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Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program. The study had 2 parallel components: (1) secondary research (hermeneutic systematic review) to identify key domains, and (2) empirical case studies of technology implementation to explore, test, and refine these domains. We studied 6 technology-supported programs-video outpatient consultations, global positioning system tracking for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organizing software, and integrated case management via data sharing-using longitudinal ethnography and action research for up to 3 years across more than 20 organizations. Data were collected at micro level (individual technology users), meso level (organizational processes and systems), and macro level (national policy and wider context). Analysis and synthesis was aided by sociotechnically informed theories of individual, organizational, and system change. The draft framework was shared with colleagues who were introducing or evaluating other technology-supported health or care programs and refined in response to feedback. The literature review identified 28 previous technology implementation frameworks, of which 14 had taken a dynamic systems approach (including 2 integrative reviews of previous work). Our empirical dataset consisted of over 400 hours of ethnographic observation, 165 semistructured interviews, and 200 documents. The final nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework included questions in 7 domains: the condition or illness, the technology, the value proposition, the adopter system (comprising professional staff, patient, and lay caregivers), the organization(s), the wider (institutional and societal) context, and the interaction and mutual adaptation between all these domains over time. Our empirical case studies raised a variety of challenges across all 7 domains, each classified as simple (straightforward, predictable, few components), complicated (multiple interacting components or issues), or complex (dynamic, unpredictable, not easily disaggregated into constituent components). Programs characterized by complicatedness proved difficult but not impossible to implement. Those characterized by complexity in multiple NASSS domains rarely, if ever, became mainstreamed. The framework showed promise when applied (both prospectively and retrospectively) to other programs. Subject to further empirical testing, NASSS could be applied across a range of technological innovations in health and social care. It has several potential uses: (1) to inform the design of a new technology; (2) to identify technological solutions that (perhaps despite policy or industry enthusiasm) have a limited chance of achieving large-scale, sustained adoption; (3) to plan the implementation, scale-up, or rollout of a technology program; and (4) to explain and learn from program failures.

Research Summary Why do incumbent firms frequently reject nonincremental innovations? Beyond technical, structural, or economic factors, we propose an additional factor: the degree of the top management team's (TMT) frame flexibility, i.e., their capability to cognitively expand an innovation's categorical boundaries and to cast the innovation as emotionally resonant with the organization's identity, competencies, and competitive boundaries. We argue that inertial forces generally constrict how TMTs perceive innovations, but that frame flexibility can overcome these constraints, increasing the likelihood of adoption and broadening the organization's innovation practices. We advance a theoretical model that relaxes the assumption that cognitive frames are static, showing how they become flexible via categorical positioning, and introduce a role for emotional frames that appeal to organizational members' sentiments and aspirations in innovation adoption. Managerial Summary Confronting a technological change is one of the most difficult challenges facing any incumbent firm. Technological transitions create pressure for leaders to reframe their mental models while continuing to develop existing capabilities and product category variants. Yet at key junctures in a product class and during technological change, a concrete definition of the firm's innovation boundaries and identity hold a firm hostage to its past. We show how a flexible cognitive frame—coupled with emotional framing—helps leaders and organization members become emotionally engaged in transformation efforts and, in turn, learn about executing nonincremental innovation over time. At technological transitions, perhaps there is no more important role for leaders than to expand their cognitive frames and to infuse these expanded frames with emotion.

PurposeIn the era of knowledge economy, the significance of intellectual capital has been increasing globally. Similarly, recent studies have focused on the importance of green intellectual capital in mitigating environmental degradation. However, only a few studies have analysed green intellectual capital and its impacts in the specific case of Pakistan. Hence, this study aims to investigate the effects of green intellectual capital on green innovation adoption in Pakistan’s manufacturing small and medium-size enterprises (SMEs).Design/methodology/approachWe used a data sample of 235 SMEs, gathered from the four manufacturing sectors of Pakistan including: textile, chemical, pharmaceutical and steel and analysed using a multiple regression analysis approach.FindingsThe empirical results of this research indicate that green human capital and green structural capital significantly increase green innovation adoption. However, it must be noted that green relational capital has a positive but insignificant impact on green innovation adoption in manufacturing SMEs in Pakistan.Originality/valueThe findings and recommended policy measures of this study are important for the managers of manufacturing SMEs and policymakers to mitigate environmental destruction and achieve sustainable development through green intellectual capital.

Over recent years, there was a substantial rise globally in the importance of the environmental agenda for SMEs. The customer becomes now conscious of their consumer choices' environmental consequences. This research has also identified obstacles to introducing green business activities in small- and medium-sized enterprises and increase sustainable development. The green innovation barriers refer to green products, processes, and management; therefore, it is important to minimize restrictions on clean technology implementation in small- and medium-sized enterprises. This study uses an integrated decision process to define primary barriers, sub-obstacles, and approaches to addressing those obstacles to Saudi Arabia's green innovation practices. Through extensive literature review and twelve experts' opinions, six key barriers, twenty-five sub-barriers, and plans to reduce obstacles were identified. Using the fuzzy analytical hierarchy process (FAHP), key barriers and sub-barriers are assessed. The methodology used to rank strategies is the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (FTOPSIS). Five Saudi Arabia SMEs are involved in the study of the proposed integrated decision model. The FAHP reports that the key obstacles to introducing green practices in SMEs are “political obstacles” The FTOPSIS, therefore suggesting that “developing research methods to deliver green innovation in small- and medium-sized enterprises\" is the best approach to addressing barriers in green innovation adoption in SMEs.

