The DOI matches its Crossref record; 61 of the 62 references it cites were found in a registry or an index; none of the 73 sources its claims cite is checked for support yet.
Development of a theory of implementation and integration: Normalization Process Theory
Open accessAbstract
BACKGROUND: Theories are important tools in the social and natural sciences. The methods by which they are derived are rarely described and discussed. Normalization Process Theory explains how new technologies, ways of acting, and ways of working become routinely embedded in everyday practice, and has applications in the study of implementation processes. This paper describes the process by which it was built. METHODS: Between 1998 and 2008, we developed a theory. We derived a set of empirical generalizations from analysis of data collected in qualitative studies of healthcare work and organization. We developed an applied theoretical model through analysis of empirical generalizations. Finally, we built a formal theory through a process of extension and implication analysis of the applied theoretical model. RESULTS: Each phase of theory development showed that the constructs of the theory did not conflict with each other, had explanatory power, and possessed sufficient robustness for formal testing. As the theory developed, its scope expanded from a set of observed regularities in data with procedural explanations, to an applied theoretical model, to a formal middle-range theory. CONCLUSION: Normalization Process Theory has been developed through procedures that were properly sceptical and critical, and which were opened to review at each stage of development. The theory has been shown to merit formal testing.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This paper describes how Normalization Process Theory (NPT) was developed through three phases: empirical generalizations from qualitative healthcare studies, an applied Normalization Process Model (NPM), and a formal middle-range theory. NPT explains implementation, embedding, and integration through four generative mechanisms—coherence, cognitive participation, collective action, and reflexive monitoring—and is presented as meriting formal testing.
Key findings
- NPT was built in three phases: empirical generalizations from secondary analyses of qualitative healthcare data (2001–2004), an applied NPM (2003–2007), and a formal middle-range theory (2006–2009).
- The NPM’s four constructs—interactional workability, relational integration, skill-set workability, and contextual integration—became the collective action component of NPT; NPT adds coherence, cognitive participation, and reflexive monitoring as generative mechanisms.
- Road testing included applying the NPM in three large qualitative studies and coding two datasets with both NPM and NPT; the authors report that the constructs did not conflict, had explanatory power, and were stable enough for formal testing.
- NPT is presented as a middle-range sociological theory of implementation, embedding, and integration; formal testing was not conducted in this paper, and results are said to be forthcoming.
Methods
- Design: a theory-building account using secondary analysis of qualitative data, grounded theory-building techniques, extension and implication analysis, analytical theorizing, and “road testing.”
- Data/sample: qualitative studies of healthcare work and organization across four domains—telemedicine normalization, professional–patient interaction and chronic illness care, and the social production and operationalization of evidence in the clinical encounter—plus later applications in e-health, telecare, a randomized controlled trial, and shared decision-making.
- Analysis: derived empirical generalizations, built the NPM, reformulated its constructs as generic mechanisms, mapped macro–micro links, and assessed construct stability and analytic advantage by applying NPM and NPT to data and research syntheses.
Limitations
- The paper states that it did not formally test or falsify the NPM or NPT; “road testing” only assessed whether the theory was fit to be tested, and formal test results are forthcoming.
- The authors state that procedural accounts of theory-building risk imposing an artificial order on processes that are highly contingent, opportunistic, and organic.
- Evident from the text: no empirical outcomes, effect sizes, or formal validation results are reported; the claims rest on conceptual coherence, face validity, and practical application rather than definitive testing.
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Claims the paper makes
42 Not checked yet · 21 Own interpretation · 21 No basis given · 7 Own method · 2 Own result
In the paper
“At this stage, the NPM synthesized empirical generalizations from groups of related studies, and producing taxonomies, maps of relations between concepts, and generalizations [24].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase two: Building an applied theoretical model
What the sources say
- Not checked yetcites [24] Dixon-Woods M, Agarwal S, Jones D, Young B, Sutton A: Synthesising qualitative and quantitative evidence in reviews: a review of methods. J Hlth Serv Res Pol. 2005, 10: 45-53. 10.1258/1355819052801804. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Each phase of theory development showed that the constructs of the theory did not conflict with each other, had explanatory power, and possessed sufficient robustness for formal testing.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“'Road testing' showed that it had utility in explaining factors that promoted and inhibited collective action in operationalizing practices.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Research synthesis
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Each phase of theory development showed that the constructs of the theory did not conflict with each other, had explanatory power, and possessed sufficient robustness for formal testing.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In fact, it extends it.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Relationship between the NPM and NPT
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Each phase of theory development showed that the constructs of the theory did not conflict with each other, had explanatory power, and possessed sufficient robustness for formal testing.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The formal theory (NPT) does not conflict with the applied model (NPM) from which it was drawn.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Relationship between the NPM and NPT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As the theory developed, its scope expanded from a set of observed regularities in data with procedural explanations, to an applied theoretical model, to a formal middle-range theory.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Reviews of relevant theory published at that time [1-4] explicated these explanatory gaps.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > Why was NPT developed?
What the sources say
- Not checked yetcites [1] Ashford AJ: Behavioural change in professional practice: supporting the development of effective implementation strategies. 2002, Newcastle upon Tyne: Centre for Health Services Research
- Not checked yetcites [2] Wensing M, Bosch M, Foy R, Weijden van der T, Eccles M, Grol R: Factors in theories on behaviour change to guide implementation and quality improvement in healthcare. 2005, Nijmegen: University of Nijmegen
- Not checked yetcites [3] Grol R, Wensing M, Hulscher M, Eccles M: Theories on implementation of change in healthcare. 2004, Nijmegan: WOK
- Not checked yetcites [4] Grol RP, Bosch M, Hulscher M, Eccles M, Wensing M: Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Quarterly. 2007, 85 (1): 93-138. 10.1111/j.1468-0009.2007.00478.x. source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In other words, they were observational rather than explanatory.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase one: Developing empirical generalizations
plain- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 38
- It may state two separate claims as one. 20
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The empirical generalizations produced by these processes were general conclusions about regularities in the data, and were framed as formal propositions.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase one: Developing empirical generalizations
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“By the end of 2006, the NPM in its published form [7] was sufficient as a set of conceptual tools to analyse specific processes, and it has been successfully applied to this purpose [32-36].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Research synthesis
What the sources say
- Not checked yetcites [7] May C: A rational model for assessing and evaluating complex interventions in health care. BMC Health Serv Res. 2006, 6: 86-10.1186/1472-6963-6-86. source
- Not checked yetcites [32] Morriss R: Implementing clinical guidelines for bipolar disorder. Psychology and Psychotherapy-Theory Research and Practice. 2008, 81: 437-458. 10.1348/147608308X278105. source
- Not checked yetcites [33] Gask L, Rogers A, Campbell S, Sheaff R: Beyond the limits of clinical governance: the case of mental health in primary care. BMC Health Serv Res. 2008, 8: 63-10.1186/1472-6963-8-63. source
- Not checked yetcites [34] King G, Richards H, Godden D: Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study. J Teleme Telecare. 2007, 13 (8): 382-386. 10.1258/135763307783064430. source
- Not checked yetcites [35] Mair FS, Hiscock J, Beaton SC: Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease. Chronic Ill. 2008, 4 (2): 110-117. 10.1177/1742395308092482. source
- Not checked yetcites [36] Finch TL, Mair FS, May CR: Teledermatology in the UK: lessons in service innovation. Brit J Dermatol. 2007, 156 (3): 521-527. 10.1111/j.1365-2133.2006.07608.x. source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, we can say that the processes of theoretical development described in this paper were opportunistic and organic in the beginning.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > Why was NPT developed?
