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

Purpose: 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 Methods: 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. Results: 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. Conclusion: 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.