ABSTRACT
Macarov (1978) identified four major determinants of technological change: (a) scientific feasibility, (b) technical feaSibility, (c) economic practicality, and (d) social acceptability. Even when scientific, technical, and economic determinants are favorable, many things that can be done will not occur in a consistent manner unless and until they are socially
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acceptable. According to Macarov (1978), social acceptance is influenced by (a) technological forces (for example, technical diffusion is changing education, medical practice, professional/community outreach programs, forms and quality of social interaction and support), (b) economic changes (for example, multiple changes have impacted cost-effectiveness of health care services. A primary change is managed care, a force that has curtailed many services and added many hours per month that are not direct client services to the professional workload. Many professionals who were in private practice have elected to work for agencies or have left the field entirely), (c) ideas and people (for example, Harrington's [1963] The Other America which was a force in the War on Poverty of the Johnson administration. Martin Luther King, Jr., Margaret Sanger, Rachel Carson, and Benjamin Spock all impelled changes in awareness and social action), and (d) physical changes (for example, epidemics, natural disasters, toxic waste, and deforestation lead to widespread social effects and responses. One of the most pronounced of contemporary social change agents is AIDS).
