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Systems analysis and the evaluation of innovation diffusion

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Systems analysis and the evaluation of innovation diffusion a study of planned change in Lee County, Florida, human service agencies
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Glover, William Gerald
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xi, 264 leaves : ill. ; 28 cm.

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Anthropology ( jstor )
Colleges ( jstor )
Community colleges ( jstor )
Counties ( jstor )
Cultural anthropology ( jstor )
Educational evaluation ( jstor )
Government human services ( jstor )
Institutionalization ( jstor )
Mental health ( jstor )
Opinion leaders ( jstor )
Diffusion of innovations -- Florida -- Lee County ( lcsh )
Social change -- Evaluation ( lcsh )
Social service -- Evaluation -- Florida -- Lee County ( lcsh )
System analysis ( lcsh )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Thesis:
Thesis (Ph. D.)--University of Florida, 1981.
Bibliography:
Includes bibliographical references (leaves 257-261).
General Note:
Typescript.
General Note:
Vita.
Statement of Responsibility:
by William Gerald Glover.

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University of Florida
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Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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SYSTEMS ANALYSIS AND THE EVALUATION
OF INNOVATION DIFFUSION: A STUDY OF
PLANNED CHANGE IN LEE COUNTY, FLORIDA,
HUMAN SERVICE AGENCIES











BY

WILLIAM GERALD GLOVER


A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY


UNIVERSITY OF FLORIDA


1981


































Copyriqht 1981

by

William Gerald Glover



































Dedicated to

Blanche Glover

and

Joanne Hartke












ACKNOWLEDGMENTS


Grateful thanks go to the many people who helped to make

this study possible including the faculty and administration

of Edison Community College, the administrators of human serv-

ice agencies in Lee County, Florida, and the workers and stu-

dents who have, hopefully, benefited from the project. Their

interest and participation made my more difficult tasks seem

easier.

Dr. Otto von Mering and my other committee members have

provided support, guidance, and wisdom to help me to complete

this project. My appreciation will continue long after this

study because they have given me the skills with which to

apply my knowledge in future endeavors. Also, the editorial

reading of Dr. Donald F. Chichester and Louise Bomberger was

helpful in completing this manuscript.










FOREWORD

It is desirable to establish the rationale for this

study, and to develop the conceptual basis for the discussion

to follow. In the first chapter, an overview of the study,

the cross-cultural definition of human services, a brief ex-

planation of the functions of human service organizations in

the United States, and a statement of the problem are pro-

vided as an initial orientation for the reader. A brief de-

scription of the research setting, as well as the social sys-

tem components of the innovation, are the remaining content

of the initial chapter.

The body of this research is organized in three parts.

Part One includes an overview of this study of planned change

in human services, the development of a theoretical and meth-

odological basis for the research, and the formulation of a

research design.

Part Two includes a description of the social, cultural,

and physical environment in which the study was initially

conceived, planned, and implemented. The physical environ-

ment of Lee County, Florida, the innovating organization, and

the recipient human service networks are discussed to docu-

ment the need for a particular innovation in human service

training.

Part Three includes a presentation of the research re-

sults and findings. Implications of this study for the eval-

uation of planned change programs are discussed within a sys-

tems perspective.










TABLE OF CONTENTS


PAGE

ACKNOWLEDGMENTS..................................... ..... iv

FOREWORD..... ........... ................................. v

ABSTRACT............................ ...................... ix


PART ONE


CHAPTER I


CHAPTER II


CHAPTER III


CHAPTER IV


CHAPTER V


THE PROBLEM AND FORMULATION OF A RESEARCH
DESIGN............................................. .. 2

THE STUDY OF PLANNED CHANGE IN HUMAN
SERVICES.. .................................. 2

Background and Overview of Present Study.. 2
The Setting of the Present Study........... 9
The Nature of the Innovation Under Study.. 10

TOWARD A SOCIAL ANTHROPOLOGY OF HUMAN
SERVICES.. .. ............................... 14

The Evolution of Human Services............ 21
Human Services in Industrialized Nations.. 27
Human Services in Developing Countries
Illustrate Problems and Methods........... 32
Human Services and Social Systems.......... 37
Summary..................................... 38

SYSTEMS THINKING AND SOCIAL CHANGE:
CONCEPTS AND TERMS.......................... 39

The Mechanical Equilibrium Model........... 39
The Biological Model...................... 40
Modern Systems Theory..................... 42
Definitions of Concepts and Terms......... 46
Implications for the Research Design...... 47

RESEARCH DESIGN AND TESTABLE HYPOTHESES
OF THE STUDY............. .. ................. 48

The Research Design....................... 48
Statement of Research Hypotheses.......... 51
Summary...................................... 52
Note...................................... 53

METHODS AND PROCEDURES...................... 54

Description............................... 54
Data Reduction Procedures................. 56
Means of Analysis......................... 57










PAGE

Interpretation............................ 57
Summary..................................... 59

CHAPTER VI THE SETTING................................ 61

The Physical Environment................. 61
The Human Population..................... 65
The Needs for Innovation................. 71
Summary................................... 76
Note ................ ................... 77

CHAPTER VII THE INNOVATING ORGANIZATION................ 78

System Structure......................... 78
Organizational Constraints to Innovation. 79
Organizational Needs for Innovation...... 84
Summary..................................... 86

CHAPTER VIII THE HUMAN SERVICE SYSTEM................... 87

Socio-cultural Context of Mental and
Physical Health.......................... 88
Socio-cultural Context of Government
Services.................................. 96
Socio-cultural Context of Services for
the Aged.................................. 99
Socio-cultural Context of Educational
Services..................................103
Socio-cultural Context of Economic
Assistance.............................. 105
Socio-cultural Context of Mental
Retardation Services..................... 108
General Needs for Innovation.............111

PART THREE PRESENTATION, ANALYSIS, AND DISCUSSION OF
THE RESULTS................................ 113

CHAPTER IX INSTITUTIONALIZATION OF THE INNOVATION:
EDISON COMMUNITY COLLEGE ...................113

Innovation Evaluation Results ............114
Two Year Summary.......................... 129

CHAPTER X INSTITUTIONALIZATION OF THE INNOVATION:
HUMAN SERVICE NETWORKS ....................131

Innovation Evaluation Results............. 131
Aging Services Network...................132
General Networks .........................137
Government Networks......................141
Education Network........................146


vii










PAGE

Economic Assistance Network...............150
Mental Retardation Network................154
Mental Health Network.....................159
Health Network............................164
Chapter Summary...........................168

CHAPTER XI DISCUSSION AND CONCLUSIONS ................169

Summary of All Networks...................169
Support for the Hypothesis................172
General Findings...........................177
Implications for Future Research........... 183

APPENDIX A DESCRIPTION OF HUMAN SERVICE PROGRAM.........188

APPENDIX B LOGS OF ADOPTION AND ACTIVITY...............197

BIBLIOGRAPHY... .......................................... 257

BIOGRAPHICAL SKETCH..... ................................262


viii















Abstract of Dissertation Presented to the Graduate Council
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy



SYSTEMS ANALYSIS AND THE EVALUATION
OF INNOVATION DIFFUSION: A STUDY OF
PLANNED CHANGE IN LEE COUNTY, FLORIDA,
HUMAN SERVICE AGENCIES


By


William Gerald Glover


June, 1981


Chairman: Otto von Mering
Major Department: Anthropology


Effective evaluation of planned social change attempts

has been a problem for change agents in all socio-ecological

settings. A need exists for a perspective, and subsequent

methodology, which will permit the measurement of innovation

acceptance at critical stages in the diffusion process. In

this study, systems analysis is field-tested to demonstrate

its advantages for social change evaluation.

A historical and comparative review of human services is

presented to support the need for a rethinking of the human

services concept by anthropologists and other social scien-

tists. Human services can be a means of understanding the










cultural patterns for meeting human needs in any society. Se-

lected previous innovation attempts in human services are al-

so reviewed to establish the general operating assumptions

for the study.

Systems analysis, particularly the concepts of feedback

control and social networks, is used to plan and develop the

research design for the study. The relationships among feed-

back regulation (change agent activity) and feedback manage-

ment (opinion leader participation and general adoption) are

documented to support the general hypothesis that institution-

alization of an innovation occurs as feedback control is

transferred from the change agent to recipients. This trans-

fer process is classified by three distinct time periods,

i.e., system intervention, network development, and system

disengagement.

The particular innovation under study involves develop-

ment of training programs for human service workers in Lee

County, Florida. A community college was selected as the in-

novating organization and served as the donor network to men-

tal health, health, aging, government, public assistance,

mental retardation, education, and general administrative

networks.

Data were collected in the nine networks from September,

1976, to August, 1978. Methods of collection included the

author's notes, records, and logs of change agent activity,

opinion leader participation, and general adoption. The proc-

ess of institutionalization is documented and analyzed by









obtaining correlation coefficients and graphic representations

for the relationship between feedback regulation and feedback

management in each network.

Results support the general hypothesis. Innovation dif-

fusion is documented in the human service system and, in all

but two networks, institutionalization and feedback control

transfer can be demonstrated. This study concerns a partic-

ular innovation in human services, but has implications for

all diffusion and planned social change endeavors.





































PART ONE

THE PROBLEM AND FORMULATION
OF A RESEARCH DESIGN















CHAPTER I
THE STUDY OF PLANNED CHANGE IN HUMAN SERVICES



Background and Overview of Present Study

The proper provision of health and social service care

has been a long-standing problem faced by preliterate and

contemporary human societies. In general, traditional and

western ways of providing medical care reflect a great vari-

ety of particular alternative delivery systems. Moreover,

social change is an important component of all known systems

which provide services.

Indeed, the historical record of planned change in all

domains of human services is worldwide. Citizens of indus-

trial and postindustrial nations are frequent recipients of

innovation projects including health education, product mar-

keting, business and governmental development, self-help, and

many others. In particular, health and social service sys-

tems are especially subject to frequent innovation attempts

designed to change both providers and consumers.

This study is a formal evaluation of the diffusion of an

innovation within a contemporary health and social service

complex. It is based on a systems theoretical and method-

ological approach. The particular innovation under investi-

gation concerns an information and resource-sharing program

designed to provide current and prospective human service









workers with training related to health and social service,

the helping professions. Documentation and analysis of the

process and outcome of this innovation occurred in Lee

County, Florida.

Human Services Defined

It has not been typical of anthropologists to examine

human services cultural activities. In recent years, anthro-

pologists have often studied education, mental health, health,

poverty, recreation, aging, and mental retardation as con-

ceptually independent phenomena. The need exists to concep-

tualize services in these and other aspects of human activity

within a comprehensive process framework.

Outside the field of anthropology, particularly among

service practitioners, the concept of "human services" has

been used widely. Human services is a unifying and central

concept which enables the social scientist and practitioner

to study innovation in what at first may appear to be net-

works of unrelated and diverse helping activities.

Human services, defined in a cross-cultural perspective,

are the cultural patterns or networks of activity and infor-

mation exchange of the members of a society who are involved

with the procurement and allocation of goods and services

necessary for living in that society. These services may be

delivered to societal members by both formal and informal

means. Formal organizations for service delivery are the

focus of this study.










In the course of cultural evolution, human societies

have utilized a wide variety of social patterns for the allo-

cation of essential and secondary resources to their members.

Every society has culturally defined means of meeting basic

and derived human needs (Malinowski, 1944). In tribal and

band-level societies humans met these needs through cultural

activities based on kinship, economic exchange modes of re-

ciprocity and redistribution, and adaptations to local re-

sources. Cultural evolution has produced less equalitarian

resource procurement and distribution systems, i.e., chief-

doms, early states, peasant communities, industrial states,

and recent forms referred to as postindustriall" or "service

societies" (Gartner & Riessman, 1973).

Human Services in "Developed Countries"

In stratified, complex nations, e.g., the United States,

formal human service organizations have been developed in hu-

man resource allocation systems. Human services have become

an essential resource component in industrial and postindus-

trial societies and they have been defined in a variety of

ways. Health, welfare, recreation, mental health, aging, and

education services, as institutionalized in the United States,

are generally included as major components of human services

(Demone & Harshbarger, 1974:9).

