Background
From Normalization Process Model (NPM) to Normalization Process Theory (NPT)
NPT theoretical constructs (from Finch, Mair et al.)
Methods
Search terms and strategy
Inclusion and exclusion criteria
Data abstraction and framework analysis
Results
Search results
Findings as per the research objectives
What interventions is NPT being used to analyze?
Author | Country of origin | Topic | Research focus |
---|---|---|---|
Mair et al.[28] | UK | E-health | A systematic review of reviews of e-health implementation studies, focusing on implementation processes rather than outcomes. |
Blakeman et al.[34] | UK | Chronic kidney disease in primary care | Qualitative interview study in general practices participating in a chronic kidney disease (CKD) collaborative, that aims to explore processes underpinning the implementation of CKD management in primary care. |
Franx et al.[35] | The Netherlands | Primary care: stepped-care treatment | An intervention study using a controlled before and after design. Part of the study was a process evaluation utilizing semi-structured group interviews to provide insight into the perceptions of the participating clinicians of the implementation of stepped cared for depression into their daily routines. |
Ehrlich et al.[36] | Australia | Registered nurses in general practice | A qualitative focus group study designed to develop understanding about how a registered nurse-provided care coordination model can ‘fit’ within organizational processes and professional relationships in general practice. |
Finch et al.[15] | UK | E-health | This paper describes the process and outcome of a project to develop a theory-based instrument for measuring implementation processes relating to e-health interventions, and identifies key issues and methodological challenges for advancing work in this field. A 30-item instrument (Technology Adoption Readiness Scale (TARS)) for measuring normalization processes in the context of e-health service interventions was developed and pre-tested in two professional samples. |
Gallacher et al.[19] | UK | Chronic heart failure | A secondary analysis of qualitative interview data to assess the burden associated with treatment among patients living with chronic heart failure. |
Watson et al.[37] | UK | Transitional care for young people | Scoping review of the evidence to identify successful models of transitional care for young people with complex healthcare needs. Three conditions were used as exemplars: cerebral palsy, autism spectrum disorders, and diabetes. |
Forster et al.[5] | Australia | Maternity care | Authors use two case studies where new models of maternity care were implemented and evaluated via randomized controlled trials (RCTs) to discuss how (or whether) the use of theory might inform implementation and sustainability strategies. |
Atkins et al.[38] | South Africa | TB treatment | A qualitative interview and focus group study documenting providers’ experiences of the implementation of a new tuberculosis treatment programme. |
Godden and King [29] | UK | Telehealth in respiratory medicine | To determine the potential for applying telehealth in a region of the UK by exploring the distribution of patients and examining attitudes to implementation of telehealth. |
James [39] | UK | Speech and language therapy | A review and data synthesis of qualitative research data on a speech and language intervention. |
MacFarlane and O’Reilly-de Brún [40] | Ireland | Language interpretation services | A reflexive account of the authors’ experience of using a theory-driven conceptual framework, in a qualitative evaluation of general practitioners’ uptake of a free pilot language interpreting service. Authors conducted an inductive thematic analysis using the constant comparative method. |
Murray et al.[18] | UK | E-health initiatives | A qualitative semi-structured interview study, using a case study methodology. Three case studies were selected to provide a range of healthcare contexts to assess factors that promote or inhibit the successful implementation, embedding, and integration of e-health initiatives. |
Sanders et al.[41] | UK | Back pain | A qualitative interview study of the perceptions of general practitioners towards the use of a new system for treating back pain. |
May et al.[30] | UK | Telecare for chronic disease management in the community | Large-scale comparative study employing qualitative data collection techniques, including semi-structured interviews. |
May et al.[31] | UK | Development of a simplified approach and web-enabled toolkit | A description of processes by which the authors developed a simplified approach of NPT for use by clinicians, managers, and policy makers, and which could be embedded in a web-enabled toolkit and online users manual. |
Furler et al.[42] | Australia | Diabetes | A qualitative interview study exploring the use of insulin in general practice with a focus on barriers and enablers for timely initiation. |