We evaluate causal impacts of a large-scale agricultural extension program for smallholder women farmers on technology adoption and food security in Uganda through a regression discontinuity design that exploits an arbitrary distance-to-branch threshold for village program eligibility. We find eligible farmers used better basic cultivation methods, achieved improved food security. Given minimal changes in adoption of relatively expensive inputs, we attribute these gains to improved cultivation methods that require low upfront monetary investment. Farmers also modified their shock-coping methods. These results highlight the role of information and training in boosting agricultural productivity among poor farmers and, indirectly, improving food security.

This article contributes to the study of process innovation as a growth strategy for SMEs, enriching and complementing the well-researched debate about product innovation. Thus, underresearched process innovation strategies are analyzed, and their antecedents and innovative performance implications explored. The results show that process innovation strategy is mainly shaped by the acquisition of embodied knowledge, which acts as a key mechanism for countering firms' weak internal capabilities. As process innovation is mainly production oriented, performance consequences are measured using the production process indicators of cost reduction, flexibility and capacity improvement, avoiding traditional misguided measures based on sales, which are more product oriented. Drawing on information for 2,412 firms taken from Spanish CIS data, our results suggest that R&D efforts are not positively related to production process performance, but that the latter is improved by the synchronous co-adoption of organizational and technological innovation. SMEs conducting a process innovation strategy rely heavily on the acquisition of external sources of knowledge in order to complement their weak internal innovative capabilities, and their pattern of innovation shows clear-cut differences from traditional R&D-based product innovation strategies. The article uses a resource-based view framework to generate hypotheses.

PurposeCompanies utilize increasingly capable Artificial Intelligence (AI) technologies to deliver modern services across a range of consumer service industries. AI autonomy, however, sparks skepticism among consumers leading to a decrease in their willingness to adopt AI services. This raises the question as to whether consumer trust in companies can overcome consumer reluctance in their decisions to adopt high (vs low) autonomy AI services.Design/methodology/approachUsing a representative survey (N = 503 consumers corresponding to N = 3,690 observations), this article investigated the link between consumer trust in a company and consumers' intentions to adopt high (vs low) autonomy AI services from the company across 23 consumer service companies accounting for six distinct service industries.FindingsThe results confirm a significant and positive relationship between consumer trust in a company and consumers' intentions to adopt AI services from the same company. AI autonomy, however, moderates this relationship, such that high (vs low) AI autonomy weakens the positive link between trust in a company and AI service adoption. This finding replicates across all 23 companies and the associated six industries and is robust to the inclusion of several theoretically important control variables.Originality/valueThe current research contributes to the recent stream of AI research by drawing attention to the interplay between trust in companies and adoption of high autonomy AI services, with implications for the successful deployment and marketing of AI services.

Studies of the association between innovation characteristics and innovation adoption at the level of organization are scarce. This study develops direct and moderating hypotheses for the relationship between innovation characteristics, manager characteristics, and innovation adoption in public organizations. The hypotheses are tested using survey data on the adoption of 25 innovations in 725 local governments in the United States and data from a panel of experts. The findings suggest that both innovation characteristics and manager characteristics influence the adoption of innovation; however, they do not reveal significant moderating effects of manager characteristics on the relationship between innovation characteristics and innovation adoption. The implications of the findings are discussed for further research on innovation adoption in the public sector.

New ideas, products, and practices take time to diffuse, a fact that is often attributed to some form of heterogeneity among potential adopters. This paper examines three broad classes of diffusion models-contagion, social influence, and social learning-and shows how to incorporate heterogeneity into each at a high level of generality without losing analytical tractability. Each type of model leaves a characteristic \"footprint\" on the shape of the adoption curve which provides a basis for discriminating empirically between them. The approach is illustrated using the classic study of Ryan and Gross (1943) on the diffusion of hybrid corn.

In this paper, we advance and test the idea that innovation and export are complementary strategies for SMEs' growth. We argue that innovation and export positively reinforce each other in a dynamic virtuous circle, and we identify and describe the process through which this complementarity relationship takes place. Participating in export markets can promote firms' learning, and thus enhance innovation performance. At the same time, through innovation, firms can enter new geographical markets with novel and better products, therefore making exports more successful, and, by the same token, they can also improve the quality - and consequently increase the sales - of the products sold domestically. We test our theory using an unbalanced panel of Spanish manufacturing firms over the period 1990-1999. We find robust empirical support for our hypothesis: consistent with the presence of complementarity, we show that the positive effect of innovation activity on firms' growth rate is higher for firms that also engage in exports, and vice versa. Furthermore, we show that, Ceteris paribus, firms' adoption of one growth strategy (e.g., entering export markets) positively influences the adoption of the other (e.g., innovation).