Sudsawad, P. (2005). A conceptual framework to increase usability of outcome research for evidencebased practice.

The American Journal of Occupational Therapy, 59, 351-355.

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

Purpose
The purpose of the article was give an introduction to a

conceptual framework to guide the design, implementation, and diffusion of research for the purpose of increasing research utilization for EBP by occupational therapy practitioners.

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

Evidence Based Practice (EBP)

Definition: EBP is defined as the conscientious,

explicit, and judicious use of the current best evidence in making decisions about the care of individual patients (Sackett, Richardson, Rosenberg, & Haynes, 1997).

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh.

Barriers in utilization of research outcomes:

1) Lack of relevance of research studies to practice. 2) Lack of communication of research results from the

researcher to the practicing therapists. 3) Lack of skills in interpreting research evidence.

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh.

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.

Diffusion of Innovations Theory (Rogers, 1995)

The Diffusions of Innovations Theory identifies the

process and the factors influencing communication (diffusion) of an idea, practice, or object that is perceived as new (innovation).

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh.

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 the innovation by the user.
Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh. 7

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.

Concepts that may facilitate research utilization by practitioners.

Social Validity Ecological Validity Clinical Significance

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh.

Social Validity (Wolf, 1978)

Social Validity (SV) is defined as something of social

importance. Three questions to assess SV of the research process and outcomes are: 1. Are the goals of the intervention relevant to the society? 2. Are the intervention techniques acceptable to the consumer 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 Occupational Therapy,SHRS, University of Pittsburgh. 10

How does SV help?

SV increases Compatibility.
SV increases Triability.

SV achieves this by involving both the consumers and the practitioners in the research process.

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy, SHRS, University of Pittsburgh.

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Ecological Validity
Ecological Validity (EV) is defined as the functional

and predictive relationship between a persons performance on a test and his or her performance in a variety of real-world settings (Sbordone, 1996).
EV emphasizes the importance of conveying research

findings in ways that are related to real-life performances.

Hence, EV helps reduce Complexity.
Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh. 12

Clinical Significance
Clinical Significance is defined as a way to move

beyond merely showing statistically significant change (Kazdin & Kendall, 1988) because statistically significant differences between groups do not necessarily indicate practical, meaningful, or clinically significant differences between groups (Ogles, Lunnen & Bonesteel, 2001)
Hence it helps increase Observability.
Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

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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 practitioners Includes consumers in research Include natural environment

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

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Message:
The success of Evidence Based Practice depends on utilization of research findings. Hence research should be designed, conducted and presented in a manner which would facilitate greater utilization of research findings in to clinical practice.

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

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THANK YOU

Abhishek Rajan Desai, Graduate Student, MS Occupational Therapy,SHRS, University of Pittsburgh.

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