Table 1.

Description of Normalisation Process Theory mechanisms and subconstructs

Coherence Differentiation: how participants understand a set of practices and their objects to be different (or not) from each other. Communal specification: extent to which participants have a shared understanding of the aims, objectives, and expected benefits of a set of practices. Individual specification: how participants understand their own specific tasks and responsibilities around a set of practices. Internalisation: how participants perceive the value, benefits and importance of a set of practices.

Cognitive participation Initiation: whether or not key participants are working to drive a new set of practices forward. Enrolment: the extent to which participants organise or reorganise themselves and others in order to collectively contribute to the work involved in new practices. Legitimation: the work of ensuring that other participants believe it is right for them to be involved in the new set of practices, and that they can make a valid contribution to it. Activation: the work that participants do collectively to define the actions and procedures needed to sustain a new practice and to stay involved.

Collective action Interactional workability: the interactional work that people do with each other, with tools/systems, and with other elements of a set of practices, when implementing a new practice. Relational integration: the work that is needed to build accountability and maintain confidence in a set of practices and in each other as they use them. Skill set workability: the allocation of work among participants with different roles and skills in relation to the new set of practices. Contextual integration: the work of managing a set of practices through the allocation of different kinds of resources and the execution of protocols, policies and procedures to support the practices.

Reflexive monitoring Systematisation: the work undertaken by participants to determine how effective and useful the new set of practices is for them and for others, and the information collected to enable this. Communal appraisal: the work undertaken by participants collectively (sometimes in formal collaboratives, sometimes in informal groups) to evaluate the worth of a set of practices. Individual appraisal: individual participants’ own appraisals, based on their experiences, of the effects of a new set of practices on them and the contexts in which they are set. Reconfiguration: the extent to which appraisal work by individuals or groups may lead to respecification or modification of the set of practices.