Improving the normalisation of complex interventions: Developing quantitative measures for users based on Normalization Process Theory

Lead Research Organisation: Newcastle University
Department Name: Inst of Health and Society

Abstract

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Publications

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Cook C (2020) Developing oral health risk assessment as routine practice during early stages of clinical careers: A cross-sectional study of dental students using the NoMAD questionnaire. in European journal of dental education : official journal of the Association for Dental Education in Europe

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Loch AP (2020) Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese. in Revista da Associacao Medica Brasileira (1992)

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May C (2013) Towards a general theory of implementation. in Implementation science : IS

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May C (2016) Implementation, context and complexity in Implementation Science

 
Description We describe four key achievements:

1. We have developed and evaluated a 23-item implementation measurement tool (NoMAD) that reflects implementation process as explained by Normalization Process Theory (NPT) (Objectives 1-3). Tested on 6 different interventions being implemented in different settings (831 respondents), the tool has excellent face validity and construct validity, and adequate to good reliability (internal consistency) for the items representing the four theoretical constructs. Working with individual implementation project leads, we observed a range of ways in sites could use the data available from NoMAD, including making comparisons between groups, triangulating data sources within large projects, and achieving buy-in and staff representation during early stages of implementation. NoMAD provides users of NPT with a theory based assessment tool that is easy to adapt and administer in their work settings. The NoMAD tool has been downloaded over 300 times in 3 months since launch (18/11/15), by academic and non-academic users from all over the world.

2. We have upgraded the NPT website (http://normalizationprocess.org), and extended it to include the NoMAD survey tool (Objective 6). A new section for NoMAD is included, that explains the study, provides practical guidance on using the NoMAD tool, and allows users to download it. The website also has improved: aesthetics and design, interactivity with search engines, functionality with mobile devices, and linking with user metrics for assessing impact.

3. Through NoMAD, we have significantly advanced knowledge in understanding and measuring implementation processes and outcomes (Objectives 1-4). We undertook a comprehensive tool development process, involving a range of approaches with different users (those delivering interventions, supervising/managing, evaluating, as well as 'experts' in NPT), in iterative rounds of data collection, analysis and project team workshops. This process has deepened our understanding of the complexity of implementation work, and of how any efforts at 'measuring' implementation activity must account for this complexity (see website: 'How to use NoMAD'). This work has extended our understanding of NPT and how to apply it (Objective 4), through the formal research activity undertaken (eg. experiences of working with site contacts, interpretation of statistical data supporting the theoretical assumptions of NPT); and through interactive workshops run by project members with diverse user groups (health care professionals, service managers/providers, complex interventions researchers, postgraduate students) where we have helped others work through examples using the NPT tools.

4. We have already developed new collaborations nationally and internationally, as a direct outcome of the project. NoMAD is already being used in a study of person-centred care in nursing homes, led by Boston University (RECHARGE study). In Europe, NoMAD is being translated to Dutch for use in a study of the implementation of e-mental health (MasterMind project, VU Amsterdam), with other language translations expected to follow. Nationally, NoMAD will be used in a Health Foundation funded project aimed at improving Tracheostomy care at a national level, commencing in March 2016. Further collaboration opportunities are being discussed, and the project team (Tracy Finch and Tim Rapley) will continue to extend the work of NoMAD in these settings.
Exploitation Route Our Pathways to Impact document still reflects our expectation of impact from the project. These plans focused on making Normalization Process Theory more 'usable' for a wide range of academic and non-academic users through the development of a survey instrument that could be adapted for use in different contexts, including research but also by those who are undertaking implementation projects as part of service development (e.g. within the NHS). As described under 'main achievements' above, we already have evidence of a high level of interest in the NoMAD instrument from diverse users, and have established collaborations with partners who are already using it in research (eg. RECHARGE study of patient-centred care, Boston University; MasterMind project implementing e-mental health in Europe, Vree University Amsterdam; The Royal College of Anaesthetists' Tracheostomy project, UK), or planning to use it (eg: Implementation of enhanced recovery after surgery, Bristol University; 'Checklist' project for patient centredness, University of Southampton).
Through the contacts that we are receiving about NoMAD, we will particularly seek out opportunities to evaluate its impact in service development and implementation in non-academic (real world) settings as a tool for shaping and improving implementation success, as well as assessing progress in implementation efforts.
Sectors Communities and Social Services/Policy,Education,Healthcare,Other