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“'Road testing' the NPM enabled us to work through these problems and provided a context in which to make rational decisions about face validity, and to ask whether the NPM merited formal testing.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Refining and testing the NPM
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These were linked together by sociological explanations of the relations between its constructs, their dimensions, and components.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase two: Building an applied theoretical model
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“We show how these procedures led to a set of propositions that possessed sufficient face validity and conceptual robustness to warrant formal testing.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The extended NPM that was derived from this work now had a general character, and the generative mechanisms and components to which it referred were not exclusive to complex interventions or even healthcare.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This process was important because it paralleled the final revisions of the NPT as subsequently accepted for publication.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Road testing the NPT
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The NPT, however, extends the applied theoretical model to include the ways by which actors make sense of a set of practices (coherence), the means by which they participate in them (cognitive participation), and the forms of appraisal that they apply (reflexive monitoring)”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Relationship between the NPM and NPT
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The constructs of the NPM are central to the formal theory and constitute its collective action component.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Relationship between the NPM and NPT
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Between 2006 and 2009, the applied theoretical model of the NPM was extended, new constructs defined, and generative mechanisms defined, so that it formed a formal middle-range theory – NPT.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It did not, however, explain how practices were formed in ways that held together, how actors were enrolled into them, or how they were appraised.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Research synthesis
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“They referred instead to generic properties of implementation processes and offered an explanation of them without reference to specific social contexts.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Taken together these set the scene for possible empirical verification.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase two: Building an applied theoretical model
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to be clear that this was not formal testing, because we did not at this stage seek to falsify the NPM. Instead, we practically tested its usefulness as an analytic tool.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Qualitative data analysis
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“They reflect calls for the use of theories to generate testable hypotheses linking tailored strategies with factors that promote or inhibit implementation, and various attempts to identify theories or constructs within theories best suited for successful implementation [15].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > Why was NPT developed?
What the sources say
- Not checked yetcites [15] Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005, 14 (1): 26-33. 10.1136/qshc.2004.011155. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“3. Integration, by which we mean the processes by which a practice or practices are reproduced and sustained among the social matrices of an organization or institution.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is a theory of action.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The starting point of the theory is that to understand the embedding of a practice we must look at what people actually do and how they work.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“2. Embedding, by which we mean the processes through which a practice or practices become, (or do not become), routinely incorporated in everyday work of individuals and groups.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1. Practices become routinely embedded – or normalized – in social contexts as the result of people working, individually and collectively, to enact them.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“3. The production and reproduction of a practice requires continuous investment by agents in ensembles of action that are carried forward in time and space.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1. Implementation, by which we mean the social organization of bringing a practice or practices into action.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Normalization Process Theory explains how new technologies, ways of acting, and ways of working become routinely embedded in everyday practice, and has applications in the study of implementation processes.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Background
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“An important critique of theory building is that it is sometimes precipitate, proceeding before the generalizability of the phenomena it is concerned with is properly established [26].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Refining and testing the NPM
What the sources say
- Not checked yetcites [26] Goldthorpe JH: On Sociology: Critique and Program. 2006, Stanford: Stanford University Press
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
In the paper
“A second critique is that theory-builders focus too early on the problem of defining and measuring variables supposed to be relevant, without sufficient consideration of the coherence and robustness of basic concepts and constructs of the theory itself [27].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Refining and testing the NPM
What the sources say
- Not checked yetcites [27] Wacker JG: A theory of formal conceptual definitions: developing theory-building measurement instruments. J Operations Management. 2004, 22 (6): 629-650. 10.1016/j.jom.2004.08.002. source
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This was framed as a set of analytic propositions (see Appendix 2) that were supported by rigorous data analysis.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase two: Building an applied theoretical model
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Normalization Process Theory explains how new technologies, ways of acting, and ways of working become routinely embedded in everyday practice, and has applications in the study of implementation processes.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Background
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“They did not in themselves make a theory because they were specific to particular contexts (i.e., although they were generalizations, they were not necessarily generalizable), and were not linked together by some account of causal relations, generative mechanisms, or organizing principles.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase one: Developing empirical generalizations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“NPT provides a set of sociological tools to understand and explain the social processes through which new or modified practices of thinking, enacting, and organizing work are operationalized in healthcare and other institutional settings.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background > What is NPT?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unless there is already a large body of literature that presents studies that have interrogated or tested a particular theory in play, we are then stuck with the problem of how to evaluate its relation to the phenomena that it seeks to explain.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The importance of transparency
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“So, although there are many papers that seek to present some new theory, we can often discover little about where they come from or about the methods by which they were derived.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The importance of transparency
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The processes of theory development described here have included changes in scope, as well as method.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The changing scope of the theory
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Such theories sometimes seem to spring fully-formed from critiques of the literature, or by assertions about prior theories.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The importance of transparency
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“The goal of theory-building at this level is to isolate the generic properties of phenomena and understand their operation [37].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