The tasks of human services in the United States have

been formulated in an all-embracing manner. Thus, human serv-

ices strengthen and repair family and individual functioning

with reference to ongoing roles, provide new institutional









outlets for socialization, development, and assistance, and

develop institutional forms for new activities essential to

individuals, families, and other social groups in a complex

urban society. From a social evolutionary perspective, for-

mal human services have not merely replaced most of the tra-

ditional family functions of mutual help among kin and clan.

They have become the alternative institutional responses to

new situations (Kahn, 1973:16).

Restated, formal human service organizations in contem-

porary postindustrial societies assume major responsibilities

in the socialization of members of a society into various fu-

ture roles, serve as major social control agents by identi-

fying individuals who fail to conform to their prescriptions,

and assume a social integration function by providing the

means and resources for the individual to become integrated

in various social units (Hasenfield & English, 1975:2-3).

Indeed, general human service providers are thought of today

as the unifying and integrating profession of our society's

many health and social service subsystems (Eriksen, 1977:8).

Specialized human service practitioners who are common

in the United States and other complex industrial and postin-

dustrial societies have their antecedents in the shamans,

headmen, and other male and female "expert" roles of tribal

societies. Speaking from a comparative perspective, human

services in statal societies have many similarities to those

observed in tribal societies despite their differences.

These include form and frequency of specialization, governance,









conflict resolution, health and well-being, nutrition, bodily

comforts, reproduction, physical activities, safety, and move-

ment through the life cycle.

The evolutionary trends toward specialization and diver-

sity of roles have been well-documented in the ethnographic

record. Resource procurement and allocation in smaller,

tribal societies are accomplished with no or limited special-

ization. Shamans and headmen represent the first specialized

human service practitioners. As societies increased in com-

plexity, role specialization eventually resulted in formal

human service organizations and their practitioners. These

practitioners are attempting the delivery of the essential

goods and services not provided by the family unit or other

cultural institutions.

The Problem of Institutionalizing Planned Change

A crucial issue in the evaluation of planned change pro-

grams is the degree to which institutionalization, i.e., the

structural modification of the social system and its cultural

patterns to reflect the intent of the innovation, has occur-

red. Institutionalization is a necessary requirement for any

innovation if the change agent expects it to remain after he

or she withdraws from the project. Social change and commu-

nity development literature by anthropologists and other so-

cial scientists indicates an abundance of programs which are

not considered to be a success because the change agent's

withdrawal was followed by a decline in interest, or even










rejection, of the innovation by the recipient population

(Niehoff, 1966; Paul, 1955; Rogers & Shoemaker, 1971).

Niehoff states that planned socio-cultural change or

technological innovation is a process that begins with an

idea on the part of a change agent and ends in its adoption

or rejection by the potential recipients. Adoption means

that the new idea has been incorporated into the local socie-

ty and the efforts of the change agent are no longer neces-

sary. There are basically two forces at work once the plan

of a new idea is put into effect: the action of the change

agent and the reaction of the community of persons whom he

expects to adopt the idea (1966:40).

There is general agreement among social scientists that

new research is needed to identify and specify a framework

from which the change agent can measure the extent of his or

her involvement or withdrawal from a project. Indeed, a uni-

formly reliable method for understanding social change in a

given socio-cultural environment has not yet been developed.

A systems theoretical perspective, with emphasis on communi-

cation, feedback control, and social networks, has value in

meeting this need of innovation methodology and procedure.

This perspective enables the researcher to study the process

of planned change, i.e., the dynamics of an innovation in a

time series framework.

The process of innovation involves the transfer of con-

trol from the change agent to the recipients, and particu-

larly to opinion leaders or early adopters, who serve as










influences in the development of communication networks nec-

essary for diffusion to the remaining recipient populations.

This control function may be explained in systems terms as

feedback regulation, i.e., activities of the change agent,

and feedback management, i.e., development of opinion leaders

and influential earlier adopters as operators of the inno-

vation.

Feedback channels have probably been neglected more and

are probably more critical than any other aspect of communi-

cation other than personal contact, which also involves feed-

back (Niehoff, 1966:18). Measurement and documentation of

feedback control transfer may be accomplished by a time se-

ries comparison of three variables: change agent effort, de-

velopment of early opinion leaders or adopters, and the rate

of adoption. A method for analysis of this transfer process

has implications for change programs in all forms of human

organization.

The plan for innovation diffusion initially centers on

the identification of key individuals in the recipient sys-

tems. Identification of influential "doers" (von Mering &

King, 1957) in the human service networks is necessary for

establishing nodal points for information flow and exchange.

These doers, after acceptance of the innovation, become com-

ponents of the feedback management of the information system.

An initial group of doers in this study consists of those

persons expressing a felt need for the innovation in its early

planning stage. Recruitment of additional doers continues










throughout the development of an innovation program. Early

adopters form the basic network structure for the continua-

tion of the diffusion of the innovation. Their acceptance of

the innovation may influence "watchers of doers" and, in some

cases, "watchers of watchers of doers" (1957:28).

The Setting of the Present Study

The results of the study herein reported have been ob-

tained from the people and their social organizations within

the political boundary of Lee County, Florida. This area is

located in Southwest Florida and is characterized by a semi-

tropical climate with flora and fauna typical of a coastal,

lowland terrain. Rapid population growth, housing develop-

ment, and a high in-migration rate, particularly by the el-

derly, are socio-ecological features of the area.

Edison Community College is the innovating organization

and the human service agencies of the area are the recipient

organizations. These agencies include the Lee County School

System, three hospitals, a mental retardation facility, Lee

County Parks and Recreation, one county and six city govern-

ments, the Dr. Ella Piper Center for Aging Services, Lee Men-

tal Health Clinic, and others.

A more detailed description of the research setting is

presented in Part Two. Therein, Chapter V concerns the phys-

ical environment of Lee County. Chapter VI describes the in-

novating organization. Chapter VII describes the human serv-

ice agencies.









The Nature of the Innovation Under Study

An initial survey by the author, of human service admin-

istrators in Lee County, revealed a wide-spread felt need for

desiqninq and implementing a new human service worker train-

ing program. The innovation to meet this need involved the

choice of a community college as the primary vehicle for

training.

A stated primary objective, therefore, of the innovation

became the devising of an area-wide training program for em-

ployees and prospective employees of human service agencies.

In particular, it called for curriculum planning and design

in light of four principles:

1. developing a transdisciplinarv approach;
2. providing opportunities for practical experi-
ence and observation of human service de-
livery for students;
3. using local resource persons in the planning,
implementation, and teaching of the content;
and
4. enhancing agency workers' understanding of
cross-cultural and socio-ecological implica-
tions of human services.

Secondary objectives of the innovation included:

1. providing for a format for interorqanizational
cooperation in human service delivery;
2. contributing to planned change in the service
delivery system; and
3. enhancing the understanding and cooperation
between the community college and the human
service system.

Organizational Components

The training program consists of two components: aca-

demic and community adult education. Academic education of-

fers three possible options for the student:










1. an Associate in arts degree,
2. an Associate in Science degree, or
3. a Certificate program.

Curricula of all options require the students to complete

courses specifically designed for human services and in at

least four supporting social science areas. Social science

areas include anthropology, economics, geography, education,

political science, sociology, and psychology. (A description

of the academic options is presented in Appendix A.)

Innovation of this type requires changes in the inno-

vating organization, human service system, and general commu-

nity. In this study, such changes were directed initially by

a designated change agent, the author, who functioned as a

communications feedback regulator. Gradually this turned in-

to a matter of feedback management which was undertaken by a

college and community organizational structure composed of a

faculty human services committee, an advisory committee, the

students' club, and key individuals in the community.

Particular changes in the innovating organization, the

college, included:

1. obtaining the support of faculty, adminis-
tration, and other personnel for the train-
ing program;
2. revising the curriculum in both the academic
transfer and community adult education
offerings;
3. developing a human and financial resource
base for program management; and
4. modifying policies of the college to enhance
its effectiveness as the vehicle for human
service delivery training.

These modifications in the organization were necessary before









the innovation diffusion networks could be developed with the

recipient systems.

Changes in the human service system required for the in-

novation included:

1. obtaining the support of administrators,
supervisors, and direct service workers for
the training program;
2. developing a human and financial resource
base for specific need areas;
3. establishing communication and feedback
channels for program maintenance; and
4. modifying the policies of agencies to pro-
vide workers' motivation for the training.

Each service network, i.e., mental health, aging, and the

others, required separate organizational changes.

General community changes included:

1. developing a general awareness of the pro-
gram via the news media and informal means and
2. presentation of community forums to involve
the general population in the operation of
the innovation.

The community also provided a source of potential students,

human resources, and political support. The community adult

education component offers in-service training, informational

and problem-solving workshops, and community forums for human

services personnel, students, and the general community.

Restatement of Goals of This Research

This study assumes that innovation involves community

development by means of informal and formal communication.

In particular, the acceptance of the innovation is viewed as

depending on the establishment and maintenance of social net-

works within the total innovation environment: the community

college, human service system, and general community. Thus,









in this study, the evaluation of planned change programs be-

came a task that has taken into full account the nature of

the innovation and the social, cultural, and physical envi-

ronments within which it occurred. In essence, then, the

study is a systematic record of the many interlocking cycles

of change brought on in the community, its institutions and

people, by an initial innovative action, the start of a new

program in human service training.

Consequently, this study, as a whole, may be viewed as

an argument that anthropology and the social sciences can

both benefit from and contribute to systematic evaluation of

human services in specific social, cultural, and physical

settings. By analyzing planned change in human services, it

is possible to contribute to a better theoretical understand-

ing of the process of innovation and institution-building.















CHAPTER II
TOWARD A SOCIAL ANTHROPOLOGY OF HUMAN SERVICES



A social anthropology of human services reflects the ev-

olution of cultural organizations from tribal to civilized

societies. Delivery of human services is accomplished by

family and kin in all human societies. In industrial and

postindustrial societies institutional alternatives, i.e.,

hospitals, clinics, schools, and other agencies, are sharing

the functions and responsibilities of service delivery previ-

ously vested in kinship systems of preliterate societies.

The concept of human services involves a new means of

analyzing the allocation and distribution of resources in hu-

man societies. This concept provides a method for under-

standing and comparing the institutions developed in human

societies for meeting their members' primary and secondary

needs. The new concept of human services provides a useful

tool for looking at this old issue. It enables one to organ-

ize data into a new model for analyzing human activities ba-

sic to every society. Previous cultural evolution involved a

process by which human services became the product of in-

creasing specialization of roles, responsibilities, and

functions.

It is important for anthropologists and other social

scientists to reconceptualize their understanding of the









activities for individual survival and be able to analyze hu-

man behavior in terms of "rearing," "nurturing," "caring,"

"feeding," "treating," "curing," "socializing," "educating,"

"training," "advising," and other forms of serving or servic-

ing people and their needs. This serving or servicing has

been performed by family, kin, clan, band, tribe, and village

in past human societies, and in present societies by alterna-

tive forms of diverse institutionalized operations of special

agencies. Individuals as members of households and/or fami-

lies from time to time have been aided by an "outsider,"

i.e., a part-time specialist in tribal societies such as a

shaman, and "service experts" of complex societies who have

taken up symbolic residence in every household while actually

practicing in a clinic, an agency, a health center, a col-

lege, a department, or an office.

Anthropologists and social scientists with this perspec-

tive can readily study with profit the contemporary alter-

native equivalents of serving or servicing others by examin-

ing the nature of the organization of this basic human activ-

ity. This organization includes systems for health, educa-

tion, mental health, mental retardation, youth, government,

public assistance, and aging services. The problems and proc-

esses of innovation can be observed and measured in a partic-

ular categorical human service system, e.g., health care.

Education and training aspects of human service systems are

the foci of the innovation project described in this study.









Selection of Edison Community College as an innovating

organization requires transformation of the internal opera-

tions of such a particular kind of institution. These

changes included altered curriculum content, reallocations of

time and resources, and reformulation of policies to satisfy

the training needs of other human services agencies.

Conceptual Underpinnings Developed from Pertinent Literature

The literature on planned change in human service sys-

tems is abundant and variable in approach and results. There

does not appear to be a universally acceptable theory or

methodology. However, there are many previous studies which

provide illustrations of "successes" and "failures." Re-

search reports commonly share many problems of innovation

diffusion in human services.

