Improving the normalisation of complex interventions: NoMAD

The NoMAD study developed and validated a survey instrument for assessing the implementation of complex interventions from the perspective of (healthcare) staff, based on Normalization Process Theory (NPT). The data set contains 522 surveys from 6 different implementation projects. The data comprises responses to 43 statements that reflect factors affecting routine embedding of new interventions, developed to reflect the NPT constructs (coherence, cognitive participation, collection action and reflexive monitoring); and 3-6 items (per site) that represent overall assessment of implementation progress. The data has been generated to test psychometric properties of the newly developed NoMAD survey instrument.<p>Understanding implementation processes is key to ensuring that complex interventions in healthcare are taken up in practice and thus maximise intended benefits for service provision and (ultimately) care to patients. Normalisation Process Theory (NPT) provides a framework for understanding how a new intervention becomes part of normal practice.

This study aims to develop and validate simple generic tools derived from NPT, to be used to improve the implementation of complex healthcare interventions. Our objectives are to:

(1) develop a set of NPT based measures and formatively evaluate their use for identifying implementation problems and monitoring progress;
(2) conduct preliminary evaluation of these measures across a range of interventions and contexts, and identify factors that affect this process;
(3) explore the utility of these measures for predicting outcomes;
(4) develop an online users' manual for the measures.

A combination of qualitative (workshops, item development, user feedback, cognitive interviews) and quantitative (survey) methods will be used to develop NPT measures, and test the utility of the measures in a variety of (n=6) healthcare intervention settings. The measures developed in the study will be available for use by those involved in planning, implementing and evaluating complex interventions in healthcare.</p>