URL http://www.normalizationprocess.org
 
Description Reporting in 2020, NoMAD continues to be used around the world, in research studies of complex health and social care interventions. The main publication (Finch et al, Improving the normalisation of complex interventions part 2) has already been cited 20 times in its first 15 months after publication. Since the last update, the team have collaborated on further language translations of NoMAD into Brazillian Portuguese (publication submitted) and Norweigan (in preparation). Reporting in March 2018, the primary outputs of the project, the NoMAD survey tool and the extended NPT (Normalization Process Theory) website (www.normalizationprocess.org), continue to generate significant local, national and international interest. In its first year, the NoMAD survey was downloaded over 1000 times (Nov 2015-Oct 2016), and the rate of downloads has been maintained over this time (almost 200 in January & February 2018). We receive enquiries about the tool (applying/adapting/scoring/translation) on a weekly basis, and know that NoMAD is being used worldwide as an implementation measure in research projects. The NPT website, interactive toolkit, and NoMAD survey tool are being embedded into training for care and support planning at Year of Care partnerships (http://www.yearofcare.co.uk ) Year of Care is an NHS based organisation that develops capacity for improving long term condition care using care and support planning. The objective of care and support planning as facilitated by Year of Care is to involve people in their own care, and to provide a more personalised approach and which supports self management. We are working with Sue Roberts and Lindsay Oliver, who lead the national training and support team (based in Northumbria Healthcare NHS Foundation Trust). Developments stemming from the project include: (1) use of NPT (and interactive online toolkit items) in training workshops to identify barriers and facilitators of care and support planning; (2) use of NPT/toolkit to identify and address barriers to engagement of participants in training and delivery of care and support planning in localised NHS organisations; (3) adaptation of the NoMAD survey tool for assessing and monitoring the progress of care and support planning, within and across NHS organisations participating in Year of Care training. For Year of Care, the application of NPT (and tools we have developed) as part of their training programme represents a shift away from traditional theoretical concepts of practice change drawn from psychological/behavioural models, to a recognition of the need to understand and address wider (contextual, organisational, work-related) issues relevant to embedding practice change. Academic impact ('enhancing the knowledge economy'). The NoMAD survey tool is being used to assess progress of the implementation of quality improvement bundles in tracheostomy care across the UK, funded by the Health Foundation. Led by the Royal College of Anaesthetists, Tracy Finch is working with the project team (Brendan McGrath (RCA, Mike Firn, Springfield Consultancy) on a consultancy basis to adapt, administer and analyse the results of a package of quality improvement interventions to improve safety and outcomes for tracheostomy patients, across a minimum of 20 sites in the UK. NoMAD data has been collected from 20 participants in each of the sites, and at project end will have 3 waves of data (approx. 1200 surveys), thus representing a significant extension of ongoing validation on the NoMAD survey tool. NoMAD has also been used (approx. 100 surveys) in mixed methods research to understand the implementation of acute kidney injury alerting on hospital wards (in write up stage, Finch as co-I). The NPT/NoMAD tools have been central to achieving multi-national research funding worth 6 million Euros from the European Commission (Horizon 2020). We are 15 months into the (51 month) ImplementAll study, that involves 18 partners across the world http://www.implementall.eu/ ). Led by Tracy Finch and Tim Rapley, we have developed 'ItFits' as the intervention that will be evaluated in ImpleMentAll. ItFits is a theory and evidence based tool to facilitate the implementation and scaling up of mental health service provision through targeted implementation work, focusing on the work that is done by implementers within service organisations. We have developed ItFits by working with academic, public and private care providers in e-mental health. Implementation of ItFits is now underway and will include services in UK, Denmark, Netherlands, Spain, Germany, France, Italy, Kosovo, Albania, and Australia. NoMAD is the outcome measure for the project, and translation of the survey into all languages of the project participants has been completed: these translated versions are now available for public use, and can be accessed via the ImpleMentAll website (on the 'resources' web page). It has also been translated to Swedish, validated as a Dutch version on a large (>300) sample of mental health providers (both Dutch and Swedish translations are now published), and we have advised researchers on translation also to other languages (eg Malaysian). The work of ImpleMentAll in particular is breaking new ground in the evaluation of theory-based implementation approaches as it represents a shift of focus away from evaluating effectiveness of services, to evaluating and advancing implementation strategies for maximising benefit of service initiatives.
First Year Of Impact 2015
Sector Healthcare
Impact Types Policy & public services