What the sources say
- Not checked yetcites [37] Turner JH: Analytical Theorizing. Social Theory Today. Edited by: Giddens A, Turner J. 1987, Cambridge: Polity Press, 156-194.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We then had to demonstrate that these constructs could be operationalized in a way that conferred an analytic advantage.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Road testing the NPT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The process of theory-building described in this paper has led from secondary analysis of qualitative data through to the development of a set of generic theoretical propositions that can be employed to explain implementation and integration.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Conclusion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The criteria for stability were that the generic constructs could be translated into specific contexts without the addition of ad hoc conditions, and that sceptical researchers were able to use them in practice with minimal support.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Road testing the NPT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The production of a formal theory is a quite different enterprise than the work that goes into the identification of empirical generalizations or applied explanations.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The NPM is unchanged by this, and researchers can continue to successfully use the NPM in settings where only those factors that promoted or inhibited collective action are at issue [32-35,45,46].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Relationship between the NPM and NPT
What the sources say
- Not checked yetcites [32] Morriss R: Implementing clinical guidelines for bipolar disorder. Psychology and Psychotherapy-Theory Research and Practice. 2008, 81: 437-458. 10.1348/147608308X278105. source
- Not checked yetcites [33] Gask L, Rogers A, Campbell S, Sheaff R: Beyond the limits of clinical governance: the case of mental health in primary care. BMC Health Serv Res. 2008, 8: 63-10.1186/1472-6963-8-63. source
- Not checked yetcites [34] King G, Richards H, Godden D: Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study. J Teleme Telecare. 2007, 13 (8): 382-386. 10.1258/135763307783064430. source
- Not checked yetcites [35] Mair FS, Hiscock J, Beaton SC: Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease. Chronic Ill. 2008, 4 (2): 110-117. 10.1177/1742395308092482. source
- Not checked yetcites [45] May C, Mair FS, Dowrick C, Finch T: Process evaluation of complex interventions in primary care: understanding trials using the normalization process model. BMC Fam Pract. 2007, 8: 42-10.1186/1471-2296-8-42. source
- Not checked yetcites [46] Wilkes S: Evaluation of open access hysterosalpingography in the initial management of infertility in primary care. 2007, Unpublished PhD Thesis, University of Sunderland
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The development of a set of explanatory ideas around normalization has shifted from an initial set of empirical generalizations presented as synthetic propositions or assertions [17], to a robust conceptual model that presented generalizable propositions [7], and finally to a middle-range theory that offers a set of mechanism-based explanations for processes of implementation, embedding, and integ”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The changing scope of the theory
What the sources say
- Not checked yetcites [17] May CR, Harrison R, Finch T, MacFarlane A, Mair FS, Wallace P: Understanding the normalization of telemedicine services through qualitative evaluation. J Am Med Informat Ass. 2003, 10 (6): 596-604. 10.1197/jamia.M1145. source
- Not checked yetcites [7] May C: A rational model for assessing and evaluating complex interventions in health care. BMC Health Serv Res. 2006, 6: 86-10.1186/1472-6963-6-86. source
- Not checked yetcites [5] May C, Finch T: Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology. 2009,
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to emphasise that the purpose of this work was not to formally test the theory, but rather to demonstrate that it was fit to be tested:”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Road testing the NPT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Normalization Process Theory has been developed through procedures that were properly sceptical and critical, and which were opened to review at each stage of development.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This theory-building process has been a highly collaborative one, in which many people have made very important contributions to the development of theoretical explanation.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To summarise, 'road testing' NPT required that we establish that its constructs actually defined mechanisms, components, and investments that could all be prospectively revealed by empirical research, and that these could be characterised in a stable way.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Road testing the NPT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“When they exist, these often take the form of personal histories [56], or accounts of particular social networks [57].”
§ Development of a theory of implementation and integration: Normalization Process Theory > Results > The importance of transparency
What the sources say
- Not checked yetcites [56] Rogers EM: A prospective and retrospective look at the diffusion model. J Health Communicat. 2004, 9: 13-19. 10.1080/10810730490271449. source
- Not checked yetcites [57] Collins HM: Tacit knowledge in scientific networks. Science in context: readings in the sociology of science. Edited by: Barnes B, Edge D. 1982, Buckingham: Open University Press, 44-64.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“We therefore presented it as a general, and generalizable, middle-range theory, NPT [5,41]), that seeks to explain the processes of implementation, embedding, and integration of material practices in formally defined contexts, relates these processes to causal social mechanisms [42], identifies components of those mechanisms, and defines the investments that are required to energize them.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Phase three: Making a formal theory
What the sources say
- Not checked yetcites [5] May C, Finch T: Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology. 2009,
- Not checked yetcites [41] May C: Mundane Medicine, Therapeutic Relationships, and the Clinical Encounter.'. Handbook of the Sociology of Health, Illness, and Healing: A Blueprint for the 21st Century. Edited by: Pescosolido B, Martin JA, Rogers A. New York: Springer
- Not checked yetcites [42] Hedstrom P: Dissecting the Social: On the Principles of Analytical Sociology. 2005, Cambridge: Cambridge University Press source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although it has been developed through a series of multi-disciplinary collaborations, NPT is a sociological theory in that it takes as its focus the contribution of social action to implementation, embedding, and integration.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > NPT is a middle-range theory
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper relies on this without support.
It is important to show that a theory has been derived through rigorous methods, applied sceptically, and critically assessed.
“It is important to show that the theory has been derived through processes that have involved the application of rigorous methods, that these methods have been applied in a properly sceptical way, and that the outcomes of their application have been critically assessed.”
The paper relies on this without support.
The limited scope, conceptual range, and claims of middle-range theories make them practically workable in analysing practice.
“The limited scope, conceptual range, and claims of middle-range theories are important because they are what make them practically workable in analysing practice.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“NPT is a theory of implementation that focuses on what people—both individuals and groups—do rather than what they believe or intend, and it has been built up from studies of practice in many different healthcare systems.”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The development of NPT first involved the iterative development of a robust generic theory of implementation [5–9, 11, 12].”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“In the second iteration of the theory—Normalization Process Theory (NPT) [7, 8]—we characterised mechanisms (coherence, cognitive participation, collective action and reflexive monitoring) that motivate and shape implementation processes and explained their operation.”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“the content of our framework (data derived from primary care) is comparable and overlaps considerably with the CFIR which is not primary care specific and has resonance with NPT.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [92]
The cited source says what the claim attributes to it.
