Table 1.
Normalization Process Model Construct Description, Feasibility Factors and Tracking Tools.
| Construct description | Feasibility factors assessed | Tracking tools |
|---|---|---|
| Interactional workability describes how a complex intervention affects interactions between health care clinicians, staff, and patients within the clinical practice. | Multidisciplinary team relationships. Referral source education. Recruitment of referrals. Determination of available clinician time. Number of clinicians completing assessments. Number of participants entering and completing the program. | Project log |
| Relational integration describes how a complex intervention relates to current knowledge and relationships in health care practice. | Establishment of clinician and leadership meetings and frequency. Clinician participation in review of the literature, evaluating the evidence, and learning the therapy. Evaluation of participants’ perception of benefit. Spontaneous comments by participants and clinicians. | Meeting minutes Project log Fidelity to treatment form Treatment evaluation form |
| Skill-set workability describes how the division of health care labor is influenced by a complex intervention. | Allocation and acceptance of tasks by discipline. Development of competence in particular tasks by discipline. Current skills of clinicians. Establishment of inter-rater reliability. Training attendance. Participant learning of concepts and completion of homework. | Project log Fidelity to treatment form Treatment evaluation form |
| Contextual integration describes how a complex intervention relates to the context of the health care organization. | Departmental funding for training and materials. Secretarial and scheduling support. Time for program coordination. Priority scheduling of group rooms. History of support for group programs. Cost effectiveness of group programs in the department. | Project log Fidelity to treatment form |
Note. Adapted from “Understanding the Implementation of Complex Interventions in Health Care: The Normalization Process Model,” by C. May, T. Finch, F. Mair, L. Ballini, C. Dowrick, M. Eccles, …B. Heaven, 2007, BMC Health Services Research, 7(148), 1–7. doi:10.1186; 1472-6963-7-148. Copyright 2007 by May et al.; licensee BioMed Central Ltd.