 
Description European Commission Horizon 2020
Amount € 6,000,000 (EUR)
Funding ID 733025 ImplementAll 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 01/2017 
End 03/2021
 
Description Health Foundation Scaling Up Innovation (3)
Amount £500,000 (GBP)
Organisation The Health Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 11/2017 
End 10/2019
 
Title Final NoMAD survey instrument 
Description This is the main practical output of the project. It is a 23-item implementation measurement tool (NoMAD) that reflects implementation process as explained by Normalization Process Theory (NPT). It is intended to be used by those implementing new practice based interventions (academic or non-academic settings) and has potential for understanding barriers and facilitators to successful implementation, and for helping to direct improvement efforts as an implementation process progresses. NoMAD provides users of NPT with a theory based assessment tool that is easy to adapt and administer in their work settings. 
Type Of Material Improvements to research infrastructure 
Year Produced 2015 
Provided To Others? Yes  
Impact The NoMAD tool has been downloaded over 300 times in 3 months since launch (18/11/15), by academic and non-academic users from all over the world. The team have had many requests for using the tool, and there are several projects (at least 2 internationally) that are already using NoMAD as part of their implementation approach. A major European Union grant application is in progress for submission in April, in which the NoMAD instrument is a central component of a broader implementation toolkit being developed and evaluated (and the project PI is a Workpackage lead) The study will be evaluating an implementation framework for e-mental health service implementation. 
URL http://normalizationprocess.org
 
Title NoMAD: A measure for Improving the Normalisation of Complex Interventions 
Description The tool is intended for complex interventions researchers and implementers, for assessing implementation process and outcome. Based on Normalisation Process Theory (NPT), it was developed using a combination of qualitative methods (workshops, item development, user feedback, cognitive interviews). Development of the tool has focused on generating and testing items representing the four constructs of NPT (process items, 43 items) and a small number of measures relating to implementation outcomes (Outcome Items, 3 items). 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2014 
Provided To Others? Yes  
Impact The tool is currently been utilised in a number of research sites to assess the psychometric properties of the items and to provide further knowledge about the constructs of the NPT and relationships amongst them. 
 
Title Normalization Process Theory (NPT) Website 
Description In the NoMAD project, the original NPT website was extended and upgraded in terms of design, content and functionality. The NoMAD survey instrument is now available through the website along with guidance for users. The website provides users with a range of tools for applying Normalization Process Theory to understanding and solving problems relating to implementation. 
Type Of Material Improvements to research infrastructure 
Year Produced 2015 
Provided To Others? Yes  
Impact The original website which was developed in 2010 was always popular, but the inclusion of NoMAD and updated functionality and revision of content has increased website use. The NoMAD survey tool alone is being downloaded at least once every day at present, following the launch in November 2015. Direct impacts so far include a large number of enquiries about research collaboration, some of which have already lead to the development of further funding applications and/or incorporation of the tool into existing (funded) studies. 
URL http://normalizationprocess.org
 
