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Sudsawad, P. (2005). A conceptual framework to increase usability of outcome research for evidence-based practice. The American Journal of Occupational Therapy, 59, 351-355.
Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh. 1
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Purpose The purpose of the article was give an introduction to a
conceptual framework to guide the design,
implementation, and diffusion of research for thepurpose of increasing research utilization for EBP byoccupational therapy practitioners.
Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh.
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Evidence Based Practice (EBP)
Definition: EBP is defined as the conscientious,explicit, and judicious use of the current best evidencein making decisions about the care of individualpatients (Sackett, Richardson, Rosenberg, & Haynes,1997).
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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Barriers in utilization of research
outcomes:
1) Lack of relevance of research studies to practice.
2) Lack of communication of research results from theresearcher to the practicing therapists.
3) Lack of skills in interpreting research evidence.
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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Factors negatively affecting the potential for
high quality patient care:
Slow diffusion of research findings into practice
Scarcity of practice-based research
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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Diffusion of Innovations Theory (Rogers, 1995)
The Diffusions of Innovations Theory identifies theprocess and the factors influencing communication(diffusion) of an idea, practice, or object that isperceived as new (innovation).
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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Characteristics of innovations according to
The Diffusion of Innovations Theory:
Relative Advantage: Advantages over the existing ideas
Compatibility : Consistency with existing values, past
experiences and the current needs Complexity : Difficulty to understand
Triability : Degree of usage
Observability : Visibility of results
These characteristics influence the eventual use of theinnovation by the user.
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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According to The Diffusions of Innovations
Theory utilization of research for EBP should
increase if : Research findings have relative advantage over other
types of evidences.
Research conduct has good compatibility. Research has less complexity.
Research findings have good triability.
Research findings are observable.
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.
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Concepts that may facilitate research utilization
by practitioners.
Social Validity
Ecological Validity
Clinical Significance
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, Universit of Pittsbur h.
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Social Validity (Wolf, 1978)
Social Validity (SV) is defined as something of socialimportance.
Three questions to assess SV of the research processand outcomes are:
1. Are the goals of the intervention relevant to thesociety?
2. Are the intervention techniques acceptable to theconsumer or do they cost too much in terms of effort,
discomfort, ethics etc.3. Are the consumers satisfied with the intervention
outcomes?
Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh.
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How does SV help?
SV increases Compatibility.
SV increases Triability.
SV achieves this by involving both the consumers andthe practitioners in the research process.
Abhishek Rajan Desai,Graduate Student, MS Occupational Therapy,SHRS, Universit of Pittsbur h.
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Ecological Validity
Ecological Validity (EV) is defined as the functionaland predictive relationship between a personsperformance on a test and his or her performance in avariety of real-world settings (Sbordone, 1996).
EV emphasizes the importance of conveying research
findings in ways that are related to real-lifeperformances.
Hence, EV helps reduce Complexity.Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh.
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Clinical Significance
Clinical Significance is defined as a way to movebeyond merely showing statistically significant change(Kazdin & Kendall, 1988) because statisticallysignificant differences between groups do notnecessarily indicate practical, meaningful, or clinicallysignificant differences between groups (Ogles, Lunnen& Bonesteel, 2001)
Hence it helps increase Observability.
Abhishek Rajan Desai,Graduate Student, MS OccupationalThera SHRS Universit of Pittsbur h.
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Suggestions to facilitate the usability of
outcome research for EBP. Researchers should verify the relevance of research
questions/hypothesis.
Team up with practitionersIncludes consumers in research
Include natural environment
Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh.
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Message:The success of Evidence Based Practice depends onutilization of research findings. Hence research should
be designed, conducted and presented in a mannerwhich would facilitate greater utilization of researchfindings in to clinical practice.
Abhishek Rajan Desai,Graduate Student, MS OccupationalTherapy,SHRS, University of Pittsburgh.
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THANK YOU
Abhishek Rajan Desai,Graduate Student, MS OccupationalTh SHRS U i i f Pi b h
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