In the citing paper
“NPT is a theory of implementation that focuses on what people—both individuals and groups—do rather than what they believe or intend, and it has been built up from studies of practice in many different healthcare systems.”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“Normalization Process Theory (NPT) identifies, characterises and explains key mechanisms that promote and inhibit the implementation, embedding and integration of new health techniques, technologies and other complex interventions.”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“we have argued that theories are conceptual toolkits that can be used flexibly to deal with practical problems.”
From Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review (2018) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“For example, the social influences and environmental context and resource domains point to organisational and systems context for change and can be further elaborated, e.g. by Normalisation Process Theory [66], the Consolidated Framework For Implementation Research [67] and the Yorkshire Contributory Factors Framework [68].”
From A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems (2017) · cites this paper as [66]
In the citing paper
“One that has been applied in healthcare is normalisation process theory [77, 78], which acknowledges the interaction of actors (recipients) within their context and proposes four constructs titled coherence, cognitive participation, collective action and reflexive monitoring as the generative mechanisms required to routinely embed innovations.”
From PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice (2015) · cites this paper as [78]
In the citing paper
“Normalization includes supporting staff to make sense of the new technology in the context of their work; engaging them to participate; coordinating their implementation efforts; and monitoring benefits and costs (23).”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [23]
In the citing paper
“Previously published approaches primarily focus on implementation, although the details of implementation theory, implementation strategy or a comprehensive implementation process are often neglected (e.g., [14, 53, 84, 85]).”
From Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework (2017) · cites this paper as [84]
In the citing paper
“There is currently no published review of its empirical application, but it has been seen to have been applied to good effect in a number of social and health-care settings.121,134,135”
From ReseArch with Patient and Public invOlvement: a RealisT evaluation – the RAPPORT study (2015) · cites this paper as [135]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Refining and testing the NPM
“This consisted of two main pieces of work, quantitative data analysis and research synthesis.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Methods > Qualitative data analysis
“### Qualitative data analysis We integrated the NPM in qualitative data analysis in three large studies”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Development of a theory of implementation and integration: Normalization Process Theory > Abstract > Methods
“Between 1998 and 2008, we developed a theory.”
§ Development of a theory of implementation and integration: Normalization Process Theory > Background
“this paper described the processes by which one of them – Normalization Process Theory (or NPT) [5-7] – was developed between 2000 and 2009.”
Citations
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Research works printed but not linked: 8
- Ashford AJ: Behavioural change in professional practice: supporting the development of effective implementation strategies. 2002, Newcastle upon Tyne: Centre for Health Services Research
- May C, Finch T: Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology. 2009,
- Glaser BG, Strauss A: The discovery of grounded theory. 1967, Chicago: Aldine
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- May C: Mundane Medicine, Therapeutic Relationships, and the Clinical Encounter.'. Handbook of the Sociology of Health, Illness, and Healing: A Blueprint for the 21st Century. Edited by: Pescosolido B, Martin JA, Rogers A. New York: Springer
- Mair F, May C, Murray E, Finch T, Anderson G, O'Donnell C, Wallace P, Sullivan F: Understanding the Implementation and Integration of E-Health Services. 2009, London: National Co-ordinating Centre for the National Institute for Health Research Service Delivery and Organisation Programme (NCCSDO)
- Wilkes S: Evaluation of open access hysterosalpingography in the initial management of infertility in primary care. 2007, Unpublished PhD Thesis, University of Sunderland
Cited by
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van den Muijsenbergh, M. E. T. C., LeMaster, J. W., Shahiri, P., Brouwer, M. A. E., Hussain, M., Dowrick, C. F., Papadakaki, M., Lionis, C. D., & MacFarlane, A. E. (2020) · Health Expectations · doi:10.1111/hex.13034 · Cited by 26
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Deutsch, R., & Strack, F. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.012 · Cited by 30
Watkinson, F., Dharmayat, K. I., & Mastellos, N. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06771-z · Cited by 22
LeBlanc, A., Ruud, K. L., Branda, M. E., Tiedje, K., Boehmer, K. R., Pencille, L. J., Houten, H. V., Matthews, M. R., Shah, N. D., May, C. R., et al. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-130 · Cited by 26
“To complement the RE-AIM framework, we will use the Normalization Process Theory (aim 2) [6,14].”
MethodSelf-citationInvestigating healthcare IT innovations: a “conceptual blending” approach
Cranfield, S., Hendy, J., Reeves, B. C., Hutchings, A., Collin, S. M., & Fulop, N. (2015) · Journal of Health Organization and Management · doi:10.1108/jhom-08-2015-0121 · Cited by 30
“A further theoretical candidate is normalisation process theory (NPT) (May et al. , 2009).”
BackgroundInfluentialTaylor, S., Allsop, M. J., Bekker, H., Bennett, M., & Bewick, B. M. (2016) · Palliative Medicine · doi:10.1177/0269216316677470 · Cited by 26
Managing expectations: cognitive authority and experienced control in complex healthcare processes
Hunt, K. J., & May, C. R. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2366-1 · Cited by 27
“health services research and implementation science [2, 34, 35].”
Self-citationLionis, C. D., Petelos, E., Mechili, E. A., Sifaki-Pistolla, D. I., Chatzea, V., Angelaki, A., Rurik, I., Pavlič, D. R., Dowrick, C. F., Dückers, M., et al. (2018) · BMC International Health and Human Rights · doi:10.1186/s12914-018-0150-x · Cited by 26
““NPT is a theoretical framework concerned with the work that individuals and organisations have to carry out in order to embed and normalise new, complex ways of working into routine practice” [11].”
BackgroundSelf-citationSmith, E., Bradbury, K. J., Scott, L., Steele, M., Little, P. S., & Yardley, L. (2017) · Implementation Science · doi:10.1186/s13012-017-0596-6 · Cited by 30
Jeong, S., Barrett, T., Ohr, S. O., Cleasby, P., David, M., Chan, S. W., Fairlamb, H., Davey, R., & Saul, P. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4118-x · Cited by 25
Patton, D., Ryan, C. A., & Hughes, C. M. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05282-7 · Cited by 25
“Use Review (MUR) service [19], are delivered face-toface and so this was deemed likely to be acceptable to both pharmacists and patients and support future implementation into practice [20].”
