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
Cites
(1998) · Sage eBooks · Cited by 38,631
(1999) · Cited by 28,356
(1980) · Medical Entomology and Zoology · Cited by 25,810
The Discovery of Grounded Theory: Strategies for Qualitative Research
Glaser, B. G., & Strauss, A. L. (2017) · Aldine (Routledge reprint) · doi:10.4324/9780203793206 · Cited by 25,789
Communities of Practice: Learning, Meaning, and Identity
Wenger, E. (1998) · doi:10.1017/cbo9780511803932 · Cited by 23,500
(2006) · Cited by 18,730
Reassembling the Social: An Introduction to Actor-Network-Theory
Latour, B. (2005) · doi:10.1093/oso/9780199256044.001.0001 · Cited by 16,778
Qualitative Analysis for Social Scientists
Strauss, A. L. (1987) · doi:10.1017/cbo9780511557842 · Cited by 12,277 · cited 2×
“Between 2003 and 2007, using grounded theory-building techniques [21,22], an applied theoretical model of normalization processes – the Normalization Process Model, or NPM, [7] – was derived from earlier empirical generalizations across all four domains of study.”
(1990) · Cited by 11,110
Social Theory and Social Structure
Ross, E. J., & Merton, R. Κ. (1958) · The American Catholic Sociological Review · doi:10.2307/3709394 · Cited by 10,318
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
- Goldthorpe JH: On Sociology: Critique and Program. 2006, Stanford: Stanford University Press
- Hechter M, Horne C: Theory is explanation. Theories of social order. Edited by: Hechter M, Horne C. 2003, Stanford CA: Stanford University Press
- 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
Sorted by citations
Items 501–600 of 1,000
Webb, T. L., & de Bruin, M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.037 · Cited by 16
Benn, J. J., Arnold, G., D’Lima, D., Wei, I., Moore, J., Aleva, F. E., Smith, A. F., Bottle, A., & Brett, S. J. (2015) · Health Services and Delivery Research · doi:10.3310/hsdr03320 · Cited by 14
Engström, M. S., Johansson, U., Leksell, J. K., Linder, E., & Eeg‐Olofsson, K. (2022) · JMIR Diabetes · doi:10.2196/34561 · Cited by 14
Owusu, L., Tuwor, R. D., Ackam, N., Loglo, A. D., Agbavor, B., Agbanyo, A., Dornu, O., Antwi, P. B., Oppong, M. N., Adjei, J. K., et al. (2023) · BMC Public Health · doi:10.1186/s12889-023-16015-w · Cited by 13
“Participant recruitment and sampling The study used a semi-structured interview guide (Additional file 1) adapted from the construct of the Normalisation Process Theory (NPT) [32] to assess and explain how the work of CBSVs can be nested in community healthcare delivery particularly in the management of skin NTDs.”
MethodInfluentialGherson, S., Tripp, R., Goudelias, D., & Johnson, A. M. (2023) · Journal of Voice · doi:10.1016/j.jvoice.2023.06.024 · Cited by 15
Gray, C. S., Ramachandran, M., Brinton, C. G., Forte, M., Loganathan, M., Walsh, R., Callaghan, J., Upshur, R. E. G., & Wiljer, D. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.116962 · Cited by 14
Henderson, E. J. (2014) · Public Health Nutrition · doi:10.1017/s1368980014002249 · Cited by 13
The process of implementation of the diabetes register in Primary Health Care
Hallgren, I.-M., Törnvall, E., & Grodzinsky, E. (2012) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzs019 · Cited by 13
“From 2002 until 2005, the P4P programme was carried out and the implementation had reached a stage where the registration routine was embedded in everyday practice [15].”
