1. Models + Frameworks Measurement Efficacy Efficiency Effectiveness
Burden of disease
Causation
Determinants
Implementation
Measurement
Efficacy
Efficiency
Effectiveness
After P Tugwell, 1985

2. Selye’s Stress Model

3. Defining Dimensions of Quality of Life and Health-Related Quality of Life
Health Canada-Quality of Life
Mayo Clinic- Health-Related Quality of Life

4. Professional Expertise Model

5. Models + Frameworks Measurement Efficacy Efficiency Effectiveness
Burden of disease
Causation
Determinants
Implementation
Measurement
Efficacy
Efficiency
Effectiveness
After P Tugwell, 1985

6. Generic Predictive Model

7. International Classification of Determinants of Functional Outcomes
ICF Model
Application to COPD

8. Theory of Planned Behavior Ajzen, 1985, 1991, 2001

9. CIHR: Causal Map for Identifying Determinants and Policy Priorities for Obesity in Canada

10. Public Health Model of Determinants of Diarrheal Disease

11. Models + Frameworks Measurement Efficacy Efficiency Effectiveness
Burden of disease
Causation
Determinants
Implementation
Measurement
Efficacy
Efficiency
Effectiveness
After P Tugwell, 1985

12. The Precede-Proceed Model of Health Program Planning & Evaluation Green, Lawrence: Health Program Planning: An Educational and Ecological Approach, New York: McGraw-Hill, 2005.
Heath Education,
Media,
Advocacy
Predisposing
Lifestyle
Quality of Life
Health
Reinforcing
Policy,
Regulation,
Resources.
Organization
Environment
Enabling

13. Patho-physiological Models Alternate Therapy Targets for Multi-Drug Resistance in TB

14. Models + Frameworks Measurement Efficacy Efficiency Effectiveness
Burden of disease
Causation
Determinants
Implementation
Measurement
Efficacy
Efficiency
Effectiveness
After P Tugwell, 1985

15. Ottawa Model of Research Use
Assess Monitor Evaluate
Innovation
Potential Adopters
Interventions
Adoption
Outcomes
When the barriers related to the practice environment, potential adopters and innovation have been addressed, strategies are designed to disseminate the new practice for use.
Practice Environment
University of Ottawa/ CIHR 16

16. Ottawa Model of Research Use
Assess Monitor Evaluate
barriers & supports interventions outcomes & degree of use
Innovation
(CPG, tools)
Potential Adopters
Interventions
Adoption
Outcomes
When the barriers related to the practice environment, potential adopters and innovation have been addressed, strategies are designed to disseminate the new practice for use.
Practice Environment
University of Ottawa/ CIHR 16

17. Ottawa Model of Research Use
Assess Monitor Evaluate
barriers & supports interventions outcomes & degree of use
Innovation
Implementation
Interventions
barrier
management
transfer
follow-up
Potential Adopters
Outcomes
Adoption
When the barriers related to the practice environment, potential adopters and innovation have been addressed, strategies are designed to disseminate the new practice for use.
Practice Environment
University of Ottawa/ CIHR 16

18. Ottawa Model of Research Use
Assess Monitor Evaluate
barriers & supports interventions outcomes & degree of use
Innovation (guideline)
development process
innovation attributes
Potential Adopters
awareness
attitudes
knowledge/skill
concerns
current practice
Interventions
barrier
management
transfer
follow-up
Adoption
intention
use
sustained use
Outcomes
patient
practitioner
system
When the barriers related to the practice environment, potential adopters and innovation have been addressed, strategies are designed to disseminate the new practice for use.
Practice Environment
structural
culture/social
patients
economic
University of Ottawa/ CIHR 16

19. Ottawa Model of Research Use
Assess Monitor Evaluate
barriers & supports interventions outcomes & degree of use
Innovation
development process
innovation attributes
Potential Adopters
awareness
attitudes
knowledge/skill
concerns
current practice
Outcomes
patient
practitioner
system
Interventions
barrier
management
transfer
follow-up
Adoption
intention
use
sustained use
When the barriers related to the practice environment, potential adopters and innovation have been addressed, strategies are designed to disseminate the new practice for use.
Practice Environment
structural
culture/social
patients
economic
University of Ottawa/ CIHR 16

20. Micro-Theories of Adoption Technology Acceptance Model
2 ½%
Innovators
34%
Early
majority
34%
Late
majority
16%
Laggards
These physicians could be considered to be early adopters of technology.
Research demonstrates that the success of technology diffusion depends on the experience of this group.
Also market evidence in NA of substantial rejection rate in e-rx systems, with no real evaluation
Within this group, the ability to predict the rate of utilization will be associated with the likelihood of success, the speed of the diffusion, and the magnitude of the benefit for improving safety and qualitiy.
Although efficiency and integration issues have been proposed as reasons for failure to utilize e-rx systems, there is sufficient variation in utilization rates to warrant further investigation.
Equally important is the fact that drivers of physician behaviour in the current system (including remuneration schemes, access to physicians, lack of integration of care, lack of practice evaluation/measurement of quality and safety). The question remains then, what predicts physicians utilization of e-rx.
13 ½%
Early adaptors
Time to adoption of innovations

21. Predicting the Adoption of Electronic-Prescribing
e-RX Utilization
Practice Characteristics
Continuity of Care
Practice Volume
Practice Size
Medication Use
Gender
Age
Computer Experience
Information Acquisition Style
Perceived Value
of Technology
Perceived Ease
Of Use
Perceived
Usefulness
Social
Influence
Behavioural
Intention
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 Utilization (p-value 0.001)
Explains 86% of Behavioural Intention (p-value <0.001)
Facilitating Conditions:
Physician Characteristics
Explains 23% of Utilization (p-value 0.32)
Adjusted R2=8.4%
Adjusted R2=82.1%
Adjusted R2=3.6%
Adjusted R2=29.6%
Adjusted R2=0.9%