Commonly shared experiences of past studies are used in

this discussion to construct a framework of assumptions held

by the author. These assumptions represent an overview of

the state of the art of planned change at the beginning of

this particular research program. The statement of problem,

hypothesis, and methods for the present study are developed

on these conceptual underpinnings.

A general agreement is found in the literature for the

need to understand the social, cultural, and physical milieu

in which the innovation is to operate. This milieu includes

the setting, innovator, the innovating organization, and the

recipients.









The comprehensive ecological framework of the area, or

setting, designated for the innovation can be an influence on

acceptance. Huqhes and Hunter, in their review of public

health innovations in Africa, contend that development often

has effects other than those intended by the planner (1970:

443).

Constant feedback should be available to the change

agent about the continuous operation of the innovation within

both the innovating organization and the recipient group.

Innovation plans based on a static conception of cultural or-

ganization are prone to failure. The change agent and the

innovation must be flexible in order to adapt to unantici-

pated circumstances during the change process (Holmberg,

1965:5-7; Niehoff, 1966:119; Arensberg & Niehoff, 1971:167-

169; Adair & Deuschle, 1970:XIV).

Improvement as seen by the innovator is not necessarily

an improvement as seen by the potential user. If innovations

do violence to any of the social, cultural, or psychological

needs and expectations of the people involved, they will

probably be rejected. These expectations and needs are not

necessarily obvious, as countless failures in technical aid

programs testify (Foster, 1969:7; Arensberg & Niehoff, 1974:

8; Niehoff, 1966:117).

The perceived status of the innovator and the innovating

organization are also influences on acceptance or rejection.

A new idea is always introduced by someone--extension agent,

technician, administrator, native leader, or social scientist.









An innovator is a part of the situation and his/her role as a

factor must be assessed (Spicer, 1952:290).

Knowledge of the innovating organization is just as im-

portant as knowledge of the target group. Just as barriers

to change are found in the cultural forms of the recipient

group, they are found in the structure, values, and operating

procedures of bureaucracies (Foster, 1969:95).

Adair and Deuschle (1970) also stress the importance of

an understanding of the innovating organization. The Cornell-

Navajo project revealed that the change agents did not pay

sufficient attention to the beliefs, values, and structuring

of their own society.

Recipients evaluate an innovation according to their own

matrix of culturally conditioned understandings (Paul, 1955:

5). In many directed culture change programs the failure of

the innovators to appreciate the cognitive orientation of the

recipient group toward whom programs are directed results in

misinterpretation. Foster reports a case from Rhodesia in

which Eurooean health educators combating tuberculosis worked

out a wall poster with a crocodile, one of the most deadly

threats to African life, assuming this would impress Africans

with the seriousness of tuberculosis symptoms. African vil-

lagers concluded that crocodiles cause tuberculosis, further

confirming their belief that they should at all costs be

avoided (1969:10-11).

The discovery of the felt needs of the recipients by the

change agent is frequently reported as crucial to the success










of innovations. This procedure requires the innovator to es-

tablish communication linkages with the recipients in the

early stages of the program. Small group discussions and lo-

cal participation are purported to be successful means to de-

termining felt needs (Spicer, 1952:292).

The existence of the felt need is an indication that the

recipient group recognizes a problem. Needs can be generated

by the change agent but, in general, they require far more

effort than changes based on existing needs.

Participation through their own social organization not

only gives people a chance to develop a feeling of need for

the change, but also enables them to work out in their own

way adjustments of the new to the pattern of existing customs.

Real participation involves taking part in the planning and

discussion of advantages to be gained, in devising the meth-

ods for introduction, and in the execution of the innovation

(Spicer, 1952).

Adair and Deuschle (1970:167) report effective use of

"bicultural" Navajos to transmit the new ideas, techniques,

and beliefs of Western medicine to the more conservative mem-

bers of the recipient society. Other researchers also cite

successful change programs that used the recipients as opin-

ion leaders and participants in all phases of the operation

(Arensberg & Niehoff, 1971:115; Lele, 1975:162-164; Cassel,

1955:40; Niehoff, 1966:40).

The psychological characteristics of innovation recipi-

ents are also necessary considerations of the change agent.









Some individuals are more predisposed than others to accept

an innovation (von Mering & King, 1957:28; Adair & Deuschle,

1970). Conspicuous ownership and conspicuous production are

also motivational influences in development situations ac-

cording to Erasmus (1961).

The transition from innovation to institutionalization

is the critical phase of change. Only those ideas of people

that constitute a practical allocation in a concrete situ-

ation will be effected. If there is a system of allocations

in process--it will be the rates and kinds of payoffs of al-

ternative allocations within that system that determine

whether they will be adopted, that is, institutionalized

(Barth, 1967:668-669).

Institutionalization of the innovation is perhaps the

most important long-term influence on innovation success.

Holmberg, the director of the Vicos project, stated the prin-

cipal goals of the plan to be the devolution of power to the

community, the production and broad sharing of greater

wealth, the introduction and diffusion of new and modern

skills, the promotion of health and well-being, the enlarge-

ment of the status and role structure, and the formation of a

"modern" system of enlightenment through schools and other

media (1965:5).

Continuity and maintenance are essential to institution-

alization of an innovation. Arensberg and Niehoff contend

that the only final proof that an innovation has been ac-

cepted occurs when the local people are using it as their own,









are teaching it to one another or to their children, and the

change agent can discontinue his/her efforts. The final in-

tegration of a new idea into a cultural system is achieved

when patterns of maintenance are established. Innovations

can be maintained if new skills are transferred, sources of

needed new material are provided, and responsibility for con-

tinuance is established (1971:172-174).

The need exists for an interdisciplinary approach to

change. Cochrane expresses concern that problems in develop-

ment projects are created by the way things are approached as

much as by the attitudes, beliefs, and values of those for

which the assistance is designed. He also contends that no

sound theory on the prediction or production of social change

has emerged from previous research (1971:11-14).

The Evolution of Human Services

The ethnographic record reveals some important trends in

the development of human services. Table I illustrates the

changes in certain human service features of cultures that

are illustrative of bands and tribes, chiefdoms, peasant so-

cieties, and preindustrial societies.

Band and Tribal Societies

In band and tribal level societies human services are

not specialized in organization and personnel. The family

and kin are the human service providers. Part-time shaman

and headmen are the only human service specialists. Politi-

cal organization is essentially egalitarian with no class

stratification. Resources are shared and reciprocity is













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common. The family is the basic mode of resource allocation

and procurement, and the division of labor is simple, i.e.,

by sex only except for male shamans. Socialization is the

responsibility of the family in daily activities. Yahgan and

Copper Eskimo cultures illustrate these human service features

typically found in band and tribal cultures.

Chiefdoms and Early States

In chiefdoms a significant change occurs in human serv-

ice features. Class stratification and unequal access to re-

sources are important factors. Surplus production above sub-

sistence level permits occupational specialists, i.e., the

headmen, chief, and shaman. The division of labor is still

relatively simple and based on sex. Redistribution and re-

ciprocity are essential modes of exchange, and the family is

the basic unit of resource procurement and allocation. So-

cialization is still the responsibility of family and kin al-

though village activity may also be an influence. In chief-

doms there are the beginnings of several key antecedents to

contemporary human services, i.e., excess production, human

service specialists, unequal access to goods and services,

and redistribution as a major exchange mode.

The increased importance of the redistribution process

in chiefdoms and early states is crucial to the growth of

specialization. Service comments on this phenomenon:

The amount of redistributional exchanges mediated by
a central agency is, like the amount of reciprocal
exchanges, and like trade itself, extremely varied
and sporadic in the primitive world, depending on
adaptive circumstances. Circumstances favoring










redistribution are those that create a number of
local ecological niches. To exploit fully the
potentialities that inhere in increasing special-
ization, either of differing localities or of skills,
a society must have confidence in the fairness and
judgment, in the administrative skills, of the redis-
tributor--who is normally, therefore, the leader of
greatest influence in other respects. Successes in
the redistributive process are tremendously suppor-
tive of the bureaucracy and lead to further develop-
ment of specialization--a snowballing effect--inasmuch
as the effectiveness of the system is increasingly
obvious. (1975:292)

However, the system is inherently unstable. A success-

ful leader may die, become ill, or fall from favor. The ba-

sic problem is the bureaucratic one of how to transform char-

ismatic hierarchies of leadership into institutionalized,

permanent positions, i.e., offices. An important circum-

stance involves the transfer of the personal power from the

holder to the successor. This is necessary for chiefs, sha-

mans, and other individuals who are integral components of

human services in these societies.

All chiefdoms are theocracies, and an important aspect

of the bureaucracy is its function as a priesthood. Priests

have knowledge of the supernatural and are thought to exert

some control over it, and therefore, to control the fortunes

of ordinary people. In most chiefdoms there are also witches

and sorcerers, and they too may serve the authority structure

by threatening supernatural harm to political malefactors.

The priest-chief can be a very awesome figure, but he can

also be a benefactor.

The fact that the supernatural, and his closer relation-

ship to it, permeates all the priest-chief's activities should









be emphasized. In more complex civilizations the beginnings

of a differentiation in the bureaucracy between secular and

priestly functions is found (Service, 1975:296).

The beginnings of a bureaucracy and specialization in

chiefdoms were critical antecedents to the complex system of

human services that exists today. Family and kin units still

remained important in the delivery of essential resources

necessary for living to each individual in the chiefdom soci-

eties, but surplus production allowed specialists and bureauc-

racies to develop. Shamans and priest-chiefs began to pro-

vide health, subsistence, socializaion, governance, and other

services on at least a limited basis.

Peasant Societies and Preindustrial States

Open peasant villages like Tepoztlan and Morne-Paysan

illustrate distinct service delivery roles. Peasants are of-

ten operating daily within the larger nation state's cash

economy. Redistribution, markets, and other modes of re-

source allocation are localized, but often subject to influ-

ence from the larger system.

Occupational specialization and a small localized bu-

reaucracy are found in peasant villages. "Outsiders" like

the public nurse, doctor, teacher, landowner, hacienda owner,

policeman, priest, and others are often human service provid-

ers. However, labor-intensive agriculture or fishing remains

the primary occupation.

A source of human services may be either sacred or secu-

lar. The cargo system of the Mava is an illustration of a









redistributive mechanism that has both sacred and secular le-

gitimatization.

Sjoberg, in his study of preindustrial societies states

that the feudal bureaucracy derives its authority from appeal

to tradition and absolutes. The preindustrial bureaucracies

are unique in the following ways:

1. for each office there is no clearly defined
sphere of activity subject to impersonal
rules, i.e., the person is often more impor-
tant than the office;
2. no universal criteria governs the appoint-
ment or promotion procedures, i.e., special-
ized, technical knowledge is not a require-
ment for a position;
3. there is no system of tenure rights or fixed
salaries; and
4. a bureaucratic position is often part-time.

The preindustrial technology demands few highly special-

ized roles or complex hierarchies with well-defined tasks and

duties, nor could these exist. One result is that feudal

bureaucrats were frequent procrastinators in decision-making,

the city and the society being aligned against change. Com-

munication networks, which were primarily by word-of-mouth,

did not enhance decision-making.

What is viewed as graft in industrial societies, is

throughout the feudal world an accepted means of redistribu-

tion. Functionaries do not receive an adequate or fixed sal-

ary, and tenure rights are few. The office holder is often

fully expected to supplement his income by extracting gratui-

ties from those for whom he grants special favors. Control

of graft is almost unattainable without effective record-

keeping; the systems of checks and balances so elaborate in









industrial bureaucracies is not operable in preindustrial so-

cieties (Sjoberg, 1960:240-244).

Human services in peasant societies are often provided

in the form of dyadic relationships between a peasant and an

"outsider" from the larger nation-state. Fictive kinship re-

lations, friendships, caste systems, secret societies, and

other patron-peasant relationships are means of obtaining re-

sources necessary for basic and secondary needs in the vil-

lage.

The peasant family still remains primary in the delivery

of human services. Basic resources of nutrition, health, so-

cialization, shelter, and others are still provided to the

peasant via his/her membership in the extended three-gener-

ation family.