MethodRichards, J. A., Simon, G. E., Boggs, J. M., Beidas, R. S., Yarborough, B. J. H., Coleman, K. J., Sterling, S., Beck, A. L., Flores, J. P., Bruschke, C., et al. (2021) · Implementation Research and Practice · doi:10.1177/26334895211011769 · Cited by 25
“…by four determinants—coherence (how the intervention is understood), cognitive participation (how users engage in the intervention), collective action (how the intervention is performed), and reflexive monitoring (how the intervention is monitored over time) (May et al., 2009; May & Finch, 2009).”
BackgroundMethodInfluentialGrimmett, C., Bates, A. S., West, M. A., Leggett, S., Varkonyi-Sepp, J., Campbell, A., Davis, J., Wootton, S. A., Shaw, C., Barlow, R., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048175 · Cited by 28
La complexité : concept et enjeux pour les interventions de santé publique
Pagani, V., Kivits, J., Minary, L., Cambon, L., Claudot, F., & Alla, F. (2017) · Santé Publique · doi:10.3917/spub.171.0031 · Cited by 25
Co‐creating value in research: stakeholders' perspectives
Janamian, T., Jackson, C. L., & Dunbar, J. (2014) · The Medical Journal of Australia · doi:10.5694/mja14.00273 · Cited by 25
O'Donnell, C. A., Mair, F. S., Dowrick, C., Brún, M. O.-D., Brún, T. D., Burns, N., Lionis, C., Saridaki, A., Papadakaki, M., Muijsenbergh, M. V. D., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-014289 · Cited by 24
Self-citationRemawi, B. N., Gadoud, A., & Preston, N. J. (2023) · BMC Palliative Care · doi:10.1186/s12904-023-01241-1 · Cited by 24
“…Theory is built up around four constructs that explain the mechanisms of the routine incorporation of an organisational practice into everyday life [34, 35] ( Assessing the outcomes of the new intervention; including giving feedback on the intervention’s effects on users and those around them used…”
BackgroundMethodDurand, M., Yen, R. W., O’Malley, A. J., Politi, M. C., Dhage, S., Rosenkranz, K. M., Weichman, K. E., Margenthaler, J. A., Tosteson, A. N. A., Crayton, E., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5109-2 · Cited by 24
“Analyses corresponding to aim 3 We will use a framework analysis, guided by Normalization Process Theory (NPT) [101, 102], having successfully used this approach previously [55, 70, 103, 104].”
BackgroundMethodSelf-citationTaylor, A. K., Gilbody, S. M., Bosanquet, K., Overend, K., Bailey, D., Foster, D., Lewis, H., & Chew-Graham, C. A. (2018) · BMC Family Practice · doi:10.1186/s12875-018-0813-7 · Cited by 23
On behalf of the CHIPPS Team, Bond, C. M., Holland, R., Alldred, D. P., Arthur, A. J., Barton, G., Birt, L., Blyth, A., Desborough, J., Ford, J., et al. (2020) · Trials · doi:10.1186/s13063-020-04264-8 · Cited by 24
Dyadic Behavior Change Interventions
Scholz, U., Berli, C., Lüscher, J., & Knoll, N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.043 · Cited by 26
Hammond, A., Sutton, C., Cotterill, S., Woodbridge, S., O’Brien, R., Radford, K., Forshaw, D., Verstappen, S. M. M., Jones, C., Marsden, A., et al. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03619-1 · Cited by 29
Kwaśnicka, D., ten Hoor, G. A., van Dongen, A., Gruszczyńska, E., Hagger, M. S., Hamilton, K., Hankonen, N. E., Heino, M. T. J., Kotzur, M., Noone, C., et al. (2020) · Health Psychology Review · doi:10.1080/17437199.2020.1844037 · Cited by 25
“Understanding researchers’ motives, beliefs, and attitudes towards open data practices will support shifting social norms and effectively changing practices (May et al., 2009).”
BackgroundHardman, R., Begg, S. J., & Spelten, E. R. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255802 · Cited by 25
Melnick, E. R., Lopez, K., Hess, E. P., Abujarad, F., Brandt, C., Shiffman, R. N., & Post, L. A. (2015) · eGEMs (Generating Evidence & Methods to improve patient outcomes) · doi:10.13063/2327-9214.1136 · Cited by 24
Higman, W., WALLACE, L. M., Law, S. M., Bartle, N. C., & Blake, K. (2014) · Journal of Neonatal Nursing · doi:10.1016/j.jnn.2014.09.001 · Cited by 24
“A contemporary theory of implementation science, known as normalisation process theory (NPT) (May et al., 2009) was used as a framework to explore both the promoters and barriers of KC and PT in clinical practice and focused on three areas: 1.”
Resident Experiences With Implementation of the I-PASS Handoff Bundle
Coffey, M., Thomson, K., Li, S., Bismilla, Z., Starmer, A. J., O’Toole, J. K., Blankenburg, R. L., Rosenbluth, G., Cole, F. S., Yu, C. E., et al. (2017) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-16-00616.1 · Cited by 24
Integration as a scientific paradigm
Kaehne, A. (2017) · Journal of Integrated Care · doi:10.1108/jica-07-2017-0023 · Cited by 24
Locock, L., Graham, C. F., King, J., Parkin, S., Chisholm, A., Montgomery, C. M., Gibbons, E. J., Ainley, E., Bostock, J., Gager, M., et al. (2020) · Health Services and Delivery Research · doi:10.3310/hsdr08130 · Cited by 24
Developing Behavior Change Interventions
Hankonen, N. E., & Hardeman, W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.021 · Cited by 28
Tierney, E., O'Sullivan, M. B., Hickey, L., Hannigan, A., May, C. R., Cullen, W., Kennedy, N., Kinneen, L., & MacFarlane, A. E. (2016) · BMC Family Practice · doi:10.1186/s12875-016-0541-9 · Cited by 24
“These practices represent the range of general practice types in the Irish context, the majority of which are based in city and/or town locations with GPs in full time employment and operating group practices [44].”