BackgroundMethodInfluentialKempen, T. G. H., Gillespie, U., Färdborg, M., McIntosh, J., Mair, A. R., & Stewart, D. C. (2018) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2018.12.006 · Cited by 13
Maehder, K., Werner, S., Weigel, A., Löwe, B., Heddaeus, D., Härter, M. C., & Knesebeck, O. V. D. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03274-3 · Cited by 13
“The implementation framework that served as a basis for the development of the interview guides was Greenhalgh’s model of Diffusion of Innovations in Service Organizations [24], complemented by the Medical Research Council guidance on process evaluations of complex interventions [25] and May’s Normalization Process Th…”
MethodValidity and reliability of the Chinese version of the Normalization MeAsure Development(NoMAD)
Jiang, M., Wáng, Q., Finch, T. L., She, D., Zhou, Y., Chung, Y. F., Chen, J., & Han, L. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08737-1 · Cited by 12
“NoMAD was derived from the Normalization Process Theory (NPT) which aims at describing and explaining the implementation, embedding, integration of organizational innovations and complex interventions into clinical routine [23, 24].”
MethodSelf-citationEn busca de una salud más participativa: compartiendo decisiones de salud
Bravo, P., Contreras, A., Perestelo‐Pérez, L., Pérez-Ramos, J., & Málaga, G. (2014) · Revista Peruana de Medicina Experimental y Salud Pública · doi:10.17843/rpmesp.2013.304.254 · Cited by 13
Hazell, C. M., Strauss, C., Hayward, M., & Cavanagh, K. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2449-z · Cited by 11
Rushton, K., Fraser, C., Gellatly, J. L., Brooks, H. L., Bower, P., Armitage, C. J., Faija, C., Welsh, C., & Bee, P. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4824-4 · Cited by 13
Farré, A., & Cummins, C. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010444 · Cited by 13
Editorial: Personalized Digital Health and Patient-Centric Services
Hägglund, M., Cajander, Å., Rexhepi, H., & Kane, B. T. (2022) · Frontiers in Computer Science · doi:10.3389/fcomp.2022.862358 · Cited by 14
“Using Normalization Process Theory (May and Finch, 2009; May et al., 2009), Davis concludes that a personal health record supporting shared decision-making makes sense and is positive to the different stakeholders participating in their study.”
MethodWilliams, C. R., Bogdewic, S., Owen, M. D., Srofenyoh, E. K., & Ramaswamy, R. (2020) · Implementation Science · doi:10.1186/s13012-020-00992-2 · Cited by 10
“Sustainability will be assessed using Normalization Process Theory (NPT), which seeks to explain how new technologies and practices become embedded into health provider routines [28, 29], as well as by the post-implementation measurements of waiting time, compliance, and accuracy.”
MethodTsang, J. Y., Brown, B. C., Peek, N. B., Campbell, S., & Blakeman, T. (2020) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2020.104299 · Cited by 12
Chan, J., Blane, D., Choudhary, P., Chowdhury, T. A., Goyal, A., Hanif, W., Jacca, J., Mathur, R., Misra, S., Ocran, N., et al. (2022) · Diabetic Medicine · doi:10.1111/dme.15024 · Cited by 12
Self-citationWang, Y., Guo, D., Wang, M., Hu, M., Zhu, D., Yu, Q., Li, Z., Zhang, X., Ding, R., Zhao, M., et al. (2023) · Trials · doi:10.1186/s13063-023-07561-0 · Cited by 12
“NPT is ideal because it focuses on understanding the collective action and organizational behavior required to introduce complex and innovative interventions [37].”
BackgroundCarter, H. M., Beard, D. J., Harvey, A., Leighton, P. A., Moffatt, F., Smith, B. E., Webster, K. E., & Logan, P. (2023) · Implementation Science Communications · doi:10.1186/s43058-023-00499-z · Cited by 12
“The normalisation process theory (NPT) is a popular choice among healthcare researchers with one of the key papers outlining the theory being cited over 500 times in Scopus [7].”
BackgroundGillam, J., Evans, C., Aworinde, J., Ellis-Smith, C. I., Ross, J., & Davies, N. (2023) · Digital Health · doi:10.1177/20552076231211118 · Cited by 12
“45 Through discussion, we re fi ned areas of importance, achieved consensus on implementation requirements and identi fi ed suitable implementation strategies to overcome the barriers identi fi ed 5.”