Human Services in Industrialized Nations

Historical circumstances leading to contemporary human

service systems in industrialized and developing societies

are often tied to the spread of Western civilization and its

general patterns to much of the rest of the world in the last

500 years. The Calvinistic work ethic, colonialism, Social

Darwinism, laissez faire, Christianity, capitalism, and other

forces of Western thought and action have provided the founda-

tions for contemporary values about the allocation and dis-

tribution of resources in many contemporary nations. Equally

important, in China and other nations, is the influence of

Marx, Mao, Lenin, and others. A comparison of human service

systems in Western capitalist nations, China, and rural









African development programs illustrates the differing values

influencing the nature of these services.

The origins of English and North American values are

found in teachings and writings of the Ancient Greeks and

Jews. Words such as "charity" and "philanthropy" are of

Greek origin. Greeks, and Romans after them, had a variety

of ways for the delivery of human services, i.e., slavery,

concubinage, euthanasia, the family unit, pensions for the

crippled, public grain distribution for the needy, and insti-

tutions for the custodial care of various unfortunates, espe-

cially orphans of soldiers killed in battle (Trattner, 1974).

Ancient Jewish doctrines taught the "duty of giving" and

the "right of those in need to receive." The Talmud, a col-

lection of Jewish law in the 4th century, B.C., prescribes

how charitable funds are to be collected and distributed, in-

cluding the appointment of tax collectors to administer the

system.

The Decretum, church laws in the 12th century, A.D., es-

tablished the responsibility of the society for care of the

needy. Monasteries served as important agencies of relief

during this period.

In feudal Europe serfs were protected against sickness

and unemployment by the feudal lords. Social, craft, and mer-

chant guilds often provided resources for the needy in cities.

By 1400 A.D., there were several hundred hospitals in England.

The church in England was a public institution, and the tithe

was a compulsory tax. Portions of diocese revenue were










allocated to deliver services to those in need. This was the

prototype of later state systems.

After the rise of capitalism and worldwide colonialism,

the feudal system gave way to the industrial revolution and

responsibility of the state for service delivery. The Eng-

lish Poor Law of 1601 underlined the responsibility of the

state to individual needs. This law also stated that help-

less or needy people had a right to public-supported assis-

tance and firmly established local responsibility for human

services (Trattner, 1974).

In North America abundant resources and a relatively

sparse population contrasted sharply with conditions in Eu-

rope. Trattner (1974:17) explains the common value in the

United States during the 18th century:

a well-ordered society was hierarchial; it had
a series of ranks from top to bottom. Some men,
the great ones, high and eminent in power and dig-
nity, were at the top, others, the poor and inferi-
or sort, at the bottom. Each, however, had special
privileges and obligations; the poor to respect and
the wealthy to show deference to those below them.
Desparities in wealth and condition existed not to
separate and alienate men from one another but to
make them have more need of each other. .

Although colonial policy makers soon acknowledged public

responsibility and local support for human services, circum-

stances were different in the United States. Hard work was a

virtue and idleness was a sin. A shortage of labor underlined

the Calvinistic work ethic, and the frontier offered resources

and personal mobility to most individuals.

Classical economists, i.e., Adam Smith, David Ricardo,

and others, along with Thomas Malthus argued that poverty was










the natural state of the wage-earning classes. Possession and

accumulation of property and wealth was viewed as a natural

right with which the state must not interfere. During the

early years of the United States dependency was considered to

be a vice and wealth a moral virtue. Public aid was equated

to pauperism and not desirable (Trattner, 1974).

In the 19th century social movements developed to in-

crease the public responsibility for human services. The

work of individuals like Dorothea Dix, the establishment of

the U.S. Sanitary Commission during the Civil War and the

establishment of the first federal agency in 1865 were all

antecedents to human services in the 20th century.

There is still no comprehensive policy or even under-

standing of the formal human service system by the economic

and political power elite. This has created a structure that

is frequently fragmented, overlapping and disorganized.

Human services are often of less importance in national

priorities to economic development and military/foreign af-

fairs. Values for services are varied. Education is gener-

ally accepted as a human service that should be government

supported and universal in access. However, health care is a

major industry in which government control, i.e., "socialized

medicine," is generally regarded as undesirable. The right

of the health care industry to make profits is accepted while

education is considered a nonprofit service. This value dif-

ference is characteristic of the absence of uniform policy

for human services in the United States.









Cure, not prevention, is emphasized. The training of

service providers, the distribution of resources, and the

services provided are disproportionately focused on "curinq"

human problems after they have occurred.

Service providers have become increasingly specialized

in training and function. Persons seeking help are often re-

ferred from provider to provider. Human resources are often

underutilized. Money is regarded as the means by which serv-

ices can be provided. Community resources are often over-

looked as a solution to service delivery.

Human service needs can be linked to social changes in

the United States in the past century. A transition from a

rural, labor-intensive to an urban, capital-intensive society

has created new and different human service needs. The de-

clining frequency of extended families and increased geoqraph-

ical mobility have decreased the importance of the family and

immediate community as human service resources. Both the old

and the youna have lost much of the support traditionally

available in extended families.

Ethnicity, age grouping, sex roles, and wealth are fac-

tors influencing the distribution and need for human serv-

ices. The life expectancy of American Indian males, forty-

five years, contrasts with that of a white female, seventy-

six. Differential access to human services can be a major

factor in the length and quality of life.

Factors influencing the general health of the United

States population include stressors such as air and water









pollution, crowding, diets high in animal fats and refined

sugar, excesses of food and drug use, sedentary occupations,

exposure to radiation, and demanding life styles. These in-

fluences in the social and physical environments are related

to the need for health and mental health services by a high

percentage of the population.

Human services in the United States in the 20th century

have also been characterized by increasing federal involve-

ment, a growing professional-consumer gap, a large bureau-

cracy, and increasing expenditures. Services are often

viewed as secondary to buildings, and they are seldom located

in the areas of greatest need. Individuals involved in

direct service delivery are seldom trained, often frustrated,

and pawns of bureaucratic systems.

Human Services in Developing Countries
Illustrate Problems and Methods

Human services are a concern of every society in the

world today. Providing the essential institutional arrange-

ments to meet the necessary requirements for nutrition, well-

being, socialization, governance, and other needs is demanded

of every society.

The African Rural Development Study

Lele (1975:116) discusses the concern for human services

in the African Rural Development Study that was supported by

the World Bank:

The provision of social services has been of vital
importance in many of the projects reviewed under
A.R.D.S. The humanitarian argument for such serv-
ices is obvious. Improvement in health, water supply,










diet, and education can improve the welfare of the
rural population. There are also sound economic
reasons for introducing social welfare services,
since better health, reduced domestic chores, and
higher levels of education can contribute to increases
in agricultural productivity through increases in
the quantity and quality of labor.

There are three sets of interrelated questions that are

faced in planning rural development programs (Lele, 1975:116-

120). First, given that resources are limited, how should

additional fiscal, organizational, and manpower resources be

raised from within the rural areas? Second, are such re-

sources likely to be mobilized more easily if the services to

be provided lead to a measurable impact on productivity or if

they generate substantial enthusiasm for development programs

among rural people? In other words, are social choices re-

garding allocation of resources related to social willingness

to pay? Third, how can low-cost delivery of services be or-

ganized? Is greater participation in planning and/or imple-

mentation of programs more conducive to a low-cost delivery

of services? These questions are equally germane to develop-

ment programs in the United States. Lele justifies the eco-

nomic output for services:

To the extent that their health is affected by poor
diets, rural people are able to devote fewer and less
productive hours to agriculture. In addition, there
seems to be a relationship between malnutrition and
mental deficiencies, which poses a further constraint
in increased productivity. Efforts must also be made
to improve diet through increasing or altering food
production. In view of the substantial effect of ill
health on the allocation of time for productive activ-
ities as well as for family welfare activities such as
child care, it would appear that the provision of a
set of fairly simple health and welfare facilities










would contribute significantly to the efficiency
of time use. (1975:116-119)

The approach that Lele cites as the most desirable for

improving human services in rural Africa is:

to allow the people to delineate for themselves
their critical needs and to identify the remedial
steps that the people are willing to take. The
programs could then provide the relevant technical,
pedagogical, and other forms of assistance, making
it possible to alleviate pressing social or welfare
problems without overburdening the local resource
base. There has been considerable success in Niger
in organizing public health programs along such
lines. Health officials begin these programs by
sponsoring group meetings at which villagers dis-
cuss their medical problems. During the discussions
the formally trained medical personnel are made cog-
nizant of the villagers' explanations of and cures
for the most common diseases, for it seems much
easier for the staff to explain Western techniques,
once they have a knowledge of traditional medicine.
If the villagers have shown an interest in improving
their health, they are asked to choose a volunteer
for training at the nearest dispensary and to col-
lect money to purchase a village medical kit. The
prospective medic is given a brief course in which
hygiene, preventative medicine and first aid are
stressed. The more highly trained medical person-
nel working the area make follow-up visits to check
on the village health worker and replenish his sup-
plies. The villagers are asked to repay their medic
by helping him with farm work and by bringing him
gifts in kind. (1975:26)

Of the hundred such health workers trained in Marandi

province in Niger in 1971, eighty were actively engaged in

their villages. During the first six months of the year,

they received visits from 83,600 patients, or about half as

many patients as were received by the 18 dispensaries in the

province (Lele, 1975:126).

The Chinese Mental Health and Health Systems

Human services in China are illustrated by their ap-


proach to the community mental health system.


The Chinese










conception of "good care" for mental illness is a blend, like

their medicine, of old and new, individual and collective

techniques, with the whole held together by the daily study

of Mao Tse-Tung's thought.

Ruth and Victor Sidel (1972:163) identify seven essen-

tial components in the Chinese community mental health sys-

tem:

1. Collective help. Patients are expected to help
one another. The less sick help the sicker; the
older help the younger. Group discussions and
study sessions are heavily emphasized.
2. Self reliance. The patients are expected to
struggle against their disease, to take re-
sponsibility for their return to health, to
engage in self-analysis and self-criticism.
3. Physical therapy. Medicines and acupuncture
are used when appropriate.
4. "Heart-to-heart" talks. Mental health pro-
fessionals meet periodically with patients
individually and in groups, to discuss their
problems and to provide guidance in their
self-investigation.
5. Community ethos. This goes beyond "collective
help" offered within the treatment facility
and includes broader family and community re-
sponsibility on both a preventative and after-
care basis, for those who are mentally troubled.
6. Follow-up care. Following the discharge, reg-
ular examinations are carried out, either
through the institutions' out-patient depart-
ments or home visits.
7. The teachings of Mao. Mao's thoughts run
through the entire mental health system, in-
cluding inspirational slogans and essays.

Health services in China have been described by Victor

Sidel. He includes the following basic principles:

1. Recruitment of health workers from those who
live in the community and from those who would
otherwise not use their talents.
2. Training designed for knowledge and skill nec-
essary for work to be done in an attempt to
avoid the frustrations of over-training or










underutilization.
3. Minimization of the social distance between
primary care health workers and those they
serve. One form of what has been called
"deprofessionalization" was attempted to
enhance the access and communication be-
tween the health worker and the patient.
4. "Demystification" of medical knowledge was
attempted through mass health education
campaigns.
5. A clear referral system enables the patient,
with no loss of face or income, to obtain
specialized levels of care.
6. Decentralization of services was achieved
by placing them in a location that was phys-
ically convenient to those who used them.
7. Individuals and local communities were en-
couraged to be self-reliant, using local
resources whenever possible.
8. An emphasis on "serving the people" and co-
operation, and less on competition, was a
basic value in the system (Sidel, 1973:
742-743).

Human services in any society are a product of cultural

forces together with the level and body of knowledge and

skills available to the service system. To organize an ef-

fective human service system, the cultural and structural

factors must be managed so as to enhance human service deliv-

ery and constantly to limit or modify those institutions that

hinder the fullest development of the services causing them

to be inefficient, underutilized, and irrelevant. Falk and

Hawkins state that this is what the Chinese health care sys-

tem has attempted to do (1975:420).

An outstanding feature of the Chinese health system ap-

pears to be the strong commitment to making human services a

high priority both politically and socially, not just some-

thing that exists mainly to support industrial or agricul-

tural development. The Chinese appear to be deeply concerned










with avoiding the alienation stemming from the over-special-

ization and bureaucratization that they feel is typical of

industrial and capitalist societies. This is evident in the

stress they have for generalists rather than specialist human

service providers.