Title Translation of NoMAD into 8 different languages for use as outcome measure in ImpleMentall 
Description The NoMAD survey we developed in the grant, has been translated into 8 languages: French, Dutch, Danish, Spanish, Italian, German, Kosovo, Albanian. These are for use of the survey as an outcome measure for the ImpleMentAll study (listed under further funding outcomes). These translations are make available through the ImpleMentAll project website, and there is a link to these also on the NPT website. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? Yes  
Impact Aside from the ImpleMentAll study, these are already being used by researchers around the world. 
URL http://www.implementall.eu/9-outcomes-and-resources.html
 
Description EU Collaboration on implementing ehealth 
Organisation University of Amsterdam
Country Netherlands 
Sector Academic/University 
PI Contribution We provide the theoretical (NPT) and practical expertise on facilitating implementation and embedding of new services, and the measurement tool (NoMAD) that will be used to assess and compare implementation progress across participating sites in a recently funded European Commission study 'ImplementAll', that will be evaluating the scaling up and scaling out of e-mental health services. We thus lead a major work package that is central to the project. The study includes European countries, Uk and Australia.
Collaborator Contribution VU University Amsterdam are the scientific leads for the ImplementAll project as a whole, and will lead the Evaluation work package. They have worked with us closely prior to securing this funding, as they translated our NoMAD survey to Dutch. They led the development of the project consortium, working closely with the Administrative project leads (University of Southern Denmark).
Impact Research funding from European Commission Horizon 2020, 'ImplementA'll', commencing January 2017.
Start Year 2015
 
Description Improving tracheostomy care in England 
Organisation The Royal College of Anaesthetists
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The partner has funding from the Health Foundation to spread quality improvement in tracheostomy care, across England. I have contributed as an external collaborator, as they chose to use the NoMAD survey as one of their measures for assessing the impact of their improvement initiatives. They are the first UK based project I am aware of, to collect multiple time point data using NoMAD. My role (ongoing) is to advise on how to use and interpret the findings from the NoMAD survey. This contributes directly to further validation of the NoMAD survey in different datasets, uniquely adding the opportunity to investigate it's properties for detecting change over time, in response to implementation activities. In this study, it also allows for validation across 20 different sites nationally.
Collaborator Contribution They own and conduct the project. NoMAD is one tool they are using within a mixed methods project.
Impact Not as yet - study nearing completion.
Start Year 2017
 
Description 2014 Kings Fund UCL event - From Evidence to practice: Implementing change in primary care. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Tim Rapley gave an overview presentation of the NPT 16 item toolkit and Carl May gave a plenary presentation.

Not known.
Year(s) Of Engagement Activity 2014
 
Description Carl May Plenary - 'Understanding the dynamic elements of implementation processes' - Implementation Symposium Jan 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an invited plenary presentation at the symposium 'Innovating healthcare:an implementation science perspective' held at VU University Amsterdam, January 19th 2017. The plenary was live streamed for a wider audience.
Year(s) Of Engagement Activity 2017
URL https://assets.trimbos.nl/docs/d10d5837-e1df-4925-9488-e56c1bc955a3.pdf
 
Description Collaborating for Better Care Partnership Masterclass: Getting new ideas into practice: normalising the implementation of complex interventions across the healthcare system' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact The masterclass involved formal presentations about the use of NPT and small facilitated group interactive sessions to engage with the NPT developed toolkit.