Self-citationZhou, C., Ai, Y., Wang, S., Yuan, Y., Zhang, A., Hu, H. Z., & Wang, Y. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05645-3 · Cited by 25
O’Connor, S., Hanlon, P., O’Donnell, C. A., Gonzalez-Moral, S. G., Glanville, J., & Mair, F. S. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010895 · Cited by 24
“through its four main constructs: ‘coherence’, ‘cognitive participation’, ‘collective action’ and ‘reflexive monitoring’ (see figure 1).(39) 40 BOTT was built on the conceptual foundations of NPT to expand our knowledge of the difficulties patients experience when coping with new treatment modalities and enacting self…”
BackgroundSelf-citationGlynn, L. G., Glynn, F., Casey, M., Wilkinson, L. G., Hayes, P. S., Heaney, D., & Murphy, A. W. (2018) · BMC Family Practice · doi:10.1186/s12875-018-0737-2 · Cited by 23
“Essentially the work that individuals and groups must undertake to enable an intervention to become normalised is the primary focus of NPT and comprises four main components [22, 23].”
BackgroundLewis, A., Harvey, G., Hogan, M., & Kitson, A. A. (2018) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2018.12.016 · Cited by 23
Mills, K., Griffin, S. J., Sutton, S. R., & Usher‐Smith, J. A. (2020) · Primary Health Care Research & Development · doi:10.1017/s146342361900080x · Cited by 23
“We chose NPT because it focuses on understanding how and whether complex interventions become routinely embedded in healthcare practice (May et al., 2009).”
BackgroundInfluentialYuan, C. T., Nembhard, I. M., & Kane, G. C. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113002 · Cited by 23
Heaven, A., Bower, P., Cundill, B., Farrin, A. J., Foster, M., Foy, R., Hartley, S., Hawkins, R., Hulme, C. T., Humphrey, S., et al. (2020) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00598-x · Cited by 23
Mitchell, D. A. (2021) · Public Management Review · doi:10.1080/14719037.2020.1862289 · Cited by 23
“NPT was developed to address ‘the observed difficulty of implementing and integrating new treatment modalities and ways of organizing care in health service settings (May et al. 2009, 5).’”
BackgroundMorton, K., Dennison, L., Band, R. J., Stuart, B. L., Wilde, L., Cheetham‐Blake, T. J., Heber, E., Slodkowska‐Barabasz, J., Little, P. S., McManus, R. J., et al. (2021) · Implementation Science · doi:10.1186/s13012-021-01123-1 · Cited by 22
“Normalisation Process Theory [15] was used to inter-”
MethodInfluentialSelf-citationHawkins, R. L., McWilliams, L., Ulph, F., Evans, D. G., & French, D. (2022) · BMC Cancer · doi:10.1186/s12885-022-10134-0 · Cited by 23
Understanding Swiss Drug Policy Change and the Introduction of Heroin Maintenance Treatment
Khan, R., Khazaal, Y., Thorens, G., ZULLINO, D. F., & Uchtenhagen, A. (2014) · European Addiction Research · doi:10.1159/000357234 · Cited by 23
A study of clinical and information management processes in the surgical pre-assessment clinic
Bouamrane, M.-M., & Mair, F. S. (2014) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-14-22 · Cited by 23
“NPT is concerned with the social organisation of the work (implementation) of making practices routine elements of everyday life (embedding) and of sustaining embedded practices in their social contexts (integration) and was developed particularly in response to the evidence, which suggested that embedding and integra…”
BackgroundSelf-citationon behalf of the VST and ASTUTE investigators, Bagot, K. L., Cadilhac, D. A.-M., Bladin, C. F., Watkins, C. L., Vu, M. H., Donnan, G. A., Dewey, H. M., Emsley, H. C. A., Davies, D. P., et al. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2694-1 · Cited by 23
“One limitation of the NPT framework was that it does not specifically capture if participants had any prior experience with a similar and how that experience may influence the implementation process.”
MethodInfluentialSelf-citationGoldthorpe, J., Walsh, T., Tickle, M., Birch, S., Hill, H. R., Sanders, C., Coulthard, P., & Pretty, I. (2018) · Health Services and Delivery Research · doi:10.3310/hsdr06080 · Cited by 23
“When patients had previous experience of dental treatment in a hospital setting, a comparative experience upon which to base what May et al.(95) refer to as an individual appraisal was present.”
BackgroundMethodInfluentialRothman, A. J., Klein, W. M. P., & Sheeran, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.020 · Cited by 26
Gordon, K., Dainty, K. N., Gray, C. S., DeLacy, J., Shah, A., Resnick, M., & Seto, E. (2020) · JMIR Nursing · doi:10.2196/22118 · Cited by 32
“A pragmatic worldview was taken to evaluate the social construction of feasibility in multi-condition TM using the normalization process theory (NPT) by May [43-46] and the Framework of Implementation Outcomes (IOs) by Proctor et al [41].”
MethodMatlock, D. D., Fukunaga, M. I., Tan, A. S. L., Knoepke, C. E., McNeal, D. M., Mazor, K. M., & Glasgow, R. E. (2020) · MDM Policy & Practice · doi:10.1177/2381468320963070 · Cited by 24
Identifying knowledge to action gaps
Kitson, A. L., & Straus, S. E. (2013) · Wiley eBooks · doi:10.1002/9781118413555.ch09 · Cited by 23
Turnbull, J., Pope, C., Rowsell, A., Prichard, J., Halford, S., Jones, J., May, C., & Lattimer, V. (2014) · Health Services and Delivery Research · doi:10.3310/hsdr02030 · Cited by 22
Self-citationMartel, R., Darragh, M., Lawrence, A., Shepherd, M., Wihongi, T., & Goodyear‐Smith, F. (2019) · JMIR Research Protocols · doi:10.2196/12108 · Cited by 22
“Complex interventions, such as YouthCHAT, with the potential to improve health outcomes, can only do so if they can be successfully implemented and then integrated or normalized into routine clinical practice [88-91].”