Deprofessionalization is central to the delivery of

China's human services. This includes the beliefs that pro-

fessionals should not be more privileged than the rest of the

people, that mental and physical work should not be bifur-

cated, that an elite caste should not be permitted to emerge.

Steps have been taken to recruit professionals from the mas-

ses, to eliminate traditional selection processes, to require

manual labor for all professionals, to reduce wage differ-

ences, and to extensively use paraprofessionals, i.e., bare-

foot doctors, urban worker doctors, midwives, and Red Guard

members (Gartner & Riessman, 1973:418-420).

In China human services are seen as primary in national

policy and development programs. In the health services doc-

tors are not in control. This is in sharp contrast to the

United States where human services are secondary to capital

development and medical doctors are often in control.

Human Services and Social Systems

Human services are networks of resource allocation. A

general systems perspective is desirable because of the need

to understand these service networks that operate within a

larger sociocultural network. General systems theory, or at

least the study of societies as systems, is not new.










The value of the systems perspective in planned change

is to be found in its applicability to understanding innova-

tion diffusion. Feedback regulates both the growth and main-

tenance of an innovation in a system. A systems approach en-

ables the researcher to visualize how an information network

develops through a time series. All persons accepting the

planned change--students, human service personnel, community

college personnel, and community members in general--aid in

the diffusion of the innovation by adopting the feedback man-

agement role from the change agent to a generalized popula-

tion. Transition of the feedback regulation mechanism from

specialized control, the change agent, to generalized manage-

ment, the opinion leaders or "doers" and the general popula-

tion of innovation adopters, is crucial to institutionaliza-

tion of the innovation.

Summary

In this chapter issues which serve as necessary antece-

dents to the formation of a new hypothesis of planned social

change are reviewed. Given the background of understanding

of the currently identified salient issues of planned change

in human services, it is now possible to consider the require-

ments of a testable hypothesis to measure the effective and

efficient adoption and continuity of an innovation.















CHAPTER III
SYSTEMS THINKING AND SOCIAL CHANGE: CONCEPTS AND TERMS



The systems perspective has evolved to the point that it

can be used to evaluate the diffusion of an innovation. This

research tests hypotheses which are formulated to document

the relationships among feedback control, social networks,

and the rate of adoption in a planned change effort.

The Mechanical Equilibrium Model

Buckley (1967) traces systems "theory" origins to the

17th century "Social Physics" which regarded human beings as

physical objects whose actions and psychic processes could be

analyzed in terms of the principles of mechanics. A society

was seen as an "astronomical system" whose elements were hu-

man beings bound together by mutual attraction or differenti-

ated by repulsion; groups of societies or states were systems

of balanced oppostions. Social organization, power, and au-

thority were resultants of the "pressures" of "social atoms

and molecules." This "equilibrium" approach has as its basis

a system of elements in mutual interrelations which may be in

a state of equilibrium such that any moderate changes in the

elements or their interrelations away from the equilibrium

position are counterbalanced by changes tending to restore

it. This idea of a society as a system of interrelated parts

with a boundary, and usually tending to maintain a balanced

39










equilibrium has been held by contemporary social scientists

such as Homans, Parsons, Pareto, Sorokin, Lewin, and others.

The Biological Model

A second variety of systems thinking, the "organic" model

has led to the development of the anthropological structural-

functional approach to the study of societies. Serious usage

of the organic analogy can be traced to Herbert Spencer in

the 19th century. The general principle of mutual dependence

of parts is the similar feature between societies and biolog-

ical organisms.

Contemporary functionalism represents the modern version

of the biological model. In contrast to the Social Darwinists

of the 19th century, who used the organic model to emphasize

the competitive struggle theme, the functionalists, who empha-

size order, cooperation, and consensus, utilize the organic

model as an example of the close cooperation of parts conserv-

ing a relatively fixed structure within close limits of devi-

ation. The homeostatic approach is evident in Radcliffe-

Brown's statement:

Such a view implies that a social system has a
certain kind of unity, which we may speak of as
functional unity. We may define it as a condition
in which all parts of the social system work to-
gether with sufficient degree of harmony or inter-
nal consistency, i.e., without producing persistent
conflicts which can neither be resolved or regulated.
(1952:181).

Radcliffe-Brown further elaborates on the organic anal-

ogy:

In using the terms morphology and physiology, I may
seem to be returning to the analogy between society










and organism which was so popular with medieval phi-
losophers, was taken over and often misused by 19th
century sociologists, and is completely rejected by
many modern writers. But analogies, properly used,
are important aids to scientific thinking and there
is a real and significant analogy between organic
structure and social structure. (1952:195)

Although there were differences between the structural

functionalism of Radcliffe-Brown and the functionalism of

Malinowski, Harris points out a common theme:

It is an undeniable consequence of both the Malinow-
skian and Radcliffe-Brownian versions of functional-
ism that every sort of institution, from witchcraft
to war, receives its due as a functional contribution
to the welfare and maintenance of the social system.
(1968:534-535)

A mechanical, equilibrium model and the organic model

are certainly two widely used attempts to apply systems con-

cepts to the study of social systems. These two approaches

are generally inadequate when dynamic, changing systems are

the object of research. Buckley states that the shortcoming

of the mechanical, equilibrium model is the failure to men-

tion that every society of any complexity also has quite sta-

ble sets of alternative, diverse, deviant, or counter norms

and values, as well as a vast area of ambiguities and unin-

stitutionalized degrees (1967:10-11). The functionalists'

appeal to the organic analogy leads them to overemphasize the

more stable, over-determined, and supported normative aspects

of the social systems at the expense of other equally impor-

tant dynamic analysis.

Nadel offers a timely critique of the functional ap-

proach:










There is maladjustment as well as adjustment; the
function concept only poses the question of adequacy
but does not settle it beforehand. Only of society
in the abstract can we say that it is integrated,
and only of culture at large, that it leads to surviv-
al. Concrete societies weaken, disintegrate, or show
symptoms of "social pathology;" and concrete cultures
may be full of frustrations and threats to survival.
In their analysis, then, subservience to function
means an attempted, varying, and often problematic
adequacy. Functionalists' anthropology is apt to lose
sight of this corollary and to speak about social facts
having such-and-such functions as though these were
self-sufficient truths. (1951:375-376)

Modern Systems Theory

A third systems approach has been labeled "modern sys-

tems theory." It has its antecedents and contemporary under-

pinnings in cybernetics, information, network, and decision

theories.

Sociocultural systems are seen as "open" systems. The

open system exists by virtue of a transaction, or transposi-

tion of energy or materials across its boundaries to and from

the environment. Instead of a tendency toward equilibrium,

there is a tendency toward increasing heterogeneity of the

parts and increasing specification for differentiation.

Buckley argues the advantages of a "modern" systems ap-

proach:

1. A common vocabulary unifying the several
behavioral disciplines;
2. A technique for treating large, complex
organization.
3. A synthetic approach where piecemeal anal-
ysis is not possible due to the intricate
interrelationships of parts that cannot be
treated out of context of the whole;
4. A viewpoint that gets at the heart of soci-
ology because it sees the sociocultural
system in terms of information and commu-
nication nets;










5. The study of relations rather than entities,
with an emphasis on process and transition
probabilities as the basis of a flexible
structure with many degrees of freedom; and
6. An operationally definable, objective, non-
anthromorphic study of purposiveness, qoal-
seeking system behavior, symbolic cognitive
processes, consciousness and self-awareness,
and dynamics as well. (1967:39)

The "modern" concepts of system and organization are

proposed to replace the over-worked concept of the organicc."

This concept, along with that of mechanical equilibrium, has

performed the essential job of bringing the social scientist

to full recognition of the fact that the parts of a society

are not independent, that a society is to some degree an in-

terrelated whole. Further advance requires an appreciation

of the important ways in which a society differs from the or-

ganic or the mechanistic equilibrium.

A crucial feature is an understanding of the particular

nature of the relationships that exist among the parts of a

system. Buckley states that the relations of parts of an or-

ganism are physiological, involving complex physiochemical

energy interchanges, in contrast to the relations of parts of

society which primarily involve complex communicative proces-

ses of information exchange (1967:43).

Another crucial feature of general systems analysis is

feedback. Feedback, when operating in a qoal-directed sys-

tem, operates as a steering mechanism. Deutsch states that

for effective "self-direction" a sociocultural system must

continue to receive a full flow of three kinds of information:

1. information of the world outside;










2. information from the past, with a wide range
of recall and recombination; and
3. information about itself and its own parts.

Three kinds of feedback, which make use of these types of in-

formation, include:

1. goal-seeking, i.e., feedback of new internal
data into the system net whose operational
channels remain unchanged;
2. learning, i.e., feedback of new external
data for the changing of these operating
channels themselves, that is, a change in
the structure of the system; and
3. consciousness, or "self-awareness"--feedback
of new internal data via secondary messages,
messages about changes in the state of parts
of the system itself. (1951:185-222)

A third major feature of general systems analysis is de-

cision-making. Feedback is a key element in the decision

process. Information serves as the basis of the decision-

making process, both in the individual and the sociocultural

system. Processes are the result of possible positive and/or

negative feedbacks mediated by the selective decisions, or

"choices," of the individuals and groups directly or indi-

rectly involved.

A fourth feature is the quantification that is possible

with general systems analysis. Unfortunately, much work must

be done in this area. Attempts must be made to measure the

degrees of interdependency among the variables of a socio-

cultural system. Sophisticated methodology should yield

theoretical measures to allow prediction and refutability of

theoretical statements. Hutton summarizes systems thinking:

We are pointed in a direction which is more likely
to produce answers than those which depend upon assump-
tions that the enterprise is simpler than this, i.e.,









that it is a simple deterministic physical system
tending toward equilibrium. Noting that the socio-
technical system looks as though it is open and
self-maintained helps us to avoid seeking explana-
tions which are inappropriate. It does not auto-
matically yield explanations which are appropriate.
But, it is, I would submit to you, a powerful tool
in pointing us the right way. The theory, or rather
the framework of the theory, is at least consonant
with the data and it has a powerful orienting and
heuristic function. It does not appear to have much
reductive power and we are not really at the staqe
of refutability yet. (1969:31)

In the present research the following elements of sys-

tems analysis and theory appear to be most relevant to the

formulation of a testable hypothesis. In planned change pro-

grams it is worthwhile to look at the networks of communica-

tion and information that exist in the ethnographic context

of the training institution and the system of human services

to be affected. The training organization becomes an "open

system" in interaction with the service delivery system. A

"closed system" would not permit the flow of information and

feedback necessary for change. It is critical to the "suc-

cess" of the innovation that the training program and human

service organizations be analyzed as mutually interdependent

systems.

A general systems perspective is desirable for human serv-

ice innovation analysis. Three principal uses are stressed:

1. the "systems model" permits the introduc-
tion of an innovation designed to create an
organized system from numerous loosely re-
lated parts;
2. the systems model permits the study of con-
tinuity, or a series of changes; and
3. the change agent operates as a feedback
regulator in the innovation process.









Definitions of Concepts and Terms

A system is a set of interrelated components. Social

systems are goal-directed and include organizations with sta-

tus positions and related roles. System components related

to innovation research are organized into three rubrics:

1. feedback;
2. institutionalization or rate of adoption
indices; and
3. the social networks of the change agent,
opinion leaders, and adopters.

The particular definitions are as follows:

Feedback control--Regulation of information and resources in a

social system. Control may be specialized or generalized.

Feedback loop--Information available to a system and its con-

trol function about how that system is operating in its social

and physical environment.

Feedback management--Generalized feedback control in a social

system and an indicator of innovation acceptance.

Feedback regulation--Specialized feedback control in a social

system. Change agent activities initially involve this form

of control over innovation diffusion.

Institutionalization--The process of "fitting" an innovation

into the existing social system of the recipients.

Rate of adoption--The number of recipients or adopters in a

social system who choose to participate in an innovation in a

specific time period.

Networks--A set of people who include change agents, opinion

leaders, and adopters by which innovations may be diffused.

Change agent--An individual who attempts to implement social










change in a human organization or society.

Opinion leaders--Influential individuals in a social network

who can operate as feedback managers of an innovation if they

accept.

Adopters--Individuals in a human organization or society who

change their behavior because of an innovation.

