Table 1.
Subdomains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework used for data analysis with 2 data-led additions to the original subdomain list (n=111) [10].
| NASSS subdomain and codes | Inductive theme | Papers, n (%) | |
| 1a. Nature of condition or illness | |||
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|
1a.1 | Type or format of care needs | 11 (9.9) |
|
|
1a.2 | Ambiguous, complicated, or rare decisions | 23 (20.7) |
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|
1a.3 | Quality of current care | 18 (16.2) |
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|
1a.4 | Decision urgency and impact | 11 (9.9) |
| 1b. Comorbidities | |||
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1b.1 | Other associated health problems | 5 (4.5) |
|
|
1b.2 | Aligning patient and health priorities | 6 (5.4) |
| 1c Sociocultural factors | No subthemes | 13 (11.7) | |
| 2a. Material properties | |||
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|
2a.1 | Usability of the tool | 28 (25.2) |
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2a.2 | Lack of emotion | 12 (10.8) |
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2a.3 | Large amounts of changing data | 14 (12.6) |
| 2b. Knowledge to use it | |||
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2b.1 | Knowledge required of patients | 24 (21.6) |
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2b.2 | Enabling users to evaluate tools | 20 (18) |
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2b.3 | Agreeing the scope of use | 19 (17.1) |
| 2c. Knowledge generated by it | |||
|
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2c.1 | Communicate meaning effectively | 45 (40.5) |
|
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2c.2 | Target a clinical need | 23 (20.7) |
|
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2c.3 | Recommend clear action | 25 (22.5) |
| 2d. Supply model | |||
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2d.1 | Equipment and network requirements | 23 (20.7) |
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|
2d.2 | Working across multiple health data systems | 25 (22.5) |
|
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2d.3 | Quality of the health data and guidelines used | 33 (29.7) |
| 2e. Who owns the intellectual property? | No subthemes | 14 (12.6) | |
| 2f. Care pathway positioninga | |||
|
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2f.1 | Extent of tools’ independence | 23 (20.7) |
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2f.2 | When and to whom the tool responds | 21 (18.9) |
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2f.3 | How and where the tool responds | 20 (18) |
| 3a. Supply-side value (to developer) | No subthemes | 7 (6.3) | |
| 3b. Demand-side value (to patient) | |||
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3b.1 | Time required for service provision | 27 (24.3) |
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3b.2 | Patient-centered care | 22 (19.8) |
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3b.3 | Cost of health care | 17 (15.3) |
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3b.4 | Impact on outcomes for patients | 28 (25.2) |
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3b.5 | Educating and prompting HCPsb | 41 (36.9) |
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3b.6 | Consistency and authority of care | 33 (29.7) |
| 4a. Staff (role and identity) | |||
|
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4a.1 | Appetite and needs differ between staff groups | 33 (29.7) |
|
|
4a.2 | Tools redefine staff roles | 33 (29.7) |
|
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4a.3 | Aligning with staff values | 28 (25.2) |
| 4b. Patient (simple vs complex input) | |||
|
|
4b.1 | Inconvenience for patients | 10 (9.0) |
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|
4b.2 | Patients’ control over their care | 14 (12.6) |
|
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4b.3 | Aligning patients’ agendas with tool use | 11 (9.9) |
| 4c. Carers | No subthemes | 4 (3.6) | |
| 4d. Relationshipsa | |||
|
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4d.1 | Patients’ relationships with their HCPs | 30 (27) |
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4d.2 | Users’ relationships with tools | 13 (11.7) |
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|
4d.3 | Relationships between health professionals | 21 (18.9) |
| 5a. Capacity to innovate in general | |||
|
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5a.1 | Resources needed to deliver the benefits | 29 (26.1) |
|
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5a.2 | Leadership | 26 (23.4) |
| 5b. Readiness for this technology | |||
|
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5b.1 | Pressure to find a way of improving things | 9 (8.1) |
|
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5b.2 | Suitability of hosts’ premises and technology | 15 (13.5) |
| 5c. Nature of adoption or funding decision | No subthemes | 7 (6.3) | |
| 5d. Extent of change needed to organizational routines | |||
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5d.1 | Fitting the tool within current practices | 14 (12.6) |
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5d.2 | Change to intensity of work for staff | 22 (19.8) |
| 5e. Work needed to plan, implement, and monitor change | |||
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5e.1 | Training requirements | 17 (15.3) |
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5e.2 | Effort and resources for tool launch | 23 (20.7) |
| 6a. Political or policy context | |||
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6a.1 | Different ways to incentivize providers | 10 (9) |
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6a.2 | Importance of government strategy | 8 (7.2) |
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6a.3 | Policy and practice influence each other more | 15 (13.5) |
| 6b. Regulatory and legal issues | |||
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6b.1 | Impact on patient groups | 19 (17.1) |
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6b.2 | Product assurance | 14 (12.6) |
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6b.3 | Deciding who is responsible | 8 (7.2) |
| 6c. Professional bodies | |||
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6c.1 | Resistance from professional culture | 20 (18) |
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6c.2 | Lack of understanding between professional groups | 9 (8.1) |
| 6d. Sociocultural context | |||
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6d.1 | Culture’s effect on tool acceptability | 17 (15.3) |
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6d.2 | Public reaction to tools varies | 10 (9) |
| 6e. Interorganizational networking | No subthemes | 14 (12.6) | |
| 7a. Scope for adaptation over time | |||
|
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7a.1 | Normalization of technology and decreased resistance | 15 (13.5) |
|
|
7a.2 | Improvement of technology and its implementation | 11 (9.9) |
| 7b. Organizational resilience | No subthemes | 3 (2.7) | |
aIndicates a subdomain added to the original NASSS framework through application of the best-fit framework synthesis method [21].
bHCP: health care professional.