming population had been aware of the varieties, the adoption rate could have been up to 70% instead of the observed rate of 42%, indicating a 28% adoption gap due to partial diffusion. The findings indicate that once these varieties have been exposed, there is scope for further expansion of their cultivation. Key drivers of variety exposure and adoption include membership of farmer groups, participation in demonstration fields, and access to extension services. Thus, conscious efforts to minimize information constraints are a prerequisite for unlocking this adoption puzzle.

COVID-19 awareness, knowledge and perception towards digital health in an urban multi-ethnic Asian population

This study aimed to determine COVID-19-related awareness, knowledge, impact and preparedness among elderly Asians; and to evaluate their acceptance towards digital health services amidst the pandemic. 523 participants (177 Malays, 171 Indians, 175 Chinese) were recruited and underwent standardised phone interview during Singapore’s lockdown period (07 April till 01 June 2020). Multivariable logistic regression models were performed to evaluate the associations between demographic, socio-economic, lifestyle, and systemic factors, with COVID-19 awareness, knowledge, preparedness, well-being and digital health service acceptance. The average perception score on the seriousness of COVID-19 was 7.6 ± 2.4 (out of 10). 75.5% of participants were aware that COVID-19 carriers can be asymptomatic. Nearly all (≥ 90%) were aware of major prevention methods for COVID-19 (i.e. wearing of mask, social distancing). 66.2% felt prepared for the pandemic, and 86.8% felt confident with government’s handling and measures. 78.4% felt their daily routine was impacted. 98.1% reported no prior experience in using digital health services, but 52.2% felt these services would be helpful to reduce non-essential contact. 77.8% were uncomfortable with artificial intelligence software interpreting their medical results. In multivariable analyses, Chinese participants felt less prepared, and more likely felt impacted by COVID-19. Older and lower income participants were less likely to use digital health services. In conclusion, we observed a high level of awareness and knowledge on COVID-19. However, acceptance towards digital health service was low. These findings are valuable for examining the effectiveness of COVID-19 communication in Singapore, and the remaining gaps in digital health adoption among elderly.

Digital inclusion in social media marketing adoption: the role of product suitability in the agriculture sector

Information and communication technologies (ICT) are critical to leverage the digital divide among disadvantaged individuals, groups, and communities. Given the persistent urban–rural gap in technology adoption and usage, this study intends to understand factors motivating rural farmer’s adoption of social media marketing (SMM) tools in China. We contextualize and extend the Unified Theory of Acceptance and Use of Technology (UTAUT) framework to China’s agriculture sector. Specifically, we propose product SMM suitability as a new moderator based on the channel/product fit literature. The survey method is utilized to validate the proposed research model. Six follow-up interviews are analyzed to supplement the quantitative survey findings. While the result confirms UTAUT’s generalizability in China’s agriculture sector, it also demonstrates limited generational divide and gender divide in SMM adoption among Chinese farmers. More importantly, the newly proposed moderator, SMM product suitability, is empirically validated. Farmers consider non-grain products to be more suitable for SMM than grain products. SMM product suitability not only directly increases Chinese farmers’ SMM adoption intention, but also moderates the relationship between behavioral intention and use as well as the relationship between facilitating conditions and use.

Navigating metastatic colorectal treatment options in the USA: a survey of patient acceptance of skin toxicities associated with Vectibix

