Understanding the implementation of complex interventions in health care: the normalization process model.



May, Carl ORCID: 0000-0002-0451-2690, Finch, Tracy, Mair, Frances ORCID: 0000-0001-9780-1135, Ballini, Luciana, Dowrick, Christopher, Eccles, Martin, Gask, Linda, MacFarlane, Anne ORCID: 0000-0002-9708-5025, Murray, Elizabeth ORCID: 0000-0002-8932-3695, Rapley, Tim ORCID: 0000-0003-4836-4279
et al (show 6 more authors) (2007) Understanding the implementation of complex interventions in health care: the normalization process model. BMC health services research, 7. 148 - ?.

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Abstract

BACKGROUND: The Normalization Process Model is a theoretical model that assists in explaining the processes by which complex interventions become routinely embedded in health care practice. It offers a framework for process evaluation and also for comparative studies of complex interventions. It focuses on the factors that promote or inhibit the routine embedding of complex interventions in health care practice. METHODS: A formal theory structure is used to define the model, and its internal causal relations and mechanisms. The model is broken down to show that it is consistent and adequate in generating accurate description, systematic explanation, and the production of rational knowledge claims about the workability and integration of complex interventions. RESULTS: The model explains the normalization of complex interventions by reference to four factors demonstrated to promote or inhibit the operationalization and embedding of complex interventions (interactional workability, relational integration, skill-set workability, and contextual integration). CONCLUSION: The model is consistent and adequate. Repeated calls for theoretically sound process evaluations in randomized controlled trials of complex interventions, and policy-makers who call for a proper understanding of implementation processes, emphasize the value of conceptual tools like the Normalization Process Model.

Item Type: Article
Uncontrolled Keywords: Humans, Evidence-Based Medicine, Models, Theoretical, Physician's Practice Patterns, Guideline Adherence, Randomized Controlled Trials as Topic
Subjects: R Medicine > R Medicine (General)
Divisions: ?? sch_popsci ??
Depositing User: Symplectic Admin
Date Deposited: 06 Jun 2008 13:43
Last Modified: 14 Nov 2019 18:34
DOI: 10.1186/1472-6963-7-148
Publisher's Statement : © 2007 May et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
URI: http://livrepository.liverpool.ac.uk/id/eprint/680
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