Variance and DissentThe OFF theory of research utilization
Section snippets
Theoretical hierarchies
In addition to being the only theory to fit the definition of theory used by Eccles, the OFF theory is in the highest level of theories.
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Level one: acronyms (beyond logic); e.g., FES (the flat earth society)
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Level two: proper names (logical but not relying on common sense or evidence)
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Level three: meaningful names (logical and incorporating common sense but not relying on evidence)
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Level four: no name (based on logic, common sense, and evidence)
OFF stands for Oxman, Flottorp and Fretheim. Although
The You Need a Theory theory
Eccles et al. theorize that we need a theory-based framework to design and conduct interventions to change the behavior of healthcare professionals. They suggest that there is no a priori reason to expect success of strategies that are not theory based and that theories are necessary to look into the black box of why an intervention has or has not worked. Poppycock. The history of medicine is littered with the dead bodies of patients who were treated based on good theories. Similarly, ignoring
Desirable attributes of theories
Eccles et al. [1], in their exposition of the You Need a Theory theory, call for theories with demonstrated effectiveness in other settings, explanations of behavior in terms of changeable factors, and inclusion of nonvolitional components. In addition to not having a decent acronym for their theory, they have selected a set of criteria for selecting a theory with which we disagree. We would suggest the following alternative criteria for selecting a theory: (1) Evidence of usefulness in the
Conclusion
Theoretical, according to Webster, is synonymous with conjectural, hypothetical, speculative, suppositional, postulatory, putative, abstract, academic, and nonpractical. Antonyms include proven, known, verified, corroborated, demonstrated, substantial, established, practical, and applied. Eccles et al. want to “raise implementation research to the level of other clinical sciences” by making it more theoretical. That is not an inspiring rallying call. We offer an alternative: Let us work
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Cited by (63)
Patient-mediated interventions to improve professional practice: A summary of a Cochrane systematic review
2019, Patient Education and CounselingCitation Excerpt :As with many other behavioural change interventions, the interventions in this field are sometimes based on explicit theoretical approaches, but often they are not [41,42]. The importance of basing interventions on theory is contested [43], but a clearer understanding of the mechanisms through which patient-mediated interventions may work would likely be helpful. In addition to the challenge of categorising different types of patient-mediated interventions, we also had difficulties with the categorisation of comparisons.
Implementation Science
2019, Encyclopedia of Pharmacy Practice and Clinical Pharmacy: Volumes 1-3Can we measure ‘Sensationalisim’ and ‘Spin’?
2016, Journal of Clinical EpidemiologyOpportunities to improve the impact of two national clinical audit programmes: a theory-guided analysis
2022, Implementation Science Communications