MethodGilman, S. D., Gravitt, P. E., Paz‐Soldán, V. A., on behalf of the Proyecto Precancer Study Group, Brown, J., Jara, L. E. C., Cordova, J., Hidalgo, D. L. D. C., Escudero, D. M. F., Díaz, K. G., et al. (2024) · Implementation Science Communications · doi:10.1186/s43058-024-00566-z · Cited by 12
McLeod, J., Estcourt, C. S., MacDonald, J., Gibbs, J., Owusu, M. W., Mapp, F., Márquez, N. G., McInnes-Dean, A., Saunders, J., BLANDFORD, A. E., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0315049 · Cited by 12
Ruud, K. L., LeBlanc, A., Mullan, R. J., Pencille, L. J., Tiedje, K., Branda, M. E., Houten, H. K. V., Heim, S. R., Kurland, M., Shah, N. D., et al. (2013) · Trials · doi:10.1186/1745-6215-14-267 · Cited by 11
“Perhaps the ongoing interaction between study coordinators and clinicians recruited through the inclinic approach reinforced clinicians’ understanding of the work, thus resulting in better integration of the DA and of the trial procedures into the practice, higher levels of patient engagement in decision making, and m…”
BackgroundSelf-citationFredriksen, E., Thygesen, E., Moe, C. E., & Martínez, S. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06429-w · Cited by 13
“Appraisal of the intervention is both individual and collective, and it can be evaluated informally and formally [32, 39] in relation to critical issues and possible strategies.”
BackgroundMazza, D., Chakraborty, S. P., Camões‐Costa, V., Kenardy, J. A., Brijnath, B., Mortimer, D., Enticott, J., Kidd, M. R., Trevena, L. J., Reid, S. E., et al. (2021) · Implementation Science · doi:10.1186/s13012-021-01146-8 · Cited by 12
Egholm, C. L., Helmark, C., Rossau, H. K., Munkehøj, P., Brøndum, S., Pedersen, S. S., & Zwisler, A. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110909 · Cited by 12
Engeltjes, B., Rosman, A. N., Scheele, F., Vis, C., & Wouters, E. (2022) · JMIR Formative Research · doi:10.2196/33709 · Cited by 12
“The NPT characterizes implementation as a social process of collective action [15-18].”
BackgroundInfluentialMurphy, A., Willis, R., Ansbro, É., Masri, S., Kabbara, N., Dabbousy, T., Bahous, S. A., Molfino, L., Perel, P., & Boulle, P. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08040-z · Cited by 11
“Within these processes, the actors’ understanding of their role in enacting the intervention, their confidence in doing so, and the sense that they are the “right people” to do so are all important to supporting implementation [29, 30].”
BackgroundJarvis, H., Sanders, T., & Hanratty, B. (2022) · British Journal of General Practice · doi:10.3399/bjgp.2022.0094 · Cited by 14
van Kleef, E., Dijkstra, S. C., Seidell, J. C., Vingerhoeds, M. H., Polet, I. A., & Zeinstra, G. G. (2022) · Journal of Health Population and Nutrition · doi:10.1186/s41043-022-00328-4 · Cited by 15
“Because a school lunch implementation can be seen as a complex intervention, normalization process theory has been chosen as the underlying framework [19, 20].”
BackgroundEngaging in large-scale digital health technologies and services. What factors hinder recruitment?
