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

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Understanding the implementation of complex interventions in health care: the normalization process model.
May, Carl; Finch, Tracy; Mair, Frances; Ballini, Luciana; Dowrick, Christopher; Eccles, Martin; Gask, Linda; MacFarlane, Anne; Murray, Elizabeth; Rapley, Tim; Rogers, Anne; Treweek, Shaun; Wallace, Paul; Anderson, George; Burns, Jo; Heaven, Ben
BMC health services research 2007, 7:148
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dc.contributor.authorMay, Carlen
dc.contributor.authorFinch, Tracyen
dc.contributor.authorMair, Francesen
dc.contributor.authorBallini, Lucianaen
dc.contributor.authorDowrick, Christopheren
dc.contributor.authorEccles, Martinen
dc.contributor.authorGask, Lindaen
dc.contributor.authorMacFarlane, Anneen
dc.contributor.authorMurray, Elizabethen
dc.contributor.authorRapley, Timen
dc.contributor.authorRogers, Anneen
dc.contributor.authorTreweek, Shaunen
dc.contributor.authorWallace, Paulen
dc.contributor.authorAnderson, Georgeen
dc.contributor.authorBurns, Joen
dc.contributor.authorHeaven, Benen
dc.identifier.citationBMC health services research 2007, 7:148en
dc.description.abstractBACKGROUND: 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.en
dc.publisherBioMed Centralen
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806en
dc.subject.meshEvidence-Based Medicineen
dc.subject.meshGuideline Adherenceen
dc.subject.meshModels, Theoreticalen
dc.subject.meshPhysician's Practice Patternsen
dc.subject.meshRandomized Controlled Trials as Topicen
dc.titleUnderstanding the implementation of complex interventions in health care: the normalization process model.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentInstitute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA, UK. c.r.may@ncl.ac.uken
dc.identifier.journalBMC health services researchen
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