Adoption of innovations from applied behavioral research: "Does anybody care?".

Sulzer-Azaroff (1981) asked one blunt question: why do great ABA tools sit on shelves? The paper lists ten levers that decide if a new practice spreads or dies. Think price, ease, visibility, fit with local values, and six more.

No new data were collected. Instead, the author stitched together diffusion studies from farming, medicine, and education to build a checklist any BCBA can use.

The ten levers form a road map. If a program is cheap, simple, and easy to watch in action, people pick it up. If it needs special gear or clashes with culture, it stalls.

The author warned that even proven fixes fail when these levers are ignored.

Virues-Ortega et al. (2021) shows the map in action. Their story of Nathan Azrin mirrors the ten levers: he cut costs, ran public demos, and trimmed steps so shelters could copy his methods.

Doughty et al. (2015) extends the idea to whole schools. PBIS spread because states made it free, gave ready-made packets, and let teachers see gains in hallways—exactly the observability and trialability levers.

Sengupta et al. (2025) adds a caution. In India, the WHO caregiver program ticked most boxes yet still wobbled. Logistics and weak policy links—two levers the 1981 list flagged—turned out to be the last mile.

Sivaraman et al. (2020) and Ferguson et al. (2022) test the same logic in telehealth. They show that dropping travel cost and letting parents try short sessions raises uptake, again matching the 1981 variables.

Before you pilot a new intervention, score it on the ten levers. Can you cut price? Film a one-minute demo? Rename the steps so they sound like local slang? Small tweaks on these fronts often beat bigger effect sizes when you want a district or agency to adopt your work.