Normalization Process Theory

Normalization Process Theory

D and/or I:
The focus on dissemination and/or implementation activities. D-only focuses on an active approach of spreading evidence-based interventions to target audience via determined channels using planned strategies. D=I, D>I, and I>D means there is some focus on both dissemination and implementation. I-only focuses on process of putting to use or integrating evidence-based interventions within a setting.


Socio-Ecological Levels:
The level of the framework at which the model operates. Individual includes personal characteristics; Organization includes hospitals, service organizations, and factories; Community includes local government and neighborhoods; System includes hospital systems and government; Policy includes changes in policy.


Number of Times Cited:
The # of times the original publication for the model was cited as indicated by Google Scholar since 2016.


Field of Origin:
The field of study in which the model originated.

Health care

Name of the construct developed by classifying/aligning the elements abstracted from models.

Evaluation, Stakeholders

The original publication(s) of the model.

May C, Murray E, Finch T, Mair F, Treweek S, Ballini L, Macfarlane A, Rapley T. Normalization process theory on-line users’ manual and toolkit. 2010. May C, Finch T. Implementing, embedding, and integrating practices: an outline of normalization process theory. Sociology: J Brit Sociol Assoc 2009;43(3):535–54. Murray E, Treweek S, Pope C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC Med 2010;8:63.

Citations of studies that have used the model as an outline for their study.

Gallacher K, May CR, Montori VM, Mair FS. Understanding patients’ experiences of treatment burden in chronic heart failure using normalization process theory. Ann Fam Med 2011;9(3):235-43.

Gunn JM, Palmer VJ, Dowrick CF, et al. Embedding effective depression care: using theory for primary care organizational and systems change. Implem Sci 2010;5(1):62.

Kennedy A, Chew-Graham C, Blakeman T, et al. Delivering the WISE (whole systems informing self-management engagement) training package in primary care: learning from formative evaluation. Implemen Sci 2010;5(7).

May C, Finch T, Cornford J, et al. Integrating telecare for chronic disease management in the community: What needs to be done? BMC Health Serv Res 2011;11(1):131.

Mishuris RG, Palmisano J, McCullagh L, Hess R, Feldstein DA, Smith PD, McGinn T, Mann DM. Using normalisation process theory to understand workflow implications of decision support implementation across diverse primary care settings. BMJ Health Care Inform. 2019 Oct;26(1):e100088. doi: 10.1136/bmjhci-2019-100088.

Murray E, Burns J, May C, et al. Why is it difficult to implement e-health initiatives? A qualitative study. Implemen Sci 2011;6(1):6.

Sanders T, Foster N, Ong BN. Perceptions of general practitioners towards the use of a new system for treating back pain: a qualitative interview study. BMC Med 2011;9(1):49.

Ziegler E, Valaitis R, Yost J, Carter N, Risdon C. “Primary care is primary care”: Use of Normalization Process Theory to explore the implementation of primary care services for transgender individuals in Ontario. PLoS One. 2019 Apr 22;14(4):e0215873. doi: 10.1371/journal.pone.0215873.

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