Supporting diverse stakeholder engagement in implementation of evidence for children’s pain management: A discrete choice experiment study protocol


Canada is an international leader in children’s pain management research, yet children’s pain management solutions are infrequently implemented. Researchers have identified barriers and facilitators of implementation that apply to children’s pain management; however, these studies have not distinguished unique needs to support effective implementation across stakeholder types (e.g., researchers, health professionals, etc.). Examining what factors best support implementation in children’s pain from different stakeholder perspectives can inform tailored recommendations for stakeholder engagement to improve child health outcomes. The current objective is to present the protocol for a study that will use discrete choice experiments to examine the unique preferences of three stakeholder groups (i.e., parents/caregivers, health professionals, and researchers) for promoting implementation of evidence-based practices to improve children’s pain management. This study is the first to apply discrete choice experiments, an experimental research method, to understand stakeholder preferences for pediatric pain science implementation.


This study uses discrete choice experiments (DCE), an emerging mixed-methods approach to identify stakeholder preferences for implementing evidence-based practices for children’s pain management. The goal of DCE is to determine the factors that are most influential in individuals’ decision making; applied in the current context, this refers to determining factors deemed most important to supporting implementation processes within children’s pain, among different stakeholders. This study is comprised of two phases. Phase One involves semi-structured interviews, informed by the Consolidated Framework for Implementation Research, where stakeholders across the three groups answer questions regarding their needs when engaging in implementation activities within children’s pain. The themes generated from the reflexive thematic analysis of the data identify factors that each stakeholder group associates with successful implementation in children’s pain. These factors will be used to design the DCE. Then, in Phase Two, the DCE will be used to understand decision making preferences among diverse stakeholders. In the DCE, administered via survey, participants will complete a series of “choice sets” in which they will choose from two alternatives, with attributes (e.g., communication) that differ across options (e.g., weekly communication, monthly communication). Between-group multiple regression analyses will identify factors that each unique stakeholder group views as most supportive of implementation in children’s pain. 


The study protocol will be presented in detail. The results of this study will identify the common and unique needs across stakeholder types when it comes to effectively engaging diverse individuals within research and clinical initiatives to improve children’s pain management. Results will therefore inform recommendations on tailoring engagement strategies across different stakeholder types. 


Implementation activities are most successful when stakeholders are appropriately engaged in the process. Through the novel use of DCE, this study will be among the first to use experimental methods to manipulate variables to gain a more nuanced understanding of unique stakeholder needs. The findings from this study will advance the field of knowledge translation by facilitating a tailored approach to stakeholder engagement in implementation activities in both research and clinical practice. 

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