There have been some big successes in the past 40 years. Tobacco use is at an all time low. Heart disease is down. Family planning in developing countries infant mortality even AIDS prevention in selected countries have shown tremendous success in the diffusion of new ideas and behaviors. There have also been dramatic failures. AIDS in most of Africa and obesity and exercise in the United States are just two of the most dramatic examples of our failures in social changes. We have learned a lot about social change in the past 40 years. We know that structural changes like raising the cost of cigarettes is as effective in some settings as educating smokers and using new products like the ‘‘patch’’. We’ve seen how a dedicated creative and embattled community of people—gay men in San Francisco—can organize streetwise diffusion of innovation to bring the annual number of new HIV infections from a high of 8000 in 1987 to a low of 200 a year in 1995. We have seen new technologies used to organize anti-war protests and seat belt laws combined with effective communication increase the number of people using seat belts effectively. We have seen simple messages about Sudden Infant Death Syndrome change the way that most parents lay their infants down for sleep. We have also seen new models of social change ebb and flow through the halls of funding organizations. Health promotion media advocacy social marketing risk communication health communication health education environmental ‘‘heating up’’ and yes diffusion of innovation. Today diffusion planners have a plethora of theories— reasoned action health belief model social norm social capital stages of change—to pick from as organizing theories. One of the most robust and powerful models continues to be the Diffusion of Innovation Model promoted by Ev Rogers for over 40 years. Here is just one example of how Ev Rogers work has affected our efforts here at AED. Since 1998 LINKAGES a Breastfeeding Complementary Feeding and Maternal Nutrition Program has been working in close collaboration with the Ministry of Health (MOH) and USAID/Ghana to design and implement a behavior change communication (BCC) program to improve infant feeding practices. The program is multi-dimensional and uses a combination of strategies—both to bring about quick changes in community norms and practices and to sustain improved nutrition over the long term by working on policy changes information dissemination and curricula reform in medical and nursing schools. (excerpt)