Using the Diffusion of Innovation Theory to Understand the Challenges and Opportunities to Advancing Use of Nutrigenetics in Clinical Practice.

Abstract

The National Human Genome Research Institute (NHGRI) published bold predictions for genomic medicine to strive toward by 2030 [1]. These predictions outline a promising impact genomic information will have on health, including aspirations such as enabling individuals to securely access genome sequencing results on their smartphones and making the use of genomic information as routine in all clinical settings [1]. One application of genomic medicine is nutrigenetics (NGx), which investigates the associations between genetic variants, diet, and health outcomes [2]. NGx has the potential to use genetic information in ways that can further individualize nutrition interventions to help patients achieve improved health outcomes. While incorporating NGx testing as part of clinical care is promising, it is not routinely done in clinical settings. To better understand how NGx testing can strive toward routine use per NHGRI’s aspirational goals, the diffusion of innovation (DOI) theory will be used as a framework to examine the challenges and opportunities of integrating NGx testing into clinical care. The DOI theory seeks to explain the spread of innovations through populations and how they get adopted over time [3], with recognition that the majority of innovations fail to successfully diffuse through populations and that adoption is not necessarily based on the effectiveness of innovations [4]. In fact, effective innovations can be stalled, while ineffective innovations can sometimes diffuse farther in comparison [4]. The adoption rate for innovations relies on several factors, including the perceived attributes of the innovation, characteristics of the adopters, communication channels (e.g., mass media), and the social system (e.g., diffusion within health-care systems) [3]. The perceived attributes of NGx testing and characteristics of adopters will be discussed in more detail.