A qualitative systematic review of studies using the normalization process theory to research implementation processes

Implementation Science

Anne MacFarlane¹  Frances S Mair²  Catherine A O’Donnell²  Susanna Maltoni³  Luciana Ballini³  Rachel McEvoy¹ 

[1] Graduate Entry Medical School, 4i Research Center, University of Limerick, Limerick, Ireland;General Practice and Primary Care, Institute of Health and Wellbeing, MVLS. University of Glasgow, 1 Horselethill Road, G12 9LX, Glasgow, Scotland;Responsabile di Area, Osservatorio Regionale per l’Innovazione (ORI), Agenzia sanitaria e sociale regionale, viale Aldo Moro 21-40127, Bologna, Italy

关键词: Translational gaps;    Theory;    Normalization process theory;    Policy;    Implementation;   

Others  :  810645
DOI  :  10.1186/1748-5908-9-2

 received in 2013-05-13, accepted in 2013-12-03,  发布年份 2014

【 摘 要 】

Background

There is a well-recognized need for greater use of theory to address research translational gaps. Normalization Process Theory (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 implemented, embedded, and integrated in healthcare and other organizational settings. This review of NPT offers readers the opportunity to observe how, and in what areas, a particular theoretical approach to implementation is being used. In this article we review the literature on NPT in order to understand what interventions NPT is being used to analyze, how NPT is being operationalized, and the reported benefits, if any, of using NPT.

Methods

Using a framework analysis approach, we conducted a qualitative systematic review of peer-reviewed literature using NPT. We searched 12 electronic databases and all citations linked to six key NPT development papers. Grey literature/unpublished studies were not sought. Limitations of English language, healthcare setting and year of publication 2006 to June 2012 were set.

Results

Twenty-nine articles met the inclusion criteria; in the main, NPT is being applied to qualitatively analyze a diverse range of complex interventions, many beyond its original field of e-health and telehealth. The NPT constructs have high stability across settings and, notwithstanding challenges in applying NPT in terms of managing overlaps between constructs, there is evidence that it is a beneficial heuristic device to explain and guide implementation processes.

Conclusions

NPT offers a generalizable framework that can be applied across contexts with opportunities for incremental knowledge gain over time and an explicit framework for analysis, which can explain and potentially shape implementation processes. This is the first review of NPT in use and it generates an impetus for further and extended use of NPT. We recommend that in future NPT research, authors should explicate their rationale for choosing NPT as their theoretical framework and, where possible, involve multiple stakeholders including service users to enable analysis of implementation from a range of perspectives.

【 授权许可】

   
2014 McEvoy et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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