A Triangle Without the third Angle

A girl friend of mine believes that theories are the only tools for understanding the reality. She thinks that we think through theories; our ability to understand the reality is conceptualized in our mind by theories.  Seems that Tabak et al (2012) agree with her mostly! when they note that “theories present a systematic way of understanding events or behaviors by providing inter-related concepts, definitions, and propositions that explain or predict events by specifying relationships among variables” (p. 337).

As a starting point for this course, I found Bridging Research and Practice as a useful article. By identifying three main criteria for evaluating KT models as construct flexibility, focusing on dissemination and implementation activities and level of socioecologic operation, Tabak et al. provide a handy tool for assessing the usefulness of any other KT models.

Using this article, I would like to take a look at An Evidence Integration Triangle model by Glasgow, Green, Taylor, and Stange (2012). They criticize several research translation models as “too complex, academic or time-consuming for clinicians, community members, and health systems” (p. 646-7) and plan to represent a dynamic model beyond the current “traditional linear approach” to research translation (p. 646).

The Evidence Integration Triangle (EIT) aims to capture essential dimension of “an effective interaction between research and its practice/policy translation”. This model is designed to be “more intuitive” (p. 647). It probably means being “broad” in terms of construct flexibility (Tabak et al) and broad models are not necessarily useful ones because they “loosely outlines and defined constructs” although they allow researchers more flexibility to use it for different contexts.

This model wants to focus on implementation rather than dissemination as policy change is a key point for the model designers.  In addition, in terms of socioecologic framework, EIT tries to operate in multiple levels of individuals, organizations, community, and system as Glasgow et al. emphasize that it is designed to be “readily applied by stakeholders, including practitioners, policymakers and citizens for fostering high-impact knowledge implementation by research practitioner community partnerships” (p. 647).

For me, this model is a linear model by concept.  Under the title of Example Application, the authors state that the example of EIT “describes in detail elsewhere” (p. 652). In addition,they consider to the multilevel context in the model and believe researchers should pay attention to interpersonal/biological, interpersonal/family, organizational, policy, community/econiomic, and social/environmental and historical contexts without answering the question of “how”.

Really, how a researcher should measure all those influencing factors in the process of implementation? Glasgow et al state that “implementation success needs to be monitored”. How the effect of contextual factors can be monitored in the process? No answer in the article.

Another confusion in this model is about one of the angles; what is the exact difference between one practical process measurement and the constant feedback among the involved stakeholders? “Standardized, practical measures are needed to evaluate process toward goals and objectives” (p. 648). Any example of these standardized measures? Any difference between them and feedback? 

I didn’t get the answer.

 

 Glasgow, RE., et al. (2012). Evidence integration triangle for aligning science with policy and practice. American Journal of Preventive Medicine, 42(6), 646-654.

 

Tabak RG, Khoong EC, Chambers DA, Brownson RC. (2012). Bridging research and practice: models for dissemination and implementation research. American Journal of Preventive Medicine, 43(3), 337-350.

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