The Masteclass initiated audience feedback and discussion and raised a number of questions for the research team, which are important for how we progress our tool development work. Delegates completed a pre-survey to the Masterclass to familiarise themselves with NPT providing some useful data for the project.
Year(s) Of Engagement Activity 2014
 
Description Departmental Seminar Melbourne University 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The seminar (5/12/16) given by Tracy Finch, extended developing international collaboration with researchers at the Department of General Practice, Melbourne University, where there has been growing interest in the NoMAD tool developed in this project. The audience included academics, researchers, students and clinicians. We are in discussion about plans to host an NPT workshop in collaboration with Melbourne University, in 2018.
Year(s) Of Engagement Activity 2016
 
Description Departmental seminar - Monash University Australia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was a departmental seminar (6/12/16) given by Tracy Finch at Monash Centre for Health Research and Implementation (MCHRI), building on initial collaboration that is developing between Newcastle University (Institute of Health and Society) and MCHRI, with small group meetings and project focused discussions also held on the day. As a result, one project is now using the NoMAD tool developed in this project and discussions about future projects are ongoing.
Year(s) Of Engagement Activity 2016
 
Description Improving the normalization of complex interventions: the mundane work of translating theory into something accessible, useable and countable 
Form Of Engagement Activity Scientific meeting (conference/symposium etc.)
Part Of Official Scheme? No
Type Of Presentation paper presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Presentation given by Melissa Girling, at the BSA Medical Sociology Group Annual Conference, 11- Friday 13 September 2013 University Of York. The presentation described the methods and key issues arising from the NoMAD tool development process.

PowerPoint presentation.
Year(s) Of Engagement Activity 2013
 
Description Invited Keynote for Drug and Acohol Research Network Scotland Annual conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact This was an invited keynote lecture, as the theme of the conference was 'Maximising the impact of Scottish drugs research: from inception to publication' - I focused on how what we know from implementation science (and Normalisation Process Theory) might help to translate ideas for change into practice.
Year(s) Of Engagement Activity 2019
URL https://drns.ac.uk/files/2018/11/DRNS-Conference-delegate-pack.pdf
 
Description Invited webinar - Normalisation Process Theory - using NPT for measuring implementation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Invited webinar from the Health Behaviour Change Research Group at National University of Ireland (Galway); held online and attracted good participation internationally. Myself and Professor Tim Rapley spoke alongside one other speaker. Held on 9th November 2020.
Year(s) Of Engagement Activity 2020
 
Description Invited webinar on NoMAD for measuring implementation processes 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Invited webinar (online instead of face to face as initially planned) by University of Limerick on Implementation science and particpatory approaches, October 22nd 2020.
Year(s) Of Engagement Activity 2020
URL https://www.ul.ie/hri/health-implementation-science-and-technology-hist
 
Description NPT 2 day training workshop Edmonton 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact This was an invited training workshop to cover Normalisation Process Theory, and the tools that have been developed from it (including NoMAD). 30 participants took part. It involved offering bespoke guidance to individual participants (researchers; postgrad students) on ways in which they might apply NPT and its tools to their own research projects.
Year(s) Of Engagement Activity 2019
URL https://www.ihe.ca/advanced-search/implementation-science-if-it-s-not-knowledge-translation-or-chang...
 
Description NPt workshop at BSA Medical Sociology 50th Anniversary Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Workshop on 'Working with Normalisation Process Theory in studies of health and healthcare', co-presented between Carl May, Tim Rapley and Tracy Finch. Included a talk led by T Finch on advancing measurement of implementation processes, based on the NoMAD study.
Year(s) Of Engagement Activity 2019
URL https://www.britsoc.co.uk/media/24810/medsoc18_final_prog.pdf
 
Description NoMAD study launch event: Improving healthcare implementation through measurement 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was the end of project dissemination event, held at The Kings Fund in London. It was attended by approx 75 participants, including researchers, policy-makers, health research funders (eg The Health Foundation), students, healthcare practitioners and other participants. The new NPT website was launched, and the NoMAD survey tool was made publicly available. Keynotes included Professor Robbie Foy, Editor of BMC Implementation Science. Contributing 'implementers' to the NoMAD study also presented, alongside the key project team members.
Year(s) Of Engagement Activity 2015
URL http://www.uksbm.org.uk/event-improving-the-normalization-of-complex-interventions-development-of-a-...
 