O’Connor, S., Mair, F. S., Lennon, M., Bouamrane, M.-M., & Kate, O. (2015) · Studies in health technology and informatics · doi:10.3233/978-1-61499-512-8-306 · Cited by 12
Self-citationPersonnel and Participant Experiences of a Residential Weight-Loss Program. A Qualitative Study
Dahl, U., Rise, M. B., Kulseng, B. E., & Steinsbekk, A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100226 · Cited by 12
Implementation research ‐ its importance and application in primary care
Jackson, C. L., Janamian, T., van Weel, C., & Dunbar, J. (2014) · The Medical Journal of Australia · doi:10.5694/mja14.00063 · Cited by 12
Dupin, C. M., Larsson, M., Dariel, O. P. D., Debout, C., & Rothan‐Tondeur, M. (2014) · Nurse Education Today · doi:10.1016/j.nedt.2014.06.003 · Cited by 15
Using process-mapping to design integrated health information management systems
Bouamrane, M.-M., Lennon, M., Brewster, S. A., & Mair, F. S. (2011) · Proceedings - IEEE Symposium on Computer-Based Medical Systems · doi:10.1109/cbms.2011.5999127 · Cited by 12
“Health services and sociology practitioners and researchers, have also recently developed more sophisticated theories and analysis tools, including the Normalization Process Theory (NPT), a theoretical model of processes of intervention within health services [12, 13].”
BackgroundSelf-citationImplementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke
French, B., Thomas, L. H., Harrison, J., Burton, C. R., Forshaw, D., Booth, J., Britt, D. P., Cheater, F., Roe, B. H., Watkins, C. L., et al. (2016) · Qualitative Health Research · doi:10.1177/1049732316630975 · Cited by 12
Practice change in chronic conditions care: an appraisal of theories
Harris, M., Lawn, S., Morello, A., Battersby, M., Ratcliffe, J., McEvoy, R. D., & Tieman, J. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2102-x · Cited by 14
Anku, P. J., Amo‐Adjei, J., Doku, D. T., & Kumi-Kyereme, A. (2017) · Global Public Health · doi:10.1080/17441692.2017.1385823 · Cited by 12
“This paper sought to examine the experiences of TB–HIV co-infected patients with regard to treatment and care in the various models of care and their views on TB–HIV service integration, using the NPT as a framework.”
BackgroundMethodInfluentialCritical and Qualitative Approaches to Behavior Change
Chamberlain, K., & Lyons, A. C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.030 · Cited by 13
Nelson, L. A., Williamson, S., Nigg, A., & Martínez, W. (2020) · Current Diabetes Reports · doi:10.1007/s11892-020-01356-2 · Cited by 13
Greenwood, K., Webb, R., Gu, J., Fowler, D. G., de Visser, R. O., Bremner, S. A., Abramowicz, I., Perry, N., Clark, S., O’Donnell, A., et al. (2021) · Trials · doi:10.1186/s13063-021-05105-y · Cited by 12
Self-citationCommunity participation in primary care in Ireland: the need for implementation research
McEvoy, R., & MacFarlane, A. E. (2012) · Primary Health Care Research & Development · doi:10.1017/s1463423612000163 · Cited by 13
“A recently developed social theory, that provides a comprehensive theoretical framework to investigate, assess and support implementation of innovation in routine day-to-day healthcare settings, is Normalisation Process Theory (NPT; May and Finch, 2009; May et al., 2009).”
BackgroundSelf-citationvan der Kleij, R., Crone, M. R., Reis, R., & Paulussen, T. G. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0423-5 · Cited by 12
“This priority dilemma also links to what is referred to as contextual integration in the Normalization Process Theory [49], meaning that the implementation and normalization of activities depends on how it relates to (the demands and context of) the organization it is implemented.”
BackgroundDaneshvar, H., Anderson, S., Williams, R., & Mozaffar, H. (2018) · JMIR Human Factors · doi:10.2196/humanfactors.7856 · Cited by 11
“NPT offers a whole system perspective, to assist researchers to make sense of the social and organizational aspects of different interventions and to better conceptualize the complex adaptive systems.”
MethodInfluentialSuccessful Implementation of Technological Innovations in Health Care Organizations
Wouters, E., Weijers, T. C. M., & Finch, T. L. (2016) · Springer eBooks · doi:10.1007/978-3-319-01583-5_68 · Cited by 12
Self-citationGellatly, J., Pelikan, G., Wilson, P., Woodward-Nutt, K., Spence, M., Jones, A., & Lovell, K. (2018) · BMC Family Practice · doi:10.1186/s12875-018-0838-y · Cited by 11
“Normalisation Process Theory (NPT) is a widely used evidence-based theoretical approach that facilitates the understanding of how new interventions become part of existing practices through social organisation of the work and integration into social contexts [26].”
