Translational framework for implementation evaluation and research: a normalisation process theory coding manual for qualitative research and instrument development
posted on 2022-02-28, 15:04authored byCarl R. May, Bianca Albers, Mike Bracher, Tracy Finch, Anthony Gilbert, Melissa Girling, Kathryn Greenwood, Anne E. MacFarlane, Frances Mair, Christine M. May, Elizabeth Murray, Sebastian Potthoff, Tim Rapley
Background: Normalisation Process Theory (NPT) is frequently used to inform qualitative research that aims to
explain and evaluate processes that shape late-stage translation of innovations in the organisation and delivery of
healthcare. A coding manual for qualitative researchers using NPT will facilitate transparent data analysis processes
and will also reduce the cognitive and practical burden on researchers.
Objectives: (a) To simplify the theory for the user. (b) To describe the purposes, methods of development, and
potential application of a coding manual that translates normalisation process theory (NPT) into an easily usable
framework for qualitative analysis. (c) To present an NPT coding manual that is ready for use.
Method: Qualitative content analysis of papers and chapters that developed normalisation process theory, selection
and structuring of theory constructs, and testing constructs against interview data and published empirical studies
using NPT.
Results: A coding manual for NPT was developed. It consists of 12 primary NPT constructs and conforms to the
Context-Mechanism-Outcome confguration of realist evaluation studies. Contexts are defned as settings in which
implementation work is done, in which strategic intentions, adaptive execution, negotiating capability, and refram ing organisational logics are enacted. Mechanisms are defned as the work that people do when they participate in
implementation processes and include coherence-building, cognitive participation, collective action, and refexive
monitoring. Outcomes are defned as efects that make visible how things change as implementation processes proceed and include intervention mobilisation, normative restructuring, relational restructuring, and sustainment.
Conclusion: The coding manual is ready to use and performs three important tasks. It consolidates several iterations
of theory development, makes the application of NPT simpler for the user, and links NPT constructs to realist evaluation methods. The coding manual forms the core of a translational framework for implementation research and
evaluation