Description NoMAD workshop at Health Foundation Improvement Science Doctoral Fellow summer school 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact This was a workshop provided by Tracy Finch on invitation, for the Health Foundation's cohort of Improvement Science Doctoral Fellows during their annual two day summer school. It was a popular choice amongst event participants (approx. 15 of 30 participants, three workshops on offer), and they engaged enthusiastically in group work thinking about how the tool might be useful in their research/improvement science work. These doctoral fellows were largely from clinical practice (eg primary care, midwifery, dentistry as some examples). In addition to making a contribution to professional development, this was a key opportunity for networking with key Health Foundation personnel (eg Bill Lucas, Helen Crisp) and disseminating ongoing work using Normalization Process Theory to a wider audience.
Year(s) Of Engagement Activity 2017
 
Description Normalisation Process Theory: Why should I bother using it? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact The workshop consisted of brief presentation by Tim Rapley and Melissa Girling to introduce NPT and the ways in which NPT can be used. Small interactive group work followed whereby workshop participants completed the NPT online toolkit and came together to share their experiences of using of how and when it might be useful to use it.

The brief presentations and workshop, stimulated a number of questions relating to the use of NPT and the toolkit. Following the workshop, Tim Rapley engaged with a Public Health Research Associate/PhD candidate to discuss using NPT in their current work/thesis.
Year(s) Of Engagement Activity 2013
 
Description Normalization Process Theory: An Agnostics Adventures 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited seminar at Manchester University, given by Tim Rapley: Talk sparked questions and extensive discussions after. This included people new to the theory and those currently trying to use it. After the the seminar, I had extensive discussion with some people who where using the theory and helped them to think about how to use the theory in a more flexible way.

discussions/further collaboration.
Year(s) Of Engagement Activity 2012
 
Description Normalization process theory : guiding the implementation of good ideas 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited seminar and workshop, for Edinburgh University (Centre for Population Health Sciences), as part of departmental seminar series, held on May 29th 2012, led by Tracy Finch (and supported by NoMAD researcher, Melissa Girling).

Tracy gave a powerpoint presentation and along with Melissa, facilitated small group interactive participation in completing the NPT toolkit and subsequent discussion. Participants used our NPT tools to work through their own 'implementation problems'.
Year(s) Of Engagement Activity 2012
 
Description RDF (Internal) Seminar: Improving the Normalization of Complex Interventions (NoMAD): Developing theory-based tools and measures for multiple users across diverse settings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact This was a seminar given internally within the Institute of Health and Society (by Tracy Finch and Melissa Girling) to promote awareness locally about the work we are doing in NoMAD, and to generate methodological and conceptual discussion around the development of implementation measures. This is of interest because our audience includes complex interventions researchers, and we are also still recruiting intervention sites to take part in NoMAD.

After the presentation, colleagues gave us some feedback on our approach to the development of the measure and suggestions for possible sites to approach for inclusion.
Year(s) Of Engagement Activity 2013
 
Description Research presentation at International Congress of Behavioural Medicine - Melbourne Dec 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Tracy Finch provided an oral presentation of the NoMAD study to an international audience of behavioural medicine scientists. No specific impacts as yet, but a growing interest in implementation science within the behavioural medicine field was clearly evident, and it was an opportunity to disseminate the NoMAD study findings to an international audience.
Year(s) Of Engagement Activity 2016
URL http://www.icbm2016.com
 
Description Seminar at Leicester University on NPT 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Tim Rapley was Invited seminar talk with discussion, mostly post-graduate student audience. Covered NPT, toolkits and; NoMAD study.
Year(s) Of Engagement Activity 2015
 
Description Southampton University Seminar series: Normalization Process Theory 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact This was a set of 3 presentations relating to NPT, delivered by Prof Carl May, Dr Mark Johnson, and Dr Tracy Finch. Tracy Finch presented the findings of the NoMAD study.
Year(s) Of Engagement Activity 2016
URL http://www.southampton.ac.uk/healthsciences/news/events/2016/02/02-complex-healthcare-processes-with...
 
