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dc.contributor.authorFinch, Tracyen_US
dc.contributor.authorGirling, Melissaen_US
dc.contributor.authorMay, Carlen_US
dc.contributor.authorMair, Francesen_US
dc.contributor.authorMurray, Elizabethen_US
dc.contributor.authorTreweek, Shaunen_US
dc.contributor.authorMcColl, Elaineen_US
dc.contributor.authorSteen, Ianen_US
dc.contributor.authorCook, Claireen_US
dc.contributor.authorVernazza, Christopheren_US
dc.contributor.authorMackintosh, Nicolaen_US
dc.contributor.authorSharma, Samridhen_US
dc.contributor.authorBarbery, Gaeryen_US
dc.contributor.authorSteele, Jimmyen_US
dc.date.accessioned2019-05-29T12:39:39Z
dc.date.available2019-05-29T12:39:39Z
dc.date.issued2018en_US
dc.identifier.issn1471-2288en_US
dc.identifier.doi10.1186/s12874-018-0591-xen_US
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.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherBioMed Centralen_US
dc.publisher.placeUnited Kingdomen_US
dc.relation.ispartofchapter135en_US
dc.relation.ispartofpagefrom1en_US
dc.relation.ispartofpageto13en_US
dc.relation.ispartofjournalBMC Medical Research Methodologyen_US
dc.relation.ispartofvolume18en_US
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classifieden_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.fieldofresearchcode119999en_US
dc.subject.fieldofresearchcode1117en_US
dc.titleImproving the normalization of complex interventions: part 2 - validation of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT)en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dc.type.codeC - Journal Articlesen_US
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/en_US
dc.description.versionPublisheden_US
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.en_US
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