Implications for the Research Design

Systems analysis is used to provide the conceptual frame-

work by which the diffusion of a particular innovation is

evaluated. Feedback, institutionalization, and social net-

works are systems terms which are the foci of the research

design. The concepts and terms which are operationally de-

fined in this chapter may be helpful references for the reader

when he or she is reviewing the remainder of the text.














CHAPTER IV
RESEARCH DESIGN AND TESTABLE HYPOTHESES OF THE STUDY



The Research Design

In this study particular interest is given to the social

science techniques of documenting the rate of adoption or in-

stitutionalization of an innovation. Rate of adoption is

used to organize an analysis of the change process and in-

volves attention to all three of the above rubrics (see page

44). It is a central measure of how an innovation system op-

erates in its entirety. Rogers and Shoemaker (1971:157-158)

describe variables which influence the rate of adoption:

1. perceived attributes of the innovation;
2. communication channels used;
3. the nature of the social system; and
4. the extent of the change agent's efforts.

Stone (1952) and Petrini (1966) show that the greatest

response to change agent effort occurs at about the point

when opinion leaders are adopting the innovation. At first,

change agent's efforts do not result in many adoption deci-

sions (Figure 1). This is the first of three stages in the

process. At the second stage, when opinion leaders adopt,

the rate of adoption starts to climb under its own impetus.

The change agent withdraws from the process in the third

stage. Rogers and Shoemaker (1971) contend that when the

adoption curve starts to climb (from 5 to 20 percent adoption)


































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increased inputs of change agent activity result in direct

gains in rate of adoption. After approximately 15 to 20 per-

cent adoption, further change agent inputs seem to have no

direct effects on the rate of adoption.

Rogers and Shoemaker (1971:233) discuss a generalization

about the dynamics of the innovation process which has util-

ity for this research.1 They state that the change agent's

role can be analyzed in terms of three distinct stages:

1. system intervention;
2. communication network development; and
3. disengagement from system control.

System intervention is the first stage in which the

change agent begins to enter the various human service net-

works by interpersonal contacts with key informants in each

agency. This period of time is primarily devoted to the de-

velopment of communication channels and feedback loops by

which the innovation implementation may occur. In the first

stage, feedback regulation by the change agent is the means

of system control and information and resource sharing. The

rate of adoption among the general population is beginning to

increase as initial influences of opinion leaders (doers) are

realized.

In the second stage, networks are developed, and the

control function begins to be delegated. This is associated

with the increasing number of adopters, particularly key in-

formants and opinion leaders in the agencies, and their grow-

ing participation with the innovation. Feedback loops are

developed in which opinion leaders begin to assume a control










function for their agency. The rate of adoption continues to

increase as "watchers of doers" begin to participate.

The third stage occurs when the institutionalization

process is near completion and the change agent begins a plan-

ned disengagement from system control. Networks of communica-

tion and resource sharing are established in each of the agen-

cies with opinion leaders serving as feedback managers for

the innovation. Adoption of the innovation continues as

"watchers of watchers of doers" decide to participate. The

plan for innovation institutionalization includes establish-

ment of two-way communication and resource sharing networks

between the community college and human service systems.

Measurement and documentation of a specific innovation

process is the goal of this research. The study is a field

test of the above theoretical and methodological statement.

Statement of Research Hypotheses

In light of the above statements three particular, yet

interrelated, hypotheses may be empirically tested to provide

evidence for the support or rejection of a general hypothe-

sis. These hypotheses are:

General Hypothesis--Institutionalization of an inno-
vation occurs in human social systems in which the
function of feedback control is transferred from spe-
cialized regulation of information and resources by
the change agent to generalized management of infor-
mation and resources by opinion leaders in the recip-
ient populations.

Particular Hypothesis One--When institutionalization
is occurring in Stage I of the innovation process, an
increase in feedback regulation (change agent effort)
is positively related to an increase in (1) the number
of opinion leaders adopting the innovation and (2) the










rate of adoption among the general recipient popula-
tions.

Particular Hypothesis Two--When institutionalization
is occurring in Stage II of the innovation process,
an increase in the delegation of the feedback control
function to opinion leaders by the change agent is
positively related to an increase in (1) opinion
leader participation and adoption and (2) the rate of
adoption among the general recipient populations.

Particular Hypothesis Three--In Stage III of the inno-
vation process in systems where institutionalization
has occurred, disengagement of the change agent from
feedback control is positively related to acceptance
of (1) feedback control by the opinion leaders and
(2) the rate of adoption in the general recipient
populations.

The effort of the change agent is the independent varia-

ble; participation of opinion leaders and the rate of adop-

tion of the innovation are the dependent variables. Change

agent effort is measured by the number of hours of work in a

network during a specific time period. Participation of opin-

ion leaders is measured by records of the researcher and re-

sponses to questions asked them after the two-year project

was completed. Rate of adoption is measured by a record of

acceptors which was maintained by the change agent.

Summary

The relationships among change agent efforts, the devel-

opment of interpersonal communication channels of opinion

leaders in diffusion networks, and the rate of adoption

through time are evaluated in this research. Three stages of

the innovation process are the basis for hypothesis formula-

tion and testing. In the next chapter methods and procedures

are discussed in light of the research design.







53

Note

1A similar analysis of the innovation process is dis-
cussed by Collins. His three stages include the developmen-
tal process, innovation decision process, and transfer proc-
ess. (1977:282-290).















CHAPTER V
METHODS AND PROCEDURES



Description

A field test of the hypotheses requires documentation of

the process of institutionalization in a two-year time period.

The three variables measured to analyze this process include

a feedback control transfer, growth of communication and re-

source networks, and rate of innovation adoption.

The Populations

The target population potentially includes any resident

of Lee County, Florida. Specific recipient populations in-

clude the administration, faculty, students of Edison Commu-

nity College, and administrators and workers in human service

agencies.

Data Collection

Feedback control transfer occurs as feedback regulation

(change agent activity) is replaced by feedback management

(opinion leader participation). Measurement of time alloca-

tions in each human service network permits detailed analysis

of the ability of the change agent, as feedback regulator, to-

develop diffusion networks, and then decrease his/her involve

ment, as feedback management increases. The number of adopt-

ers and opinion leader participation in each network per time

period are indicators of the growth of feedback management.

54










The growth of communication and resource networks and

feedback control transfer are measured in this study by re-

cording change agent activity and opinion leader participa-

tion in each of the human service agencies over a two year

period. A log which provides a record of the date of his ac-

tivity, and the network in which it occurred, is maintained

by the change agent to document feedback regulation (see Log

of Change Agent Activity in Appendix B).

Feedback management is measured from three data sources

identifying opinion leaders on an innovation adopter log and

the field notes and other records of the author. The Innova-

tion Adopter Log (Appendix B) contains the names and agencies

of recipients in each network including agency administrators

and other key persons who are in a position to influence

employees to participate in the program. Their network, fre-

quency of participation, and first date of interaction are

recorded on the log.

The networks are observed to measure acceptance of the

innovation in the change process. This method requires defi-

nite criteria for determining whether an individual is an

adopter of the innovation and a working component of the new

network of information. Criteria to determine opinion leader

and agency worker adoption include:

1. serving as a guest speaker in a human serv-
ice class,
2. an expressed desire by the individual to
participate in the program,
3. serving as a field supervisor of students,
4. teaching in a human service class,
5. participating in a workshop or in-service









training, and
6. serving as a member of the advisory committee.

College staff who adopted the innovation are identified

by criteria which are dependent upon their status, i.e., fac-

ulty, student, or administrator. For administrators these

criteria include:

1. participation in an aspect of the program,
2. stated support of the program, and
3. approval of program when appropriate.

Faculty adoption criteria include:

1. instructing in the program,
2. assuming a duty in the program, and
3. participating in a committee or conference.

Students are identified as adopters if they enrolled in a

training program or academic course of study related to the

innovation.

Additional evaluative information was obtained by the

author in September, 1978. He discussed the innovation with

key administrators in each network with special regard for

opinion leaders' knowledge of the program, their participa-

tion, and general changes in attitudes concerning human serv-

ice training by Edison Community College. Each interview

also involved a review of the author's records to verify per-

sonnel and students known by the administrator to have adop-

ted the innovation. These data provide a qualitative eval-

uation of the institutionalization process and a means of

verifying the quantitative analysis in each network.

Data Reduction Procedures

Data from the Log of Activity and the Innovation Adopter

Log are recorded and classified by three distinct eight month










time periods (stages). These stages include the following:

1. Stage I is September 1, 1976 to April 30, 1977;
2. Stage II is May 1, 1977 to December 31, 1977;
3. Stage III is January 1, 1978 to August 31, 1978.

The service networks of recipient populations for which

the data were collected and analyzed include Edison Community

College, mental health, health, aging, education, mental re-

tardation, public assistance, youth and government, and gen-

eral administrative agencies. These networks are described

in Chapter VIII.

Means of Analysis

Data are classified by time stage and human service net-

work. Correlation analyses are performed to test the nature

of the relationships among change agent effort, opinion leader

participation, and rate of innovation adoption in each of

three time stages and for the general two year period.

Interpretation

Data will support the verification of Particular Hypoth-

esis One if, in Stage I, an increase in change agent effort

(X) is positively related to increases in the frequency of

opinion leader participation (Y1) and innovation adoption

(Y2). Positive correlations for XY1 and XY2 suggest system

intervention by the change agent and the initial participa-

tion of opinion leaders.

Data will support the verification of Particular Hypoth-

esis Two if, in Stage II, change agent effort is inversely

related to increases in opinion leaders and in general adop-

tion. Negative correlations for XY1 and XY2 suggest the










partial transfer of feedback control from feedback regulation

to feedback management.

Data will support the verification of Particular Hypoth-

esis Three if, in Stage III, change agent effort is inversely

related to increases in opinion leaders and the number of

general adopters. Negative correlations for XY1 and XY2,

with a decline toward zero by X, suggest that generalized

feedback management has replaced specialized feedback regula-

tion as a controlling mechanism in the innovation diffusion

networks.

All three particular hypotheses are tested to provide

evidence to support or reject the general hypothesis. In

this study, it is assumed that relationships among feedback

regulation and feedback management of an innovation demon-

strate the process of institutionalization as it is occur-

ring. Data will support the General Hypothesis if, in the

three stages of the research period, overall evidence for an

inverse relationship between feedback regulation and feedback

management, as innovation control mechanisms, is found. Neg-

ative correlations for XY1 and XY2 suggest that general feed-

back control transfer has occurred. A high positive correla-

tion of opinion leader participation (Y1) with innovation

adoption (Y2) suggests the influence of feedback management

on the growth of the innovation.

Results of this study must include a statement of reser-

vations concerning hypotheses verification. Data are collec-

ted for only one instance of planned change, and additional










replication and support is needed before the hypotheses can

be verified and accepted by the general scientific community.

In research which deals with dynamic social systems, controls

for intervening or extraneous variables are difficult or of-

ten impossible to establish. The author is aware of "outside"

variables which might affect the research results and de-

scribes their possible influence on hypotheses verification

in Chapter XI.



Summary

Methods and procedures for data collection and analysis

are described in this chapter. The process of feedback con-

trol transfer, social network growth, and rate of adoption

are field tested in three stages of a two year period. Re-

sults provide evidence to support or reject the particular

hypotheses and, subsequently, the general hypothesis.





































PART TWO

A DESCRIPTION OF THE RESEARCH
PERFORMANCE SITES














CHAPTER VI
THE SETTING



Part Two discusses the social and physical environments

of the innovation, which involved training present and future

human service workers. The setting (Chapter VI), innovating

organization (Chapter VII), and human service system (Chapter

VIII) are described in light of needs for the particular form

of innovation.

Human services are related to human populations and

their problems of adaptation to specific environments. In

the innovation, it is desirable to include an appreciation of

the socio-ecological conditions of Lee County as part of the

curricula. The purpose is to enhance workers' understandings

of the relationships among three interrelated components--the

physical environment, human population, and human services.

Observations of these components in Lee County by the author

at the beginning of the study indicated that conditions were

favorable for the innovation.

