Disruptive Innovations

Interventions that Change the Status Quo
Dr. Rotheram designs and implements interventions that have lasting effects on research science and public health, in part because she has long been committed to finding and including in her program designs what Harvard’s Clayton Christensen has called disruptive innovations: new ways of approaching health care and science that shake up the industry by making something easier, less expensive, and better. Beginning with her early successes changing the way shelters think about teen suicide prevention and turning social skills into a game for elementary school students, Dr. Rotheram has continuously implemented her vision of making science useful, realistic, and accessible to those who need it.

Several of the programs Dr. Rotheram created have been awarded high honors, including designation as model programs by the American Medical Association, the American Psychological Association, and the Centers for Disease Control and Prevention. Her Street Smart initiative, the first drug and HIV prevention program for homeless youth, was included in the CDC’s first Compendium of HIV Prevention Interventions with Evidence of Effectiveness in 1999. By 2007 the CDC had awarded eight of her programs their designation of evidence-based behavioral interventions (EBIs): 1) Street Smart, 2) Teens Linked to Care, 3) Project LIGHT, 4) CLEAR, 5) Adolescent Project LIGHT; 6) Healthy Living; 7) Imminent Danger; 8) Safety Counts. 

Today, Dr. Rotheram’s HIV prevention programs represent more than 10% of the CDC’s Diffusion of Effective Behavioral Interventions (DEBI) strategy, and have a major impact on the HIV prevention activities currently taking place throughout the United States.

Dr. Rotheram has, through her research and her teaching, advocated for disruptive innovations to provide better prevention services more efficiently and at lower cost than conventional programs. For example, in South Africa where clinics are limited and healthcare access is difficult, she pioneered a program for training peer mentors that used cell phones and computers to reach more people. In Uganda she adapted a U.S. model for HIV prevention outreach for homeless youth by including a vocational training component after learning about the cultural differences that affected the Ugandan at-risk populations. In these and similar instances of innovation and vision, Dr. Rotheram has recast the way scientists think about prevention and health.