Description Tracy Finch Invited seminar to CHILL, University of Nottingham April 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other audiences
Results and Impact Invited research seminar to department. Mixed audience of researchers and students.
Year(s) Of Engagement Activity 2016
URL http://www.nottingham.ac.uk/business/businesscentres/chill
 
Description Tracy Finch Professorial inaugural lecture 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Tracy Finch's professorial inaugural lecture. The NoMAD study is one of the most significant elements of my current and future work programme.

Abstract:

The Collaborative Work of Changing Healthcare Practices: Building an Implementation Science Fit for Users

New innovations in health and social care provision promise improvement in service user outcomes, yet fail to be successfully integrated into routine practice. Implementation Science is a response to this challenge: it advances the development and application of theoretical knowledge, frameworks, tools and measures for implementing and sustaining changes in health and social care practice. But are the fruits of its labour translatable (and useable) across the academic-practitioner divide? Does it help the practitioner-innovator to enact their 'good ideas' for improving services?

This lecture describes a programme of work focused on the development of theory-based implementation 'tools' and measures that are intended for use by practitioners. These studies demonstrate the ways in which translating theory constructs into meaningful components of toolkits and surveys is a complex and intensively collaborative process that is more than a matter of methodology. From this work, Tracy will offer principles for moving Implementation Science further towards the users who are closer to the enactment of change in practice.
Year(s) Of Engagement Activity 2019
URL https://www.northumbria.ac.uk/about-us/news-events/events/2019/02/public-lecture-professor-tracy-fin...
 
Description UK Society of Behavioural Medicine pre-conference workshop on NPT 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact This was an invited workshop, linked to the UK Society of Behavioural Medicine Conference Dec 2015. The objective was to provide an introduction to Normalization Process Theory, present different ways of using it, and included two interactive workshops where participants applied the tools (including the NoMAD instrument) to their own implementation problem examples. There were 20 participants, and it was evaluated positively. Interest in applying NPT in further projects was expressed.
Year(s) Of Engagement Activity 2015
URL http://www.uksbm.org.uk/cardiff-2016/newcastle-2015/pre-conference-workshops-asm-2015/
 
Description Understanding the implementation of new socio-technical systems: normalizing innovation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Plenary presentation given by Professor Carl May at Healthcare Computing 2013, April 17th 2013 (Birmingham).

Presentation slides and audience questions
Year(s) Of Engagement Activity 2013
 
Description WHINN Conference Denmark - how do we know when something is implemented? 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Invited talk as part of ImpleMentAll (EU) funded study - talked about NoMAD as leading move towards measuring implementation for improvement purposes.
Year(s) Of Engagement Activity 2019
URL https://www.whinn.dk/whinn-2018-presentations/
 
Description Workshop on Implementation science and NPT approaches for CPD day for Speech and Language practioners 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This was an invited workshop, delivered by Tim Rapley and Tracy Finch, to enhance speech and language practitioners' knowledge and understanding of evaluation and implementation in practice. Approximately 80 participants attended the event. Feedback was positive, and led to further invitations to teach similar sessions on Newcastle University's MSc in speech and language therapy.
Year(s) Of Engagement Activity 2017
 
Description Workshop on using the NoMAD survey tool - Implementation Symposium Netherlands Jan 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an invited workshop, co-facilitated by Tracy Finch, Carl May and colleagues from VU University Amsterdam. Some participants are using or planning to use the NoMAD survey tool. The Implementation Symposium had approx 100 delegates from across Europe/UK, with plenary speakers from the US, UK and Australia.
Year(s) Of Engagement Activity 2017
URL https://assets.trimbos.nl/docs/d10d5837-e1df-4925-9488-e56c1bc955a3.pdf