The Physical Environment

Lee County, Florida, is the political unit in which the

research was conducted. The area is located on the Gulf of

Mexico in the southwest Florida region midway between Tampa

and Miami. It is bordered by Collier County on the south,

Hendry County on the east, and Charlotte County on the north

(Fiqure 2).








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Lee County covers an area of 1,019 square miles. Sur-

face water totals approximately 234 square miles and the to-

tal land mass 785 square miles. The terrain is generally

flat and low, sloping from east to west, with a subtropical

setting, composed of low elevation barrier islands along the

Gulf of Mexico, pine forests, scrublands, and mangrove wet-

lands. Tourists and residents are attracted by the natural

beauty and recreational activities provided by the physical

attributes of the area. Farming is an important activity,

and large areas can be observed to be under cultivation. A

large shrimp fishing fleet is located in Fort Myers Beach,

and water covers much of the area within the county's bound-

aries.

The main drainage is the Caloosahatchee River which runs

southwesterly through the county, emptying into San Carlos

Bay. Other primary streams in the area are Hendry Creek and

the Estero River, both of which empty into Estero Bay.

The land mass of the county was created only a few mil-

lion years ago, during the Pleistocene and Miocene periods.

Soils of Lee County consist of sand, silt, and clay derived

from the geologic substratum, water, and organic matter.

While most of the area's soils have some suitability for ag-

ricultural uses, they act as natural constraints to urban de-

velopment in many parts of the county. Nevertheless, the

area is experiencing rapid urban growth and there are large

housing developments in Cape Coral and Lehigh Acres (Figure 3).



















































































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Resources in the physical environment include abundant

marine life, land suitable for commercial agriculture, and

scenic and recreational potentials of the area. Tourism, ag-

riculture, fishing, and housing developments are economic ac-

tivities geared to these resources.

The Human Population

The City of Fort Myers is at present the largest area of

population concentration in the county. The first permanent

settlers moved into the area now occupied by the city around

1866. The town had 349 inhabitants when it was incorporated

in 1885. In 1887 Fort Myers was designated as the county

seat of newly formed Lee County.

Cape Coral, Lehigh Acres, North Fort Myers, East Fort

Myers, Bonita Springs, Saint James City, Fort Myers Beach,

and Sanibel are the other cities and towns which eventually

were formed in the county. The entire population of the

county in 1976 was estimated to be 163,978 persons.1

Lee County experienced continuous population increase

during the past century. The two decades of rapid growth in

the 20th century, 1920 to 1930 and 1950 to 1960, reflect

periods of "boom" economic and land development activities

that brought many immigrants to the area (Table II). This

population increase continued in the 1970 to 1980 decade.

The growth rate in Lee County has averaged over nine

percent per year for a 16 year period preceding the innova-

tion. The total population has grown from 54,539 in 1960 to

163,978 in 1976. Such growth in population (Tables II and









TABLE II

History of Population Growth, Lee County


Year Population Increase Percent
Increase

1885 400 350 87.5

1895 750 193 25.7

1900 943 1,520 161.2

1910 2,463 1,215 49.3

1920 3,678 11,222 305.1

1930 14,900 2,588 17.4

1940 17,488 5,910 33.8

1950 23,404 31,135 133.0

1960 54,539 50,677 92.9

1970 105,216 64,866 61.6

1976* 163,9781 58,762 55.0



Source: U.S. Census for 1885 to 1970
*Florida Statistical Abstract for 1976









Table III

Annual Population Increases, Lee County 1970 to 1976


Estimated
Source Annual Total
Year Natural Migration = Increase Population Percent

1970 442 + 6,317 = 6,759 111,975 6.4

1971 385 + 11,902 = 12,287 124,287 10.9

1972 208 + 15,114 = 15,322 139,584 12.3

1973 163 + 16,093 = 16,256 155,840 11.6

1974 235 + 8,925 = 9,160 165,000 5.9

1975 0 + 5,082 = 5,082 170,0821 3.1


SOURCE: Lee County Planning Department









III) is not primarily the result of natural increase (Table

IV). It has resulted mainly from an influx of migrants from

northern states in recent decades (Lee County Planning Coun-

cil, 1976).

The density of the population in 1975 was 216.6 persons

per square mile (Table V). Continual increase in population

density has led to the current urban character of parts of

the county. There are still large expanses of low density

land, but much of the land is becoming "developed" and al-

tered by higher population density.

The age structure of Lee County population indicates

that 25.8 percent is 65 years and over and 26.1 percent is

under 18 years. Age structure for blacks reveals a somewhat

different pattern in that only 5.5 percent is 65 years and

older and 50.3 percent are under 19 years.

Blacks are the major non-white ethnic group in Lee County

and comprise 9.5 percent of the total population. Migrant

agricultural workers, who are black, Mexican-American, and

white, are another ethnic group living in the area during

nine months of the year. This population is estimated to be

8,000 to 10,000 each growing season. Blacks reside primarily

in the communities of Fort Myers and Harlem Heights, and the

agricultural workers reside near the farms in the eastern

half of the county (Lee County Planning Department, 1976).

Characteristics of the human population of Lee County

include high growth rates in the past 100 years, rapid urban-

ization, high percentages of persons over 65 years of age, a









Table IV

Rates of Natural Increase, Lee County, 1970 to 1976



Year Births Deaths Births Exceed
Deaths By

1970 1745 1303 442

1971 1695 1310 385

1972 1728 1520 208

1973 1727 1564 163

1974 1915 1680 235

1975 1657 1676 -19


SOURCE: Lee County Health Department









TABLE V

Population Density, Lee County


Year Population Population per
Square Mile

1930 14,900 19.0

1940 17,488 22.3

1950 23,404 29.8

1960 54,539 69.5

1970 105,216 134.0

1976* 163,9781 208.9


Total Square Miles:


Lee County = 1005
Land mass = 785
Water area = 220


Source: U.S. Census
*Florida Statistical Abstract for 1976









high immigration rate, and spatial concentrations of ethnic

and socio-economic class groups. These factors have put a

mounting strain on the distribution of health and other human

service resources in the area.

The Needs for Innovation

Human service agencies have changed in recent decades in

response to conditions in the human population and physical

environment of Lee County. Agency changes have been prima-

rily those of quantity, i.e., adding employees without im-

proving their awareness of those conditions. In his prelimi-

nary assessment of human service agencies, the author became

aware of an acute need for trained workers who, by understand-

ing their consumers' socio-ecological environments, could

provide more effective services. This environment included a

higher population density due to immigration of retirees and

tourists, spatially distinct ethnic neighborhoods, strains on

available resources such as potable water, increasing pollu-

tion, and alteration of the physical environment for construc-

tion of homes and condominiums. This need for workers who

understood the socio-ecological conditions of their consum-

ers' environments apparently existed in all of the major hu-

man service networks.

Health Services

Public health and sanitation has been influenced by the

high influx of new residents and tourists. Agency workers

serve consumers from varied age, ethnic, and socio-economic

groups. Diseases influenced by socio-ecological conditions









may include skin cancer, parasitic infections from the soil,

pesticide poisoning among seasonal farmworkers, and many oth-

ers.

Air and water quality in human environments is often re-

lated to disease and poor sanitary conditions and the need

for human services. Lee County is relatively free of air

pollution. No large, polluting industries are located in the

area and continuous breezes from the Gulf of Mexico keep the

particulate and sulfur dioxide levels at a low risk for the

population.

Water quality and availability is a major problem for

the residents of the area. Rapid population growth and an

absence of land use planning have created circumstances in

which the carrying capacities of Sanibel, Captiva, Fort Myers

Beach, and Cape Coral are near their limits for water supply

and waste disposal. The fecal coliform count, a public

health indicator of water quality, obtained from samples ta-

ken at Fort Myers Beach from 1970 to 1978 documents a rise in

water pollution. In 1970 the fecal coliform count was 31 or-

ganisms per 100 milliliters, and in 1978 it was measured at

116.5 organisms per 100 milliliters.

A county beach on the Caloosahatchee River was closed in

1978 because of sewage waste pollution. The river water is

contaminated with raw sewage, treated wastewater, and storm

drain outfalls. Fecal bacteria counts ranged from 77.4 to

612.5 organisms per 100 milliliters (DeFord, 1979:1B).









The presence of pollutants in human water supplies in-

troduces the threats of physical health hazards and depletion

of life-sustaining water resources. Acute diseases may be

contracted from drinking water, using recreational waters,

and from consuming foodstuffs grown or processed with water

contaminated by pollutants.

Workers in health agencies were observed by the author

to have specialized, technical training. However, many work-

ers did not appear to be aware of socio-ecological conditions

influencing their consumers to seek services. Training in

understanding the unique health problems of groups such as

the elderly and seasonal farm workers appeared to be criti-

cally needed.

Mental Health

A common problem of many of the new residents to the area

was the loss of social and psychological support systems

which had been available in their previous communities. El-

derly migrants and winter visitors, for example, often leave

family, life-long friends and coworkers to move to "the good

life" in the sunshine. After establishing their new resi-

dence they may become lonely, have no friends, become bored,

and are exposed to a new climate which is hot, humid, and

quite different from "home." The result, according to mental

health administrators, is anxiety, alcohol and drug use ex-

cesses, and other inadequate coping mechanisms. Agency work-

ers apparently could benefit from training to enhance their

understanding of the psychological adjustments contingent









upon migration to a new setting, problems of the elderly, and

ethnic differences in mental health problems.

Governmental Services

A governmental problem is greater demand on local re-

sources influenced by high immigration. Land and housing de-

velopment has resulted in critical shortages of potable water,

certain varieties of marine life, and vegetation in the case

of Cape Coral.

Higher densities and rates of population growth have been

followed by increases in housina needs, demands on the coun-

ty's resources, and greater competition for available jobs.

Unemployment is particularly high among young blacks and His-

spanics. The author's preliminary observations indicated

that workers in governmental agencies were often untrained.

Services for the Aged

Agencies serving the aged had needs for increased re-

sources, as well as training for workers, due to high immi-

gration of elderly retirees. Agency staffs often encountered

consumers with housing, nutritional, health, recreational,

and transportation problems, but had not usually received ap-

propriate training for helping their clients to cope with

these difficulties. Administrators expressed a strong need

to train workers to effectively serve these consumers. In-

deed, the first actual training resulting from the innovation

was conducted for workers in the area of aging.

Educational Services

The rapid urbanization and population growth of the









county have placed strains on the educational agencies. A

high proportion of blacks under 18 years of age (50.3 per-

cent), increasing numbers of consumers seeking educational

services, a high frequency of drug abuse, discipline problems

and a relatively high number of migrant farmworker children

are common characteristics within the area served by Lee

County Schools. Educational workers, particularly teacher

aides, are in need of training to cope with these situations.

Educational administrators cited job training for disadvan-

taged youth, women, and the elderly who were seeking second

careers as important needs.

Economic Assistance Services

Competition for jobs, the absence of major employers of

unskilled labor except in farming and tourism, and many per-

sons living on fixed incomes are factors influencing the need

for economic assistance services in the county. Seasonal

farmworkers and shrimp fishermen are also in need of economic

assistance when climatic or situational conditions in the

physical environment result in unemployment for them. In the

planning stage of the innovation it was apparent to the au-

thor that economic assistance workers were primarily trained

in the "bureaucratic" activities of paperwork. Few workers

were completely aware of the social and ecological circum-

stances of their consumers.

Mental Retardation

Rapid population growth apparently increased the number,

but not necessarily the proportion, of individuals and families










needing mental retardation services. A regional residence

facility, Sunland Training Center at Fort Myers, attracted

consumers from the surrounding counties. High infant mortal-

ity rates, and the frequent lack of adequate prenatal and

postnatal care for poor, black, and Hispanic mothers may also

affect mental retardation frequency in the area, according to

agency administrators. Workers in mental retardation, as

well as education, need training to enhance their understand-

ing of such influences as nutrition, infant care and utiliza-

tion of genetic screening on mental retardation. After the

author's initial observations, it was apparent that mental

retardation workers, as well as those from the other serv-

ices, could profit from the training concerning the socio-

ecological conditions of the area.

Summary

The setting for the present research is a county in

Southwest Florida which has experienced rapid population

growth and extensive alteration of the physical environment

since 1950. Land development, with subsequent modification

of the physical terrain, is a major human activity of the ar-

ea. Residents are predominately white, but local concentra-

tions of blacks and migrant farm workers exist.