BackgroundMethodLane, C., McCrabb, S., Turon, H., Bialek, C., Couper, L., Wilczynska, M., Gray, S. M., Barnes, C., Fee, M., Kuchenmüller, T., et al. (2026) · Implementation Science · doi:10.1186/s13012-025-01482-z · Cited by 14
“In this respect, our findings also relate to Normalization Process Theory, which concep-tualises the embedding of complex interventions as an ongoing process of collective work required to integrate new practices into routine settings [138].”
Maximizing User Engagement with Behavior Change Interventions
Yardley, L., Morrison, L. G., Müller, I., & Bradbury, K. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.025 · Cited by 11
Ramaswamy, R., Bogdewic, S., Williams, C. R., Deganus, S., Bonzi, G. A., Boakye, J., Koranteng, E., Mensah, R., Amanor, A., Bryce, F., et al. (2023) · Implementation Science Communications · doi:10.1186/s43058-023-00527-y · Cited by 12
Oesch, S., Verweij, L., Riguzzi, M., Finch, T. L., & Naef, R. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16544 · Cited by 10
“Collective action captures KPs' efforts to implement the FSI (May et al. 2009).”
InfluentialSelf-citationZharima, C., Mhlanga, S., Abdulla, S., Goudge, J., & Griffiths, F. E. (2024) · Digital Health · doi:10.1177/20552076241291286 · Cited by 11
“14,19 The NPT explores the factors in fl uencing the routine embedding of complex interventions into everyday practice.”
Lin, Y., Myall, M., & Jarrett, N. (2017) · Journal of Advanced Nursing · doi:10.1111/jan.13368 · Cited by 11
“Complex medical practice has been investigated from a social science perspective (May and Finch 2009; May et al. 2009; Murray et al. 2010).”
BackgroundKosse, R. C., Murray, E., Bouvy, M. L., de Vries, T. W., Stevenson, F. A., & Koster, E. S. (2019) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2019.05.004 · Cited by 12
Self-citationFoster, A., O’Cathain, A., & Harris, J. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039116 · Cited by 11
Sharp, C. A., Bresnen, M., Austin, L., McCarthy, J., Dixon, W. G., & Sanders, C. (2020) · Journal of Health Organization and Management · doi:10.1108/jhom-07-2020-0295 · Cited by 13
Hassett, L. M., Jennings, M. D., Brady, B., Pinheiro, M. B., Haynes, A. S., Sidhu, B., Christie, L., Dennis, S. M., Pearce, A. M., Howard, K., et al. (2022) · Implementation Science Communications · doi:10.1186/s43058-022-00291-5 · Cited by 11
“May CR, Mair F, Finch T, MacFarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: Normalization Process Theory.”
MethodInfluentialKhano, S., Sanci, L. A., Woolfenden, S. R., Zurynski, Y. A., Dalziel, K., Liaw, S., Boyle, D. I., Freed, G. L., Moore, C. L., Hodgins, M., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-063449 · Cited by 11
Morgan, T. L., Pletch, J., Faught, E., Fortier, M., Gazendam, M. K., Howse, K., Jain, R., Lane, K. N., Maclaren, K., McFadden, T., et al. (2023) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-023-02147-x · Cited by 14
Graffy, J., Goodhart, C., Sennett, K., Kamusiime, G., & Tukamushaba, H. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-1022 · Cited by 11
“There is a growing body of literature on factors which facilitate behaviour change and the implementation of new initiatives in health [20,23,24].”