Bouamrane et al.[32] | UK | Remote and telehealth services | The authors outline a theoretical model of processes of intervention within the health services, and describe issues with the continued sustainability of existing models of care – and the potential opportunities for new technologies in addressing these challenges. |
Spangaro et al.[43] | Australia | Screening for intimate partner violence (IPV) in Australian antenatal, mental health, and substance abuse services | Explores providers’ perceptions about the relevance of IPV to their role, the extent to which screening is routine, the existing challenges, the impact on clinical work or patient care, and the suggested changes to the policy. |
Kennedy et al.[44] | UK | Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care | Learning from formative evaluation, the purpose being to ensure that the WISE training package was robust and likely to be effective enough to be tested in an RCT. |
Gunn et al.[45] | Australia | Embedding effective depression care: using theory for primary care organizational and systems change | Authors used a method informed by the principles of participatory action research (PAR) and utilized a mix of quantitative and qualitative methods to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole-of-organization meetings. |
Gask et al.[46] | UK | Collaborative care for depression? | Qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory RCT of a collaborative model of care for depression. |
Murray et al.[33] | UK | E-health | Reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT), which aims to summarize and synthesize new and existing research on implementation of e-health initiatives. |
Wilkes and Rubin [47] | UK | Infertility management and primary care | A process evaluation of open access hysterosalpingography (HSG) utilizing the results of two qualitative studies (a focus group study and an in-depth interview study) and two quantitative studies (a pilot survey and a pragmatic cluster RCT). |
Gask et al.[48] | UK | Mental health in primary care | A longitudinal qualitative multiple case study approach in a purposive sample of 12 organizations, chosen to reflect a maximum variety of organizational contexts for mental health care provision. |
Elwyn et al.[49] | UK | Decision support technologies (DST) | A conceptual analysis of the outcomes of previous primary research and reviews to highlight implementation problems for DSTs in routine settings. Using a virtual working environment to examine: the ‘workability’ of DSTs in professional-patient interactions; how DSTs affect knowledge relations between their users; how DSTs impact on users' skills and performance; and the impact of DSTs on the allocation of organizational resources. |
Mair et al.[50] | UK | Utilization of telecare in chronic lung disease | A process evaluation of a RCT of home telecare for the management of acute exacerbations of chronic obstructive pulmonary disease (COPD). |
Morriss [51] | UK | Clinical guidelines for bipolar disorder | To critically review the evidence concerning the implementation of clinical guidelines for bipolar disorder. |
May et al.[52] | UK | Process evaluation for complex interventions in primary care | A retrospective analysis of the implementation of two different complex trials: (i) the delivery of problem-solving therapies for psychosocial distress, and (ii) the delivery of nurse-led clinics for heart failure treatment in primary care. |
How is NPT being operationalized?
Author | Level of use model/theory | Application of NPM/NPT | Study participants in empirical papers |
---|---|---|---|
Mair et al.[28] | NPT | As the literature under study focused on implementation processes rather than outcomes, the authors analyzed the extracted data qualitatively using NPT as a coding framework. | N/A |
Blakeman et al.[34] | NPT | NPT provided a framework for generation and analysis of the data. | GPs and practice nurses |
Franx et al.[35] | NPT | Related findings to NPT constructs. | Professionals (clinicians, healthcare staff including manager and team co-ordinator). |
Ehrlich et al.[36] | Although NPT was the overarching theoretical framework used for the broader series of studies in this project, NPM was used specifically to aid data interpretation and the discussion in this study. | Interpretive analysis of interview data was conducted using NPT to structure data analysis and interpretation. | Professionals (nurses) |
Finch et al.[15] | NPT | A 30-item instrument (Technology Adoption Readiness Scale (TARS)) for measuring normalization processes in the context of e-health service interventions was developed on the basis of NPT. | Professionals (First phase authors of published reviews of e-health; second phase nurses, call handlers, health info advisors, nurse advisors and others). |
Gallacher et al.[19] | NPT | A secondary analysis of qualitative interview data, using framework analysis, informed by NPT. | Patient |
Watson et al.[37] | NPT | All papers were coded using a framework analysis which evaluated the data in two ways using the 10 transition categories and four elements of Normalization Process Theory that are important for successful implementation and integration of healthcare interventions. | N/A |