PurposeTo understand the extent to which metastatic colorectal cancer (mCRC) patients receive education on the prevention and management associated with skin rash following Vectibix treatment. Furthermore, to investigate how this adverse event affects a patient’s quality of life (QoL) and influences their treatment decisions.MethodsA cross-sectional survey was administered to 200 mCRC patients (100 Vectibix users and 100 Vectibix non-users). After excluding respondents who had used cetuximab, 61 Vectibix users and 56 Vectibix non-users remained.ResultsMost Vectibix users (79%) experienced a skin rash in response to treatment of which 65% considered the rash moderate, 27% mild, and 8% severe. Vectibix users generally felt they were adequately informed about the rash (83%), with the most common messages received related to sun protection. However, sunscreen was used by only 42% of patients prior to rash and 60% of patients following the appearance of rash. The use of oral antibiotics was low prior to rash (21%) and following rash (46%). Among patients experiencing a rash within the past week (n=16), 75% reported the rash had a large negative impact on their QoL based on the Dermatology Life Quality Index.ConclusionThere was a disconnect between patients feeling they were adequately informed and use of prevention and management strategies such as sun protection. This suggests a gap in patient education and adoption currently exists on management strategies both prior to and following the appearance of rash. Given the negative impact that skin toxicity has on the patient’s quality of life, it is essential that patients receive and subsequently utilize all information that can minimize rash severity.

Adoption of Big Data Analytics in Supply Chain Management

Supported by the literature on big data, supply chain management (SCM), and resource-based theory (RBT), this study aims to evaluate the organizational variables that influence the intention of Saudi SCM professionals to adopt big data analytics (BDA) in SCM. A survey of 220 supply chain respondents revealed that both top management support and data-driven culture have a high significant influence on their intention to adopt BDA. However, the firm entrepreneurial orientation showed no significant effect. Also, the findings revealed that supply chain connectivity positively moderates the link between top management support and intention. This study contributes to the practical field, offering valuable insights for decision makers considering BDA adoption in SCM. It also contributes to the literature by helping minimize the research gap in BDA adoption in the Saudi context.

The adoption of artificial intelligence in human resource management and the role of human resources

Artificial Intelligence (AI), machine learning, and automation are rapidly advancing, significantly elevating the role of IT within business processes. From an HRM perspective, emerging AI-based solutions are increasingly relied upon in terms of processing time-consuming and complex tasks within the HRM functionalities. This study tackles the phenomenon of AI-based applications in HRM diffusion and adoption: specifically, the association between the HR roles emphasised within the organisation and the attitude of HR practitioners toward AI adoption, as well as the significance of performance expectancy, top management support, and competitive pressures as predictors of AI adoption in HRM. The study sample consisted of 186 senior HR professionals drawn from members of the Jordanian Human Resources Management Association. Results revealed that top management support and performance expectancy are significant predictors of the intention to adopt AI, while competitive pressure did not turn out to have a significant association with such an intention. For the HR roles emphasised, a significant positive influence on the intention to adopt AI has been found for the HR role of “change agent”, while the “employee champion” role possesses a significant negative influence in terms of AI adoption. Considering the noticeable research gap in AI diffusion and adoption within HRM, the study findings provide an important contribution to investigating and explaining this phenomenon. It reveals that HR leaders have a positive mindset toward the potential role of AI in enhancing HRM efficiency and quality.

Promises and potentials do not grow trees and crops. A review of institutional and policy research in agroforestry for the Southern African region

The concept of agroforestry is heralded by decades of research and development investments. However, across the Southern African region, the results of implementing agroforestry have been underwhelming as very few people are adopting the available innovations. There is a growing assertion that targeted policies and institutions will be key in addressing this adoption gap. The success of agroforestry will depend on how its institutionalisation in national and local contexts occurs. Building on institutional theories, we conducted a review to examine prominent policy and institutional issues within agroforestry research. Forty-three peer-reviewed articles representing research from the Southern African region were analysed. To allow for a nuanced evaluation, the literature review was complemented by seven expert interviews. Our results show that the concept of AF is institutionalised in research and practice. However, whilst scientists and practitioners laude the concept and attach substantial potential to it; the policy and institutional dimensions of agroforestry remain murky. Policy and institutional issues are neither prominent in research nor is there evidence of a scientific interest aimed at the development of coherent theoretical frameworks. We contend that agroforestry might face the fate of becoming a global buzzword without significant results. We advocate for a shift towards a more policy and institutional oriented research process. Further research to understand national policy contexts through probing on the state of formal institutions will prove complementary to agroforestry implementation.

