Table 2.

Four generative mechanisms of Normalization Process Theory

Generative mechanism	Description	Components
Coherence	The sense-making work that people do individually and collectively when they are faced with the problem of operationalizing some set of practices.	Differentiation
		Communal Specification
		Individual Specification
		Internalization
Cognitive participation	The relational work that people do to build and sustain a community of practice around a new technology or complex intervention.	Initiation
		Enrolment
		Legitimation
		Activation
Collective action	The operational work that people do to enact a set of practices, whether these represent a new technology or complex healthcare interventions.	Interactional Workability
		Relational Integration
		Skillset Workability
		Contextual Integration
Reflexive monitoring	The appraisal work that people do to assess and understand the ways that a new set of practices affect them and others around them.	Systemization
		Communal Appraisal
		Individual Appraisal
		Reconfiguration