Forster et al.[5] | NPM | Survey and interview questions specific to the project were designed to reflect the four constructs of NPM in the implementation of the new model of care. | Professionals and patients (midwives and women) |
Atkins et al.[38] | NPM | Data were analyzed initially using qualitative content analysis. The resulting categories were then organized under the constructs of the NPM. | Professionals and lay workers |
Godden and King [29] | NPM | Analysis was supported by NPM. The principles of NPM were used to explore how successful implementation of proposed new technologies could be achieved. | Professionals (GPs, consultants, nurses, and others involved in respiratory care) |
James [39] | NPT (Collective Action with an emphasis on Relational Integration and Interaction Workability related dimensions) | Created coding categories that were then examined under headings according to the NPM. | Practitioners and parents |
MacFarlane and O’Reilly-de Brún [40] | NPM | The authors describe their actual use of NPM to inform research questions, sampling, coding and data analysis. | Professionals and patients (GPs and patients) |
Murray et al.[18] | NPT collective action and its four subcomponents | Data were analyzed using the framework method according to four components of the Collective Action construct of NPT. | Professionals (staff with responsibility for planning and/or executing an e-health initiative—‘implementers’ were defined as any person charged with assisting with the implementation of an e-health system. |
Sanders et al.[41] | NPT specific focus on coherence | Semi-structured interviews were organized around the four dimensions of the NPT: The analysis of the second stage interviews identified seven emergent themes, which were mapped onto the ‘Coherence’ construct within the NPT. | Professionals (GPs) |
May et al.[30] | NPT | Framework analysis of qualitative data informed by NPT. | Professionals and patients (health professionals, managers, patient, carers, social care professionals and managers, and service suppliers and manufacturers) |
May et al.[31] | NPT | Presented NPT to potential and actual users for review. | Professionals |
Furler et al.[42] | NPM | Data analysis drew on the NPM in developing initial coding categories. | Professionals and patients (GPs, nurse educators and patients) |
Bouamrane et al.[32] | NPT | Review of NPT and use in three e-health supporting case studies. | Professionals and patients (case study one: nurses, doctors, patient advocates, administrators, technologists, researchers) |
Spangaro et al.[43] | NPT collective action and its four constructs | NPT was applied to the findings. | Professionals (staff and management) |
Kennedy et al.[44] | NPT | NPT provided a framework for development of the intervention. NPT was used to give a focus to discussions and analysis, and reading of the interviews was undertaken in the context of the training observations and from the perspective of NPT. | Professionals (GPs, nurses, practice managers, clerical and reception staff) |
Gunn et al.[45] | NPT | NPT identified as an analytical theory to guide the conceptual framework for implementing best practice depression care. Transcripts coded using interpretive framework of NPT. | Professionals (healthcare professionals, including receptionists, practice nurses, dieticians, nurse educators, psychologists and social workers) |
Gask et al.[46] | NPM | The authors describe their actual use of NPM to inform research questions, coding, data analysis and interpretation. | Professionals and patients |
Murray et al.[33] | NPM | The content of the e-HIT was derived by combining a theoretical framework with a literature review and new empirical data. | E-health experts and implementers |
Wilkes and Rubin [47] | NPM | The results of two qualitative studies and two quantitative studies are interpreted by mapping the results to the NPM. | Professionals and patients |
Gask et al.[48] | NPM (SSW and CI) | Framework analysis based on NPM. To examine the extent to which clinical governance of mental health care has been normalized within NHS primary care. | Professional – lay informant (clinical governance leads, mangers, audit leads and mental health leads; chief executive, and a lay informant) |
Elwyn et al.[49] | NPM | NPM was used as the basis of conceptual analysis to examine the ‘workability’ of decision support technologies in professional-patient interactions. The authors sought to develop and refine the NPM through a concept analysis approach. | Physicians, patients and managers |
Mair et al.[50] | NPM | A framework approach to data analysis was used. | Professionals (nurses) and patients |
Morriss [51] | NPM | NPM was applied to analyze the NICE guideline recommendations for bipolar disorder. | N/A |
May et al.[52] | NPM | Applied the NPM retrospectively to analyze trials of complex interventions in mental health and heart disease. | Professionals and patients |