Sources, replacement of seed and adoption gaps in berseem fodder production in Punjab

Berseem is the main nutritious rabi fodder crop in northern region of India. Despite of high nutritious value of berseem there still exists a wide gap between the knowledge available to farmers with the research work as well as its adoption at farmers’ fields. In the present study, the adoption gap in berseem production in Punjab state during 2018–19 was studied based on data collected from 80 respondents by interview method with the help of pre-tested schedule. Majority of the respondents either did not adopt or partially adopted the recommendations made by PAU. The main adoption gap found during production process existed for seed rate, source of berseem seed, seed treatment, fertilizer used, extent of quality seed used and SRR. The SRR of certified seed was 6.60 per cent whereas it was 19 per cent for TL seed. The maximum fodder yield of 516 Q/acre was observed for certified seed usewhich remained 384 Q/acre or below forpoor quality of seeds used emphasizing the strong need to be generate awareness about the use of quality seeds for higher fodder production. The share of institutional sources in berseem seed supply was only 6.25 per cent. Thus, there is a strong need for government support in terms of research activities for provision of availability of quality seed with required attributes. Extension system can further play a crucial role in enhancing production to meet the existing fodder demand. The production and productivity of berseem can further be increased by ensuring adoption of recommended production practices and by overcoming the constraints.

Adoption Gap Analysis in Tomato Cultivation in Banda District of Bundelkhand (U.P.)

Bundelkhand area of Uttar Pradesh is comprised of seven districts viz., Chitrakoot, Banda, Hamirpur, Mahoba, Jalaun, Jhansi and Lalitpur. The present study was conducted in Banda district of Uttar Pradesh where the vegetable crops are grown by farmers in large areas. Among the eight blocks of Banda, two blocks namely Badokhar Khurd and Mahua were purposively selected. Eight vegetable growing villages (4 from Badokhar Khurd and 4 from Mahua block) based on production potential of the tomato were drawn up and from each village 18 vegetable growers (six from each category) having minimum 3 years of experience in commercial tomato cultivation were selected randomly with sample size is 144. It is revealed that technological gap in marginal farmers category was observed in the nursery raising and seed-treatment (74.80%) followed by plant protection measures (67.83%) and fertilizer application (67.00%). In small farmers category Identification of insect and pest (77.16%) followed by fertilizer application (74.50%) and plant protection measures (67.33%) were major whereas for medium category the technological gap was observed in nursery raising and seed-treatment (69.30%) followed by plant protection measures (67.58%) and fertilizer application (66.17%). The technological gap level in all categories of farmers revealed that the medium level of technological gap was observed in majority of tomato growers (44.45%) followed by high level of technological gap (38.20%) and low level of technological gap (17.36%).

Comparing Digital Finance in the UK, US, India and Nigeria

Abstract This paper examines digital finance usage in the UK, US, India and Nigeria. Using data from the global financial development indicators, the findings reveal that the UK and US have higher digital finance usage than India and Nigeria. The US has higher credit card usage compared to the UK while the UK has higher debit card usage compared to the US. Also, Nigeria has higher debit card usage than India. The findings also show that higher debit card usage is correlated with higher domestic credit to the private sector in the US and Nigeria. Higher credit card usage is correlated with lower domestic credit to the private sector, lower private credit by deposit money banks, and fewer remittances to the UK. The implication of the findings is that policy makers in developing countries should develop the digital finance and payment systems in their countries to close up the wide gap in digital finance adoption between developing and developed countries.

Technological gap in adoption of recommended sericulture cultivation practices

The study was conducted in Vijayapur and Bagalkote districts of Northern Karnataka in 2019-20, which comes under non-traditional areas of sericulture. The sample size selected was 120 and the study revealed that 40.00 per cent of sericulture farmers belonged to high technological gap category. The major contributors in technological gap of sericulture production technology were soil pH management, disease control measures and chawki silkworm rearing methods. Keeping those above constraints to consideration the suitable policy implications by the government and with the suitable extension strategies it may be reduced and helped to improve sericulture status.