From a visible health problem to an actionable research priority: Development and demonstration of the...

To develop and demonstrate the VISIBLE-to-ACTION framework as a transparent method for moving from a documented health problem to a defensible research priority, while distinguishing research, evidence, decision, and implementation gaps. The framework addresses the limitation of conventional gap statements that rely primarily on claims that few studies exist without establishing why additional evidence is necessary.

A structured conceptual synthesis was undertaken across four established literatures: health research priority setting, evidence-gap mapping, knowledge translation/evidence-informed policy, and implementation science. Core constructs were retained only when they addressed problem verification, expected-versus-observed conditions, evidence insufficiency, decision relevance, or actionability. The resulting framework was iteratively specified as seven VISIBLE stages plus an ACTION test. A worked application to diabetes self-management in the Philippines was then used to operationalize the framework. Candidate gaps were scored on seven explicitly defined 1-5 criteria using equal weights; scores were treated as a transparent reasoning aid, not as a validated instrument.

The framework extends conventional research-gap identification from a literature-counting exercise toward an evidence-to-action process. VISIBLE-to-ACTION links problem verification to a defined decision that remains unsupported by adequate evidence. The worked application distinguished practical, population/context, methodological, implementation/sustainability, and decision gaps and identified a priority question concerning which context-sensitive determinants and intervention components can be implemented equitably and sustained in routine primary care. Comparison with established approaches showed that the framework is complementary rather than a replacement: evidence-gap maps organize evidence, priority-setting methods select priorities, implementation frameworks explain uptake and sustainment, logic models connect activities to outcomes, and knowledge-translation approaches guide evidence use.

VISIBLE-to-ACTION provides a structured approach for developing research rationales that move beyond the assertion that "few studies exist" toward identifying evidence that is necessary for an important health decision. The framework is a conceptual reasoning tool with a worked demonstration, not a validated prioritization instrument. Its transferability should be tested in additional diseases, policy settings, emerging topics, and data-poor environments using stakeholder-based and reliability-focused evaluations.