BackgroundTop tips for embedding chronic condition self-management support into practice
Lawn, S. (2010) · Australian Journal of Primary Health · doi:10.1071/py09070 · Cited by 11
“Use of a framework like Normalisation Process Theory (May 2006; May et al. 2009) may add further understanding of the processes at play here, in particular, the complexity of interacts within and between processes.”
MethodResultLewis, K. B., Birnie, D. H., Carroll, S. L., Clark, L., Kelly, F., Gibson, P. J., Rockburn, L., Rockburn, L., & Stacey, D. (2018) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000477 · Cited by 11
Proudfoot, J. G., Gale, N., O’Moore, K., Faraj, M., Gieng, C., & Anderson, J. (2019) · Advances in Mental Health · doi:10.1080/18387357.2019.1662318 · Cited by 11
“…et al. (2017) components and used a combination of processes involving: (1) implementation theory, specifically Normalisation Process Theory (NPT: May et al., 2009; Murray et al., 2010), (2) real-world experience involving participatory design with a PHN, and (3) consultations with GPs and…”
BackgroundMethodTiem, J. M. V., Friberg, J. E., Wilson, J. R., Fitzwater, L., Blum, J. M., Panos, R. J., Reisinger, H. S., & Moeckli, J. K. (2020) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2019.0135 · Cited by 11
Alderson, H., Kaner, E., Brown, R., Howel, D., McColl, E., Smart, D., Copello, A. G., Fouweather, T., McGovern, R., Brown, H., et al. (2020) · Public Health Research · doi:10.3310/phr08130 · Cited by 11
Orazani, S. N., Wohl, M. J. A., & Leidner, B. (2020) · Group Processes & Intergroup Relations · doi:10.1177/1368430220943265 · Cited by 11
“…– a process whereby new and previously non-normative ways of behaving and thinking become standard and embedded in people’s everyday life (May et al., 2009) – of the radical right may result in a desire by those on the left to restrict their freedom of speech and avoid exposure to…”
BackgroundHjort, A. V., Kuipers, M. A. G., Stage, M., Pisinger, C. H., & Klinker, C. D. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912489 · Cited by 11
Transformation of health visiting services in England using an Online Community of Practice
Ikioda, F., & Kendall, S. A. (2016) · Health Policy and Technology · doi:10.1016/j.hlpt.2016.02.006 · Cited by 11
Goodwin, N. (2017) · Springer eBooks · doi:10.1007/978-3-319-56103-5_16 · Cited by 11
Meurk, C., Parker, S., Newman, E., & Dark, F. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00468 · Cited by 10
“The overall coherence in views on recovery and recovery-oriented practice between peer and clinical staff indicates a key support factor for the implementation of PSW roles under the integrated staffing model (22, 35, 36).”
BackgroundLobban, F. A., Appleton, V., Appelbe, D. E., Barraclough, J., Bowland, J., Fisher, N. R., Foster, S., Johnson, S., Lewis, E., Mateus, C., et al. (2017) · Implementation Science · doi:10.1186/s13012-017-0687-4 · Cited by 10
Self-citationPetersen, H. V., Sivertsen, D. M., Jørgensen, L. M., Petersen, J., & Kirk, J. W. (2022) · Journal of Clinical Nursing · doi:10.1111/jocn.16410 · Cited by 10
Tassinari, C., Higham, R., Smith, I. L., Arnold, S., Mújica-Mota, R., Metcalfe, A. J., Simpson, H., Murray, D. W., McGonagle, D., Sharma, H., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062721 · Cited by 10
Factors Influencing the Implementation of Digital Advance Care Planning: Qualitative Interview Study
Bradshaw, A., Birtwistle, J. C., Evans, C., Sleeman, K. E., Richards, S. H., Foy, R., Martin, P. M., Carder, P., Allsop, M. J., & Twiddy, M. (2024) · Journal of Medical Internet Research · doi:10.2196/50217 · Cited by 12
“Normalization Process Theory (NPT) is an implementation theory that is used to explain how complex interventions are normalized (ie, deeply embedded into, and used as part of, routine practice) [43-45].”
