models + frameworks burden of disease causation determinants efficacy effectiveness efficiency...
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Models + Frameworks
Burden of disease
Causation Determinants
Efficacy
Effectiveness
Efficiency
Implementation
After P Tugwell, 1985
Measurement
Selye’s Stress Model
Defining Dimensions of Quality of Life and Health-Related Quality of Life
Mayo Clinic- Health-Related Quality of Life
Health Canada-Quality of Life
Professional Expertise Model
Models + Frameworks
Burden of disease
Causation Determinants
Efficacy
Effectiveness
Efficiency
Implementation
After P Tugwell, 1985
Measurement
Generic Predictive Model
International Classification of Determinants of Functional Outcomes
ICF Model
Application to COPD
Theory of Planned BehaviorAjzen, 1985, 1991, 2001
CIHR: Causal Map for Identifying Determinants and Policy Priorities for Obesity in Canada
Public Health Model of Determinants of Diarrheal Disease
Models + Frameworks
Burden of disease
Causation Determinants
Efficacy
Effectiveness
Efficiency
Implementation
After P Tugwell, 1985
Measurement
The Precede-Proceed Model of Health Program Planning & Evaluation
Green, Lawrence: Health Program Planning: An Educational and Ecological Approach, New York:
McGraw-Hill, 2005.
Quality of Life
Lifestyle
Health
Environment
Heath Education, Media, Advocacy
Policy, Regulation, Resources. Organization
Patho-physiological ModelsAlternate Therapy Targets for Multi-Drug Resistance in TB
Models + Frameworks
Burden of disease
Causation Determinants
Efficacy
Effectiveness
Efficiency
Implementation
After P Tugwell, 1985
Measurement
University of Ottawa/ CIHR
Assess + Monitor + Evaluate
Practice Environment
Potential Adopters
Innovation
Interventions
Adoption
Outcomes
Ottawa Model of Research Use
University of Ottawa/ CIHR
Assess + Monitor + Evaluatebarriers & supports interventions outcomes & degree of use
Practice Environment
Potential Adopters
Innovation
(CPG, tools)
Interventions Adoption Outcomes
Ottawa Model of Research Use
University of Ottawa/ CIHR
Practice Environment
Potential Adopters
Innovation
Implementation
Interventions
• barrier
management
• transfer• follow-up
Adoption Outcomes
Ottawa Model of Research Use
Assess + Monitor + Evaluatebarriers & supports interventions outcomes & degree of use
University of Ottawa/ CIHR
Practice Environment
• structural• culture/social• patients• economic
Potential Adopters
• awareness• attitudes• knowledge/skill
• concerns• current practice
Innovation (guideline)
• development process
• innovation attributes
Interventions
• barrier
management
• transfer• follow-up
Adoption• intention• use• sustained use
Outcomes• patient• practitioner
• system
Ottawa Model of Research UseAssess + Monitor + Evaluatebarriers & supports interventions outcomes & degree of use
University of Ottawa/ CIHR
Practice Environment
• structural• culture/social• patients• economic
Potential Adopters
• awareness• attitudes• knowledge/skill
• concerns• current practice
Innovation• development process
• innovation attributes
Interventions
• barrier
management
• transfer• follow-up
Adoption• intention• use• sustained use
Outcomes• patient• practitioner
• system
Ottawa Model of Research Use
Assess + Monitor + Evaluatebarriers & supports interventions outcomes & degree of use
Micro-Theories of AdoptionTechnology Acceptance Model
2 ½%2 ½%InnovatorsInnovators
13 ½%13 ½%Early adaptorsEarly adaptors
34%Early
majority
34%Late
majority16%
Laggards
Time to adoption of innovationsTime to adoption of innovations
e-RX Utilizatio
n
Continuity of CarePractice
VolumePractice
SizeMedication
Use
GenderAge Computer
ExperienceInformation Acquisition
Style
Perceived EaseOf Use
PerceivedUsefulness
SocialInfluence
Adapted from Venkatesh, Morris, Davis, Davis (2003) User Acceptance of Information Technology: Toward a Unified View, MIS Quarterly, 27 (3), p.447
Explains 4% of Utilization (p-value
0.29)
Explains
15% of
Utilization
(p-value
0.07)
Explains 40%
of Utili
zatio
n
(p-value
0.001)
Explains 86% of Behavioural
Intention (p-value <0.001)
Explains 23% of Utilization (p-value 0.32)
Adjusted R2=8.4%
Adjusted R2=82.1%
Adjusted R2=3.6%
Adjust
ed R
2 =29.6
%
Adjusted R2=0.9%
Predicting the Adoption of Electronic-Prescribing