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A multicentre validation study of the Swedish version of the Normalization Process Theory Measure S-NoMAD.

Anna Cristina Åberg1,2,3, Lars Wallin4, Malin Tistad4

  • 1School of Health and Welfare, Dalarna University, Högskolegatan 2, Falun, S-791 88, Sweden. anna.cristina.aberg@uu.se.

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Summary

The Swedish NoMAD (S-NoMAD) questionnaire demonstrates good psychometric properties for evaluating complex care intervention implementation. This tool effectively captures perceptions across various Swedish health and social care contexts, proving its general applicability.

Keywords:
Health and social care contextsImplementation measurementNormalization Process TheoryPsychometrics

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Area of Science:

  • Healthcare implementation science
  • Psychometric evaluation
  • Health services research

Background:

  • The Normalization Process Theory (NPT) is crucial for understanding complex care intervention implementation.
  • The NoMAD questionnaire is a key tool for applying NPT in practice and research.
  • Evaluating the psychometric properties of the Swedish version (S-NoMAD) is essential.

Purpose of the Study:

  • To evaluate the psychometric properties of the Swedish version of the NoMAD questionnaire (S-NoMAD).
  • To assess the S-NoMAD's reliability and validity in diverse Swedish healthcare and social care settings.

Main Methods:

  • Secondary analysis of pooled S-NoMAD survey data from six implementation studies.
  • Confirmatory factor analysis (CFA) to test the NPT factor structure.
  • Cronbach's alpha for internal construct reliability and fit indices for validity assessment.

Main Results:

  • The CFA confirmed that the four-factor NPT model fits the S-NoMAD data well.
  • Good internal construct validity and acceptable to good internal reliability were demonstrated.
  • External validity was also confirmed, indicating the S-NoMAD's robustness.

Conclusions:

  • The S-NoMAD exhibits strong psychometric properties for assessing implementation processes in Swedish health and social care.
  • The S-NoMAD is a generally applicable, non-context-specific tool, meeting criteria for pragmatic measures.
  • Further research is recommended to explore S-NoMAD's full potential in implementation strategy assessment.