InfluentialCarbonneau, M., Eboreime, E., Hyde, A. M., Campbell-Scherer, D. L., Faris, P., Gramlich, L. M., Tsuyuki, R. T., Congly, S. E., Shaheen, A. A., Sadler, M. D., et al. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05427-8 · Cited by 22
“ory of implementation that aims to explain the behaviour of individuals and groups around embedding and sustaining a new practice, with specific focus given to explaining how the practice impacts relationships within the clinical setting, how it is integrated into normal workflow, and how it is understood by implement…”
Backgroundvon Wyl, V. (2021) · JMIR mhealth and uhealth · doi:10.2196/25345 · Cited by 21
Bradshaw, A., Santarelli, M., Khamis, A. M., Sartain, K., Johnson, M. J., Boland, J. W., Pearson, M., & Murtagh, F. E. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-051904 · Cited by 22
The implementation and validation of the NoMAD during a complex primary care intervention
Lamarche, L., Clark, R. E., Parascandalo, F., & Mangin, D. A. (2022) · BMC Medical Research Methodology · doi:10.1186/s12874-022-01655-0 · Cited by 23
Influences of Satisfaction with Telecare and Family Trust in Older Taiwanese People
Tsai, C.-H., Kuo, Y.-M., & Uei, S.-L. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph110201359 · Cited by 22
“This phenomenon can be explored from the normalization process theory which may be a new technology becomes routinely embedded in a social context as the result of individual [25].”
SocialCycle what can a mobile app do to encourage cycling?
Navarro, K. F., Gay, V. C., Golliard, L., Johnston, B., Leijdekkers, P., Vaughan, E., Wang, X., & Williams, M. (2013) · IEEE Conference on Local Computer Networks Workshops (LCN Workshops) · doi:10.1109/lcnw.2013.6758494 · Cited by 22
Holtrop, J. S., Potworowski, G. A., Green, L. A., & Fetters, M. D. (2016) · Journal of Mixed Methods Research · doi:10.1177/1558689816668689 · Cited by 23
Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective
Hazell, C. M., Strauss, C., Cavanagh, K., & Hayward, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0178715 · Cited by 24
“The questionnaire was based on the Normalisation Process Theory (NPT) [22].”
MethodInfluentialNoble, C., Grealish, L. A., Teodorczuk, A., Shanahan, B., Hiremagular, B., Morris, J., & Yardley, S. J. (2018) · BMC Palliative Care · doi:10.1186/s12904-018-0353-x · Cited by 22
“Table 1 Normalisation process theory constructs - generative mechanisms (From May et al., 2009 [37]) NPT construct Explanation Coherence Work that defines and organises the objects of a practice Cognitive participation Work that defines and organises the enrolment of participants in a practice…”
BackgroundImagery, Visualization, and Mental Simulation Interventions
Hagger, M. S., & Conroy, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.033 · Cited by 23
Changing Behavior Using the Common-Sense Model of Self-Regulation
Cameron, L. D., Fleszar‐Pavlović, S. E., & Khachikian, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.005 · Cited by 29
Hjort, A. V., Schreuders, M., Rasmussen, K. H., & Klinker, C. D. (2021) · Implementation Science Communications · doi:10.1186/s43058-021-00140-x · Cited by 22
“In this study, implementation is defined as the social organization of the work of bringing an intervention into routine practice, which involves dynamic and contingent interactions within a context over time [11, 12].”
BackgroundCross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese
Loch, A. P., Finch, T. L., Fonsi, M., & de Soárez, P. C. (2020) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.66.10.1383 · Cited by 21
Self-citationHardman, R., Begg, S. J., & Spelten, E. R. (2021) · BMC Family Practice · doi:10.1186/s12875-021-01387-y · Cited by 22
Schubbe, D. C., Yen, R. W., Saunders, C. H., Elwyn, G. J., Forcino, R. C., O’Malley, A. J., Politi, M. C., Margenthaler, J. A., Volk, R. J., Sepucha, K., et al. (2021) · Implementation Science · doi:10.1186/s13012-021-01115-1 · Cited by 23
“NPT is a framework that was developed to understand how complex interventions become implemented in routine healthcare settings using four theoretical constructs to contextualize implementation mechanisms [45, 46].”
BackgroundSelf-citationJack, C., Hotchkiss, E. J., Sargison, N. D., Toma, L., Milne, C. E., & Bartley, D. J. (2022) · Preventive Veterinary Medicine · doi:10.1016/j.prevetmed.2022.105594 · Cited by 21
Ballard, A. Y., Kessler, M., Scheitel, M. R., Montori, V. M., & Chaudhry, R. (2017) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-017-0514-5 · Cited by 21
Self-citationCockayne, S., Pighills, A., Adamson, J., Fairhurst, C. M., Drummond, A. E., Hewitt, C. E., Rodgers, S., Ronaldson, S. J., Lamb, S. E., Crossland, S., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022488 · Cited by 21
“For example, if the intervention is shown to be effective, we will use an Normalization Process Theory (NPT framework to facilitate the development of an implementation plan for integration of occupational therapy falls environmental assessment into routine practice.”
Asiedu, G. B., Fang, J. L., Harris, A. M., Colby, C. E., & Carroll, K. (2019) · Health Science Reports · doi:10.1002/hsr2.111 · Cited by 21
“used Normalization Process Theory (NPT), a theoretical framework for interpreting how complex interventions can be routinely embedded (normalized) in health care practices, to understand how local health care professionals perceive the implementation of teleneonatology.(17-25) We specifically referenced the human, soc…”
MethodInfluentialRoe, J., Brown, S., Yeo, C. F., Rennick‐Egglestone, S., Repper, J., Ng, F., Llewellyn‐Beardsley, J., Hui, A., Cuijpers, P. J., Thornicroft, G., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.589731 · Cited by 23
Aarts, J. W. M., Faber, M. J., Cohlen, B. J., van Oers, A. M., Nelen, W. L. D. M., & Kremer, J. A. M. (2015) · Human Fertility · doi:10.3109/14647273.2015.1057901 · Cited by 21
“This is in contrast to other studies (May et al., 2007; May et al., 2009; Atkins et al., 2011), where implementation of Internet interventions was tempered by hierarchical relationships and team members did not share a common organisational goal.”
ResultBower, P., Reeves, D., Sutton, M., Lovell, K., Blakemore, A., Hann, M., Howells, K., Meacock, R., Munford, L. A., Panagioti, M., et al. (2018) · Health Services and Delivery Research · doi:10.3310/hsdr06310 · Cited by 20
de Brún, T., de-Brún, M. O., van Weel-Baumgarten, E. V., van Weel, C., Dowrick, C., Lionis, C., O'Donnell, C., Burns, N., Mair, F., Saridaki, A., et al. (2015) · Family Practice · doi:10.1093/fampra/cmv022 · Cited by 43
Self-citationPaul, D. L., & McDaniel, R. R. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1401-y · Cited by 27
Khan, K., Hollis, C. P., Hall, C. L., Davies, E. B., Mataix‐Cols, D., Andrén, P., Murphy, T. L., Brown, B. J., Murray, E., & Glazebrook, C. (2020) · Trials · doi:10.1186/s13063-019-3974-3 · Cited by 20
“Implement Sci. 2009;4(1 LB-May2009):29. https://doi.org/10.”
