TSci Impact Framework and Pain Management

What Spoth et al’s designed as the Translation Science to Population Impact (TSci Impact) framework is a kind of road map for planning an effective KT strategy in different health related fields.

Although I am struggling with the broadness of this model, I found it helpful to identify multi-level contributors/factors to any KT plan. 

I liked the framework because it is broad enough to encompass any research/individual/society related elements. My only concern is that how a researcher would assess  role-players performance in any four phases of KT function. For instance, Broth et al. state that pre-adoption phase “focuses on intervention, consumer, provider, and organizational characteristics that could influence the ultimate adoption of EBIs” (p. 323). They also assert that “wide-ranging factors” should been systematically investigated for the fulfillment of each phase goals. My question here is how?

What I liked the most about this model was dedicating a specific phase for “sustainability” that examines “how EBIs are maintained or institutionalized over the long term, or expanded within and across specific settings or services delivery systems” (p. 324). This is the most complicated process and if attains, that would be an incredible success.

I also find Table 1 of this article very useful, particularly in terms of “examples of key research questions”. Depending on at what stage a researcher is more interested, she can use the example questions as a very good start.


Based on this framework, I would like to develop a model for KT in the field of pain management. According to Statistic Canada in 2012, 14.1% of BC population aged 12 and over reported having pain or discomfort that prevents activities, plus 11.5 % of British Colombians complained of moderate or severe pain or discomfort. Therefore, from every 4 BC residents, one experienced pain in 2012. This number is gradually increasing from 2003 every year.


According to Pain in Canada Fact Sheet, Chronic pain costs more than cancer, heart disease and HIV combined. “Estimates place direct health care costs for Canada to be more than $6 billion per year and productivity costs related to job loss and sick days at $37 billion per year” (Phillips and Schopflocher 2008; Schopflocher, Jovey et al. 2010).

Therefore, I would like to work on KT strategies for managing pain.

Using Table 2 of Spoth’s article, I would set my “high priority research questions”:

  1. Pre-adoption: how do various preferences about evidence-based interventions attributes influence ultimate patients’ choices and demand who are struggling with pain?
  2. Adoption: how are various types of evidence used by patients in their adoption decision making?
  3. Implementation: which systems factors are most important in quality implementation of specific evidence-based interventions for patients in pain?
  4. Sustainability: what funding models and financing systems are most conductive to sustainability? (I would probably change my approach here, and try to answer the sustainability question for patients in pain by employing motivational theories and frameworks)

I would work on those questions for the rest of the semester.




Picture: http://news.yale.edu/sites/default/files/imce/beech-interior.jpg


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