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dc.contributor.authorFinch, Tracy L
dc.contributor.authorGirling, Melissa
dc.contributor.authorMay, Carl R
dc.contributor.authorMair, Frances S
dc.contributor.authorMurray, Elizabeth
dc.contributor.authorTreweek, Shaun
dc.contributor.authorMcColl, Elaine
dc.contributor.authorSteen, Ian Nicholas
dc.contributor.authorCook, Clare
dc.contributor.authorVernazza, Christopher R
dc.contributor.authorMackintosh, Nicola
dc.contributor.authorSharma, Samridh
dc.contributor.authorBarbery, Gaery
dc.contributor.authorSteele, Jimmy
dc.contributor.authorRapley, Tim
dc.date.accessioned2019-07-05T12:30:53Z
dc.date.available2019-07-05T12:30:53Z
dc.date.issued2018
dc.identifier.issn1471-2288
dc.identifier.doi10.1186/s12874-018-0591-x
dc.identifier.urihttp://hdl.handle.net/10072/381414
dc.description.abstractIntroduction: Successful implementation and embedding of new health care practices relies on co-ordinated, collective behaviour of individuals working within the constraints of health care settings. Normalization Process Theory (NPT) provides a theory of implementation that emphasises collective action in explaining, and shaping, the embedding of new practices. To extend the practical utility of NPT for improving implementation success, an instrument (NoMAD) was developed and validated. Methods: Descriptive analysis and psychometric testing of an instrument developed by the authors, through an iterative process that included item generation, consensus methods, item appraisal, and cognitive testing. A 46 item questionnaire was tested in 6 sites implementing health related interventions, using paper and online completion. Participants were staff directly involved in working with the interventions. Descriptive analysis and consensus methods were used to remove redundancy, reducing the final tool to 23 items. Data were subject to confirmatory factor analysis which sought to confirm the theoretical structure within the sample. Results: We obtained 831 completed questionnaires, an average response rate of 39% (range: 22–77%). Full completion of items was 50% (n = 413). The confirmatory factor analysis showed the model achieved acceptable fit (CFI = 0.95, TLI = 0.93, RMSEA = 0.08, SRMR = 0.03). Construct validity of the four theoretical constructs of NPT was supported, and internal consistency (Cronbach’s alpha) were as follows: Coherence (4 items, α = 0.71); Collective Action (7 items, α = 0.78); Cognitive Participation (4 items, α = 0.81); Reflexive Monitoring (5 items, α = 0.65). The normalisation scale overall, was highly reliable (20 items, α = 0.89). Conclusions: The NoMAD instrument has good face validity, construct validity and internal consistency, for assessing staff perceptions of factors relevant to embedding interventions that change their work practices. Uses in evaluating and guiding implementation are proposed.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherBioMed Central
dc.publisher.placeUnited Kingdom
dc.relation.ispartofchapter135
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto13
dc.relation.ispartofjournalBMC Medical Research Methodology
dc.relation.ispartofvolume18
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode119999
dc.subject.fieldofresearchcode1117
dc.titleImproving the normalization of complex interventions: part 2 - validation of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT)
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.description.versionPublished
gro.rights.copyright© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
gro.hasfulltextFull Text
gro.griffith.authorBarbery, Gaery J.


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