Moloney, M., Taggart, L., Hennessy, T., & Doody, O. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16566 · Cited by 12
“Some examples of commonly used TMFs include the CIHR Model of Knowledge Transfer (Canadian Institutes of Health Research), the Normalisation Process Theory (NPT) (May et al. 2009) and the Consolidated Framework for Implementation Research (CFIR) (Breimaier et al. 2015).”
Dorward, J., Sookrajh, Y., Ngobese, H., Lessells, R. J., Sayed, F., Bulo, E., Moodley, P., Samsunder, N., Lewis, L., Tonkin-Crine, S. K., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045373 · Cited by 10
Holden, M. A., Callaghan, M. J., Felson, D. T., Birrell, F. N., Nicholls, E. E., Jowett, S. M., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048196 · Cited by 10
“Inductive analysis (described above) will precede deductive analysis and mapping of themes to TDF or NPT constructs.”
Valaitis, R. K., Cleghorn, L., Vassilev, I., Rogers, A. E., Ploeg, J., Kothari, A. R., Risdon, C., Gillett, J., Guenter, D., & Dolovich, L. R. (2021) · JMIR Formative Research · doi:10.2196/25285 · Cited by 10
“LC coded the interview and focus groups by inductively organizing the coding using the interview guide that was guided by NPT [40].”
BackgroundMethodInfluentialSelf-citationCunningham, Y., Wood, K., Stewart, C., Nakham, A., Newlands, R. S. N., Gallacher, K., Quinn, T. J., Ellis, G., Lowrie, R., Myint, P. K., et al. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.608208 · Cited by 10
“…tasks or practices is accomplished through the operation of four mechanisms: “coherence” (sense-making work); “cognitive participation” (relationship work); “collective action” (enacting work); and “reflexive monitoring” (appraisal work) (May and Finch, 2009; May et al., 2009; Murray et al., 2010).”
BackgroundSelf-citationMoberg, J., & Schön, U. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1054028 · Cited by 10
“In semistructured focus group interviews, outpatient and inpatient care staff shared these experiences, and a number of dominant themes have been identified and interpreted within the theoretical frameworks of epistemic injustice and NPT.”
BackgroundInfluentialFactors That Influence the Use of eHealth in Home Care: Scoping Review and Cross-sectional Survey
Mathijssen, E. G. E., de Lange, W., Bleijenberg, N., van Houwelingen, T., Jaarsma, T., Trappenburg, J. C. A., & Westland, H. (2022) · Journal of Medical Internet Research · doi:10.2196/41768 · Cited by 10
“The use of theory-based implementation instruments (eg, the eHealth Implementation Toolkit) may facilitate the involvement of health care professionals and home care clients in the implementation phase of new types of eHealth [66].”
MethodOesch, S., Verweij, L., Clack, L., Finch, T. L., Riguzzi, M., & Naef, R. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-074142 · Cited by 10
“(2022), 3 Implementation strategy - mechanims based on NPT (May et al., 2009), 4 Measured outcomes according to the conceptualization of Proctor et al.”
MethodSelf-citationLeresche, E., Hossain, M., de Rubeis, M. L., Hermans, V., Burtscher, D., Rossi, R., Lonsdale, C., & Singh, N. (2023) · Conflict and Health · doi:10.1186/s13031-023-00534-9 · Cited by 10
“Used interchangeably with implementing actor [41, 42] New empirical findings Research results that bring a new form of knowledge and imply a change in practice Authors Peripheral component of an intervention A component that is not the core of the intervention and can be modified, for example the…”
MethodAn overview of electronic health information management systems quality assessment
Bouamrane, M.-M., Mair, F. S., & Tao, C. (2012) · International Workshop on Managing Interoperability and Complexity in Health Systems (MIXHS) · doi:10.1145/2389672.2389680 · Cited by 9
“The importance of the context of service delivery and implementation processes is a key element of the Medical Research Council Complex Intervention Framework and many researchers have highlighted the importance of analysing implementation processes in order to identify the factors which promote the success - or indee…”
BackgroundSelf-citationTallon, D., Wiles, N., Campbell, J., Chew-Graham, C. A., Dickens, C. M., Macleod, U., Peters, T. J., Lewis, G., Anderson, I. M., Gilbody, S. M., et al. (2016) · Trials · doi:10.1186/s13063-016-1199-2 · Cited by 10
“Both data sets will be interrogated and re-analysed against the Normalisation Process Theory framework [49] in order to consider how prescribing two antidepressants may, or may not, be normalised into clinical practice.”
