Both regions interviewed did conduct meetings with groups, but these were not specifically target at members of the underprivileged, illiterate group and were not held to discuss the innovation.

There was no direction from DHCS in the "Standards" document to concentrate efforts on those who might be late adopters. Chaffee (1986) states that late adopters may rely more on interpersonally transmitted information, which could be due to a lack of resources, including literacy. If the literacy level of the target public had been understood, theory suggests the focus on late adopters would help address the issue.

2. When the privileged have greater access to information from peers than do the underprivileged:
   • identify the opinion leaders of the lower socio-economic status portion of the target audience and feed them information

Identification of opinion leaders of any group within the target population was not a strategy developed or recommended by DHCS in the "Standards" document. Opinion leaders are a key subsection of any public and identifying and informing them can be an effective tool in message dissemination. These leaders would have been particularly helpful in reaching the underprivileged, illiterate group, as the communication of such leaders is usually verbal.

3. When the privileged have more slack resources available for complying with the message to innovate than do the underprivileged:
   • recommend innovations and behaviours that are appropriate to the lower socio-economic status portion of the target audience
   • invite the lower socio-economic portion to take part in the planning of the program

As the health system in Canada is a public system, resources available for complying with the innovation, apart, possibly, from transportation in some remote areas, are not a difficulty. The innovation is appropriate to the target group, including the lower socio-economic portion.

The suggestion of involving the lower socio-economic portion of the group in planning communication could have been considered. Of course, recognising that group, in this case the illiterate portion of the target population, is the first step. Once the group is identified, holding discussions with members of the group to develop strategies to effectively communicate to it, would inform the planning. For a group that is defined by illiteracy, recruitment of members for planning might prove problematic due to the stigma of illiteracy. However, this exercise was not attempted in any way by DHCS.