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Improving the normalization of complex interventions: part 1 - development of the NoMAD instrument for assessing
Tim Rapley1, Melissa Girling2, Frances S Mair3
1Department of Social Work, Education and Community Wellbeing, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne, NE7 7XA, UK. Tim.Rapley@northumbria.ac.uk.
BMC Medical Research Methodology
|November 17, 2018
Summary
This study developed the NoMAD instrument to measure implementation processes using Normalization Process Theory (NPT). The validated 43-item tool assesses participants' experiences in complex intervention implementation.
Area of Science:
- Implementation Science
- Health Services Research
- Psychometrics
Background:
- Measuring implementation processes is crucial for research.
- Normalization Process Theory (NPT) provides a framework for understanding implementation.
- A validated instrument is needed to assess factors affecting intervention normalization.
Purpose of the Study:
- To develop and validate an instrument to assess implementation processes from participants' perspectives.
- To create a tool based on Normalization Process Theory (NPT).
- To measure factors influencing the normalization of complex interventions.
Main Methods:
- Iterative instrument development: theoretical elaboration, item generation/reduction, appraisal (QAS-99), and cognitive testing.
- Theory re-validation with NPT experts and pilot testing.
- Refinement based on cognitive interviews and expert review, resulting in a 43-item instrument (NoMAD).
Main Results:
- Initial generation of 112 items reduced to 47, then refined to a 43-item final instrument.
- Cognitive testing identified minor wording and conceptual issues, addressed by adding items and response options.
- Pilot testing achieved 100% completion rate, indicating usability.
Conclusions:
- The iterative development process balanced theoretical integrity (NPT) with respondent usability.
- The final 43-item instrument (NoMAD) is theoretically valid and easily understood.
- NoMAD can assess implementation participants' experiences and complement other implementation measures.
Keywords:
Complex interventionsImplementation processInstrument developmentNPTNoMADNormalization process theoryQuestionnaireMore Related Videos
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