MethodGreenwood, K., Alford, K., O’Leary, I., PETERS, E. R., Hardy, A., Cavanagh, K., Field, A. P., de Visser, R. O., Fowler, D. G., Davies, M., et al. (2018) · Trials · doi:10.1186/s13063-018-3023-7 · Cited by 10
Leppin, A. L., Boehmer, K. R., Branda, M. E., Shah, N. D., Hargraves, I. G., Dick, S. R., Elwyn, G. J., Ting, H. H., Ye, S., Gilles, R., et al. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4055-8 · Cited by 10
“monitoring work) from Normalization Process Theory [38] to analyze all the 6-month qualitative data, tak-”
BackgroundMethodInfluentialSelf-citationHollinshead, L., Jones, F., Silvester, L., & Marshall-Taylor, P. (2019) · BMJ Open Quality · doi:10.1136/bmjoq-2018-000415 · Cited by 10
The Science of Behavior Change: The Road Ahead
Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N. E., & Lintunen, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.046 · Cited by 13
Yates, N. J., & Lathlean, J. (2022) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12365 · Cited by 10
“NPT was chosen to guide the interview as it is supported in the literature (May et al., 2009) as a useful tool to aid research into the application of intervention; it is, therefore, a good fit for the objectives of this study.”
MethodHow GPs implement clinical guidelines in everyday clinical practice—a qualitative interview study
Le, J. V., Hansen, H. P., Riisgaard, H., Lykkegaard, J., Nexøe, J., Bro, F., & Søndergaard, J. (2015) · Family Practice · doi:10.1093/fampra/cmv061 · Cited by 10
Harvey, G., & Kitson, A. A. (2015) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2015.214 · Cited by 10
Applying Normalization Process Theory to Explain Large-Scale Agile TransformationsPreprint
Carroll, N., & Conboy, K. (2020) · arXiv (Cornell University) · doi:10.48550/arxiv.2004.10431 · Cited by 10
“Normalization Re-examines Assumptions of Large-Scale Agile Transformations.”
BackgroundInfluentialKvæl, L. A. H., Gulbrandsen, P., Werner, A., & Bergland, A. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11647-z · Cited by 10
“Based on a JLA process and from a pragmatist perspective [42], we employed a process evaluation design [43] using NPT [37].”
BackgroundMethodInfluentialLarsson, I., Siira, E., Nygren, J., Petersson, L., Svedberg, P., Nilsén, P., & Neher, M. (2025) · BMC Family Practice · doi:10.1186/s12875-025-03057-9 · Cited by 14
“NPT provides a framework to understand the dynamics of implementing, embedding, and integrating new technology or complex interventions in clinical practice [34, 37].”
King, R., Sanders, T., & Tod, A. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14834 · Cited by 10
On behalf of the RESPECT 2 study group, van Hoorn, F., Koster, M. P. H., Kwee, A., Groenendaal, F., Franx, A., & Bekker, M. N. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03749-x · Cited by 9
“Professionals have to integrate the model into their daily work routine while being influenced by group processes, social conventions, organisational factors and social structures they operate in (normalisation process) [16].”
BackgroundZucca, C., Long, E., Hilton, J., & McCann, M. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.653588 · Cited by 9
Understanding How Newly Implemented Rehabilitation Best Practices Are Sustained: A Realist Review
Ataman, R., Ahmed, S., Zidan, A., & Thomas, A. (2022) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.05.016 · Cited by 12
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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