Human services are reviewed to inform the reader as to

the needs for innovation observed by the author in the plan-

ning stage. Needs discussed in this chapter are related to

changes in the physical environment and human population of

Lee County in recent decades. The specific service delivery









areas are also discussed in Chapter VIII, but with reference

to internal agency or network needs. In the next chapter the

conditions in Edison Community College which influenced the

author to choose it as the innovating organization are dis-

cussed.





Note

The reader should note a discrepancy between the
Lee County population size estimates provided by the Lee
County Planning Department (170,082 for 1975) and the
Florida Statistical Abstract (163,978 for 1976). The
preliminary report of the 1980 Census lists the population
of the county as 205,266 persons.















CHAPTER VII
THE INNOVATING ORGANIZATION



Edison Community College is the organization selected

for diffusion of the innovation i.e., the human service

training program, to the community. It is a socially legit-

imate donor organization from which the author could operate

as a change agent. The author's position as instructor pro-

vided him with an appropriate status and role in the commu-

nity, the human service agencies, and with potential stu-

dents.

The college, established in 1962, experienced a develop-

mental period similar to many community colleges. Character-

istics of this period included rapid growth in students and

buildings, local control by a Board of Trustees, and an iden-

tity somewhere between the long-established university system

and the high schools.

System Structure

The innovating organization includes structural compo-

nents of administration, faculty, support staff, and students.

They operate within the policies, social positions, and roles

which have been traditionally maintained as the "system of

organizational knowledge." This system includes values for

curriculum content and presentation, program attitudes of









personnel regarding their interaction with the local commu-

nity and its organizations.

Boundaries of the organization include the physical

structures, financial resources, qualification requirements

for employees, cultural values and expectations about the pur-

pose of community colleges, national and state regulations,

and admission requirements. Inputs include human and mate-

rial resources, new employees, information from various

sources, and students. Outputs include students with new in-

formation and skills, community oriented activity, and eco-

nomic resources via employee payrolls. The community college

system is designed to be optimally responsive to community

educational needs, both traditional academic and vocational,

according to its advocates.

Organizational Constraints to Innovation

Although the college initially appeared to be suitable

as the innovating organization, the author experienced con-

straints, as well as occasional resistance, to the innova-

tion. These factors are discussed below, followed by the

reasons why the college was eventually selected as the inno-

vating organization by the author. Discussion of these rea-

sons is focused on the institutional needs for an innovation

of the type designed by the author.

A Previous Attempt at Change

A human service training program had been authorized in

theory in 1972 at Edison Community College, but was not car-

ried through in practice. In any event it was not accepted









in the community's official human service system. Informants

who participated in this abortive innovation attempt stated

that the program had been planned in cooperation with Sunland

Training Center, an agency providing residence and general

services for mentally retarded individuals. The innovation

was designed to train paraprofessional workers at the Center

in basic helping techniques and skills. Reasons cited by in-

formants for the failure of the innovation include: the pro-

gram had not been accepted in either the innovating or the

recipient organization; there had been a lack of flexibility

and relevance in the curriculum and failure of the innovators

to understand the felt needs of the recipients.

Another influence on the previous attempt at developing

and implementing human service programs was the disciplinary

perspective of other human service programs in Florida and

the United States. Human service programs have traditionally

emphasized individual helping skills but have not included

cross-cultural perspectives, a socio-ecological approach to

assessing human problems and an understanding of cultural

values and patterns involved in human service delivery.

Perceptions of the Roles of Anthropologists

Anthropologists previously employed at the community

college had left traditional, if not eccentric, impressions

upon both the college and the community. One previous in-

structor, who claimed professional status as an anthropolo-

gist, actually did not have a graduate degree in anthropol-

ogy, yet he was the major role model for the profession in









the community for five years. When the author arrived in the

area, he was frequently linked in the minds of college and

community members with the interests of the former anthropol-

ogist, i.e., highly qualified to expound on non-human pri-

mates.

Perceptions about anthropologists and their expected

roles were, in effect, based on the role model of such a pred-

ecessor. Applying anthropology to contemporary human prob-

lems and involving an anthropologist as the principal innova-

tor was a new role model for the members of the college and

the community.

Faculty-Administration Conflict

As with all institutions, Edison Community College has

its particular organizational structure. The clear division

between faculty and administration was the most important

factor in the social structure when the author arrived and

was the result of several years of conflict between the two

groups. This conflict was formalized by the faculty when

they voted to approve a union in September, 1976.

The community college, when analyzed according to sys-

tems methodology, experienced a conflict between two impor-

tant components, i.e., the faculty and the administration.

There were strains within the system that influenced the ap-

proach the author took to institutionalize the innovation.

Groups of conflicting interests and motivations came into

being to polarize the college personnel. In addition to the

faculty-administration conflict, union and non-union blocs









were formed among the faculty members, and administrators be-

came divided on their approach to dealing with faculty mem-

bers. Additional areas of system strain included conflicts

between administrators, counselors and faculty, career serv-

ice employees and faculty, and disputes among persons of dif-

ferent academic disciplines.

These conflicts are the manifestations of the extensive

structural changes occurring in the community college during

the two years of this study and was the environment in which

the author began his research in August, 1976. His constant

interaction with these competing factions required cautious

and calculated actions to prevent alienation of one or more

groups against the innovation.

College-Community Interaction

Traditional relationships that existed among the commu-

nity college and other community institutions were initial

concerns of the author. Human service administrators and

workers did not use the community college as a resource for

training or consultation. The community college did not have

established communication networks with human service agen-

cies, i.e., it had not been operating as an open system.

Statewide Policies

A community college has other structural constraints.

It is part of a statewide network of colleges receiving fund-

ing and is guided by the general policy of the State Depart-

ment of Education and the legislature. Funding priorities

have traditionally been conservative in the matter of the









support of innovations in curriculum and programs of study.

The author began the diffusion of the innovation with no fi-

nancial resources from the college.

Attitudes Concerning Curriculum

Traditional curriculum in the community college includes

two components--academic and technical non-transfer programs

of study. The human services program does not fit the struc-

ture of either component. College personnel did not under-

stand a program that satisfied both academic and technical

needs. After the end of two years, in fact, many people

still had difficulty accepting a program that bridged both

component areas.

Faculty in the Social Science Division were not accus-

tomed to "applying" their knowledge of humanity to practical

problems. The author and his methods were considered to be

new and different by most members of the division.

Another constraint was the traditional attitudes of psy-

chology instructors in the division. Five of 14 faculty mem-

bers were trained in this discipline. Four of them offered

initial resistance to the development of the innovation. Ap-

parently this resistance was related to their belief that

psychology is not a human service to be included in the pro-

gram. However, one psychologist did become a major opinion

leader and influenced the other four to eventually accept the

innovation during the two year period.









Organizational Needs for Innovation

In August, 1976, the author selected the college as the

innovating organization. The expected functions of the com-

munity college, as well as the felt needs of administrators,

faculty, and students for the innovation, were the most im-

portant reasons for the decision.

Expected Functions of the College

At the beginning of the study, the college was the major

provider of higher education services to the area. Limited

educational programs were available from the University of

South Florida-Fort Myers campus. However, the community col-

lege offered a wider range of resources and community recog-

nition for the innovation.

In contrast with the university system, community col-

leqes are oriented to meeting local community educational

needs. These cultural values associated with the community

college and its expected function made it easier for the in-

novation to be accepted by key administrators.

Felt Needs of Administrators

College administrators expressed an interest for the au-

thor to develop educational programs which would not only

meet community needs, but also result in increased revenues

for the organization. For these reasons both the Social Sci-

ence Chairman and Vice President were among the first group

of opinion leaders to adopt the innovation. In fact, it was

their initial support which convinced the author that such an

endeavor was possible.









Administrators are also interested in programs which in-

crease student enrollments. These increases are directly re-

lated to increased funding for the college. The new educa-

tional programs included in the innovation were seen as po-

tential sources of new students, particularly ethnic minor-

ities and those who might not otherwise attend college.

Felt Needs of Faculty

Social science faculty expressed needs to the author for

additional financial income due to the relatively low sala-

ries paid to them by the college. The potential for earning

overload and consulting fees from instructing in the new pro-

grams were a motivation for faculty acceptance and participa-

tion in the innovation. Two faculty members, a psychology

and a political science instructor, were initially concerned

with other aspects of the innovation in addition to financial

income. They shared the author's interest in developing new

concepts in human service training.

Felt Needs of Students

Edison Community College students had been requesting an

"applied social science" program prior to the author's employ-

ment, according to some faculty and administrators. Students

did not previously have course or program offerings which pro-

vided human service education and practical experience. As

the author discussed the potential offerings with students in

his first month of teaching, it was apparent that a felt need

existed among students for innovation.










Summary

Edison Community College was selected by the author as

the innovating organization. A preliminary assessment of in-

stitutional constraints, as well as the needs for innovation,

supported the author's initial impressions that a new program

was possible. Conditions were generally favorable in Septem-

ber, 1976, to institutionalize the innovation so that the

college could serve as a donor network to the recipient human

service networks.
















CHAPTER VIII
THE HUMAN SERVICE SYSTEM



Lee County's human service system is a microcosm of lar-

ger state and national level systems. This chapter begins

with a discussion of the influence of American cultural

values and patterns for human service delivery on the recip-

ient networks in the county. It is followed by a detailed

review of the 1976 status of the Lee County human service

networks of health, mental health, aged, government, mental

retardation, public assistance, and education services. The

discussion of each service network includes an assessment of

the felt need for innovation in training among its practi-

tioners.

In the United States, cultural values of the dominant

social and ethnic groups, i.e., the white middle and upper

classes, greatly influence the types of services provided,

the availability of services, and the methods of service de-

livery. The national and local human service systems are re-

flections of traditional cultural patterns, knowledge about

the nature of societies, the role of the government in serv-

ice delivery, the nature of relationships of individuals with

kin, family and friends, the use of "total institutions"

(Goffman, 1961), and the form and effectiveness of training

for service providers.










Problems encountered by human service consumers in the

United States and Lee County include fragmentation of serv-

ices, overlapping of system boundaries, institutionalized

prejudice, bureaucratic constraints, and inertia. The na-

tional and local systems both contain component networks which

are often thought to be unrelated. Formal human services are

not delivered in a comprehensive, coordinated manner with

open communication flow among the subsystems, i.e., networks.

Administrators, service providers, and consumers per-

ceive human services as distinct network areas which include

mental and physical health, education, government, youth, ag-

ing, economic assistance, and mental retardation. The fol-

lowing description of each network is based on the author's

preliminary interviews and observations and includes the fol-

lowing:

1. cultural values and patterns relative to
service delivery;
2. specific agencies in Lee County and
3. the needs for a new form of human service
worker training.

Socio-cultural Context of Mental and Physical Health

The prevention of illness and the curing of disease con-

stitutes an area of interest to the people of all cultures.

No human group lacks an explanation for the conditions that

must be fulfilled or maintained for the individual to enjoy

good health and for the causes of illness. Medical systems

are integral parts of the cultures in which they are found.

They cannot be understood simply in terms of curing practices,

medical practitioners, and hospital services. Only a partial









understanding of a medical system can be gained unless other

components of the culture, i.e., economics, religion, social

relationships, education and family structure, are related to

it (Clark, 1973:1).

An important cultural pattern in the United States is

conceptualization of "mental" and "physical" health as sepa-

rate and distinct service delivery areas. Funding resources,

training of healers, identifying illness, and seeking cures

are all influenced by this body and mind dichotomy. The con-

sumer seeking well-being from an identified malady must

choose from mental or physical health practitioners. This

unrealistic dichotomy is perhaps a major influence on the

fragmentation of healing services and lack of emphasis on un-

derstanding the individual as a holistic system.

In both health and mental health services, the profes-

sional workers tend to come from the segment of society refer-

red to as either "middle" or "upper-middle" class. Their pa-

tients come from all strata of the society. Cultural bar-

riers often occur in the service provider-consumer interac-

tion resulting from value system conflicts (Taylor, 1970:151-

152).

Spatial distribution of health and mental health facili-

ties is another factor influencing service delivery, von

Mering et al. demonstrate that with increasing distance of an

individual from a health facility there is a decreasing tend-

ency for utilization (1976:381).




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