Communicating what works! Applying the positive deviance approach in health communication.

Most health communication campaigns, especially those that draw upon the diffusion of innovations tradition, are premised on the following tenets (Rogers, 2003; Singhal & Dearing, 2006; Singhal, 2010): that new health information or ideas come from the outside and are promoted by a change agency through expert change agents, who use persuasive communication strategies to educate their client audience. In this short essay, an alternative conceptualization of diffusing health innovations is broached whose premise is that innovative ideas are often lurking within the system, where the change agents’ primary role is to facilitate a process whereby which the community can self-discover these ideas, and where dialogue and “social proof” result in an organic spread of the innovation, in contrast to passive adopters buying into a change agency’s prescription. This alternative approach to diffusing health information or ideas is known as the positive deviance (PD) approach. PD is an approach that enables communities to discover the wisdom they already have, and finds a way to amplify it (Pascale & Sternin, 2005; Singhal & Dura, 2009). We illustrate the key tenets of the PD approach through an example of its application in dramatically reducing hospital-acquired infections in U.S. health care settings. Despite being 100% preventable, hospital-acquired infections (HAIs) kill 100,000 people each year in the United States, mainly because hygiene protocols are compromised. That is more deaths than breast cancer, HIV/AIDS, and road accidents combined. Adherence to hand hygiene protocols