InfluentialSelf-citationGray, C. S. (2020) · Journal of Medical Internet Research · doi:10.2196/17987 · Cited by 20
Engagement of Stakeholders in the Design, Evaluation, and Implementation of Complex Interventions
Hudson, J. L., Moon, Z., Hughes, L. D., & Moss-Morris, R. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.024 · Cited by 20
Foster, N. E., Konstantinou, K., Lewis, M., Ogollah, R. O., Saunders, B., Kigozi, J., Jowett, S. M., Bartlam, B., Artus, M., Hill, J. C., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24490 · Cited by 20
“4 months N= 36 N= 33 N= 59 N = 70 N = 43 N = 43 Low 31 (86) 27 (82) 37 (63) 52 (74) 17 (40) 21 (49) Medium 4 (11) 6 (18) 14 (24) 13 (19) 16 (37) 14 (33) High 1 (3) 0 (0) 8 (14) 5 (7) 10 (23) 8 (19) 12 months N= 26 N= 35 N= 50 N = 44 N = 35 N = 34”
Abel, K. M., Bee, P., Gega, L., Gellatly, J. L., Kolade, A., Hunter, D., Callender, C., Carter, L., Meacock, R., Bower, P., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24590 · Cited by 22
Holm, A., Karlsson, V., Nikolajsen, L., & Dreyer, P. (2021) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2021.100025 · Cited by 20
“Process evaluation ( Moore et al., 2015 ), normalisation process theory ( May et al., 2009 ) or diffusion of innovations ( Rogers, 2003 ), which can be used to guide evaluation and implementation, could, for example, have been useful.”
Martel, R., Shepherd, M., & Goodyear‐Smith, F. (2021) · JMIR Mental Health · doi:10.2196/30479 · Cited by 25
Depla, A. L., Pluut, B., Ruiter, M. L.-D., Kersten, A. W., Evers, I. M., Franx, A., & Bekker, M. N. (2023) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-023-00568-w · Cited by 22
Self-management education for children with epilepsy and their caregivers. A scoping review
Leviton, A., Patel, A. D., & Loddenkemper, T. (2023) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2023.109232 · Cited by 25
Carlock, K., Nygaard, M. A., & Ormiston, H. E. (2023) · School Mental Health · doi:10.1007/s12310-023-09597-8 · Cited by 22
Shepherd, V., Joyce, K., Lewis, A. L., Flynn, S., Clout, M., Nocivelli, B., Segrott, J., & Treweek, S. P. (2024) · Trials · doi:10.1186/s13063-024-07944-x · Cited by 20
“As a behavioural approach, NPT can help to explain how complex interventions work, identify factors that promote and prevent their incorporation into everyday practice, and ultimately lead to the point where an intervention becomes so embedded into routine practice that it is normalized [36].”
BackgroundSelf-citationIntroducing Evidence Through Research “Push”
Morden, A., Ong, B. N., Brooks, L. A., Jinks, C., Porcheret, M., Edwards, J., & Dziedzic, K. (2015) · Qualitative Health Research · doi:10.1177/1049732315570120 · Cited by 20
“Without appraisal, problems are unlikely to be ironed out or an intervention deemed worthwhile and sustained (May et al., 2009; May et al., 2010).”
BackgroundSelf-citationBouamrane, M.-M., Osbourne, J. A., & Mair, F. S. (2011) · International Conference on Pervasive Computing Technologies for Healthcare · doi:10.4108/icst.pervasivehealth.2011.246039 · Cited by 21
“” We refer the interested reader to a more detailed description of the theory in [11, 14] and an online tool-kit is also now available2.”
BackgroundSelf-citationMunroe, B., Curtis, K. A., Buckley, T. A., Lewis, M. J., & Atkins, L. (2017) · Journal of Clinical Nursing · doi:10.1111/jocn.13932 · Cited by 22
Values, interests and power: the politics of integrating services
Kaehne, A. (2018) · Journal of Integrated Care · doi:10.1108/jica-01-2018-0007 · Cited by 20
Metadata
- Authors
- May, C. R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., Rapley, T., Ballini, L., Ong, B. N., Rogers, A., Murray, E., Elwyn, G., Légaré, F., Gunn, J., & Montori, V. M.
- Affiliations
- Newcastle University (GB)
- University of Glasgow (GB)
- Ollscoil na Gaillimhe – University of Galway (IE)
- University of Liverpool (GB)
- University of Dundee (GB)
- Agenzia Sanitaria e Sociale Regionale (IT)
- Keele University (GB)
- University of Manchester (GB)
- University College London (GB)
- Cardiff University (GB)
- Université Laval (CA)
- The University of Melbourne (AU)
- Corresponding author
- May, Carl R
- ORCID
- Venue
- Implementation Science
- Published
- 2009-05-21
- Volume
- 4
- Issue
- 1
- Pages
- 29-29
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC2693517
- OpenAlex
- W2124199620
- Cited by
- 1,409
- References
- 62
- Citations by year
- 2026: 113 · 2025: 133 · 2024: 156 · 2023: 112 · 2022: 124 · 2021: 143 · 2020: 164 · 2019: 63 · 2018: 79 · 2017: 68 · 2016: 63 · 2015: 52 · 2014: 52 · 2013: 23 · 2012: 25
- FWCI
- 37.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Implementation Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion, cc-by)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Northumbria Research Link (Northumbria University) (acceptedVersion, other-oa)
- Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
- BIBSYS Brage (BIBSYS (Norway)) (acceptedVersion, cc-by)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- University of Limerick Institutional Repository (University of Limerick) (submittedVersion, cc-by-nc-sa)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health and Care Research (RP-PG-0407-10386)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Education › Qualitative Research Methods and Applications
- Social Sciences › Business, Management and Accounting › Management Information Systems › Information Systems Theories and Implementation
- Keywords
- Normalization Process Theory, theory development, implementation theory, middle-range theory, empirical generalization, theory testing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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