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Occupational Therapy and Rehabilitation Sciences

Guide to locating OT and Rehabilitation research evidence in books, journal articles, databases, and on the web.

Defining the Question: Background and Foreground Questions

Background questions can help you develop foundational knowledge about whatever topic interests you.

Topic example: mindfulness training and chronic pain management in patients with fibromyalgia

Here are some examples of background questions related to the topic:

  • What populations of people are most impacted by fibromyalgia?
  • What types of therapies are most commonly used to treat pain in fibromyalgia patients?
  • How is mindfulness defined? Are there different types of mindfulness training? If so, what are they?
  • What are the core principles underlying mindfulness and mindfulness training?
  • How does one measure chronic pain?

The Find Background Information section of this guide lists useful sources for answering background questions.

Foreground questions are specific. They often deal with a particular therapy or intervention of interest.

A research question framework can help you organize the concepts in your foreground question. There are a number of different frameworks. The one you choose should correspond to the type of question you are asking.

  • PICO (Problem/Population, Intervention, Comparison, Outcome): The most common clinical question framework. Useful for clinical questions addressing the effect of an intervention, therapy, or treatment. 
  • ECLIPSe (Expectation, Client Group, Location, Impact, Professionals, Service): Useful for questions about policy and services.
  • PCC (Population/Problem, Concept, Context): Useful for broad scoping questions.
  • PEO (Population, Exposure, Outcome): Useful for describing association between exposures/risk factors and outcomes.
  • SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation): Useful for evaluating the outcomes of a service, project, or intervention.
  • SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type): Useful for questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research).

PICO Framework Example

P (Population/Problem of Interest) = People with fibromyalgia

I (Intervention) = Mindfulness training

C (Comparison Intervention) = Cognitive behavioral therapy

O (Outcome) = Chronic pain management

How effective is mindfulness training compared to cognitive behavioral therapy (CBT) for chronic pain management in people with fibromyalgia? 

ECLIPSe Framework Example

E (Expectation) = To increase access to occupational therapy services

C(Client Group) = People with chronic pain living in rural communities

L(Location of service or policy) = Hospitals

I(Impact of service or policy) = Increased utilization of occupational therapy services by people with chronic pain living in rural areas

P(Professionals involved in offering the service or policy) = Occupational therapists, Hospital administrators

Se(Service)=Occupational therapy services

How can occupational therapists and hospital administrators work together to increase utilization of hospital-based occupational therapy services by people with chronic pain who live in rural areas?

PCC Framework Example

P(Population characteristics or Problem focus)=Graduate students

C(Concept being examined)=Technological literacy

C(Context for the question - could include geographic location, setting of interest, etc.)=Occupational therapy programs

How do occupational therapy programs teach and measure the technological literacy of their graduate students throughout their educational programs?

PEO Example

P(Population)=Novice occupational therapists

E(Exposure)=Mentoring programs

O(Outcome)=Professional confidence

What impact do mentoring programs have on the professional confidence of novice occupational therapists?

SPICE Example

S(Setting)=Occupational therapy graduate programs

P(Perspective)=New occupational therapy graduate students

I(Intervention/Interest/Exposure)=Mindfulness training

C(Comparison)=No mindfulness training

E(Evaluation)=Reduced stress levels

What is the impact of mindfulness training on the stress levels of new occupational therapy graduate students?

SPIDER Example

S(Sample, i.e. the group being studied)=Occupational therapists

PI(Phenomenon of Interest, i.e., the reason for the behavior or decisions)=Clinical placements in rural communities

D(Design, i.e. how the research was collected)=Surveys and interviews

E(Evaluation, i.e. the outcome being impacted)=Attitudes and experiences

R(Research type)=Qualitative, quantitative, or mixed methods

What are the experiences of occupational therapists in clinical placements in rural communities?