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Developing NPT
The first phase of developing Normalization Process Theory involved mapping the contingent (May, et al. 2003a) and normative (May, et al. 2003b) elements of embedding processes. This early work developed the concept of normalization, but did not explain how it came about.
In the second phase of development, we focused on aspects of Collective Action. This work focused on identifying and explaining the factors that promote or inhibit work to enact complex interventions in practice. First, this involved the production of a robust applied theoretical model of these factors (May 2006). This was then refined by a larger group of researchers working together (May, et al. 2007a). This theoretical model was then applied: to clinical trials (May, et al. 2007b); to mental health governance processes (Gask, et al. 2008); and telemedicine systems in practice (Finch, et al. 2007; Mair, et al. 2008). An important application of this work was by an international group led Glyn Elwyn, who used it to develop a strong understanding of problems in the design and application of tools for shared decision-making in the clinical encounter (Elwyn, et al. 2008).
The third phase of theory development has focused on building a middle-range theory that explains how material practices (the things that people do when they operationalise complex healthcare interventions) become routinely embedded in their social contexts. The key paper here will be published in Sociology in June 2009 (May and Finch 2009). It is currently available as a ‘preprint’ on the web, along with a pdf presentation that provides an 'Introduction to Normalization Process Theory'. They can be found here. Other recent work applies Normalization Process Theory to explaining the problems of understanding (Finch 2008) and implementing (May 2009a) telemedicine systems, and to the collective work of managing and organizing chronic illness (May 2009b).
Bibliography
Elwyn, G., Legare, F., Edwards, A., van der Weijden, T. and May, C. 2008 'Arduous implementation: does the normalisation process model explain why it is so difficult to embed decision support technologies in routine clinical practice', Implementation Science 3: 57.
Finch, T. 2008 'Teledermatology for chronic disease management: coherence and normalization', Chronic Illness 4(2): 127-134.
Finch, T. L., Mair, F. S. and May, C. R. 2007 'Teledermatology in the UK: lessons in service innovation', British Journal of Dermatology 156(3): 521-527.
Gask, L., Rogers, A., Campbell, S. and Sheaff, R. 2008 'Beyond the limits of clinical governance: the case of mental health in primary care' BMC Health Services Research 8: 63
Mair, F. S., Hiscock, J. and Beaton, S. C. 2008 'Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease', Chronic Illness 4(2): 110-117.
May,
C., Mort, M., Williams, T., Mair, F. S. and Gask, L. 2003a 'Health
Technology Assessment in its local contexts: studies of
telehealthcare', Social Science and Medicine 57: 697-710.
May,
C. R., Harrison, R., Finch, T., MacFarlane, A., Mair, F. S. and
Wallace, P. 2003b 'Understanding the normalization of telemedicine
services through qualitative evaluation', Journal of the American Medical Informatics Association 10(6): 596-604.
May, C. 2006 'A rational model for assessing and evaluating complex interventions in health care', BMC Health Services Research 6: 86
May, C., Finch, T., Mair, F., Ballini, L., Dowrick, C., Eccles, M., Gask, L., MacFarlane, A., Murray, E., Rapley, T., Rogers, A., Treweek, S., Wallace, P., Anderson, G., Burns, J. and Heaven, B. 2007a 'Understanding the implementation of complex interventions in health care: the normalization process model', BMC Health Services Research 7: 148
May, C. R., Mair, F. S., Dowrick, C. F. and Finch, T. L. 2007b 'Process evaluation for complex interventions in primary care: understanding trials using the normalization process model', BMC Family Practice 8: 42
May, C. and Finch, T. 2009 'Implementation, embedding, and integration: an outline of Normalization Process Theory', Sociology In Press.
May, C. 2009a 'Innovation and Implementation in Health Technology: Normalizing Telemedicine', in J. Gabe and M. Calnan (eds) The New Sociology of the Health Service, London: Routledge.
May,
C. 2009b 'Mundane Medicine, Therapeutic Relationships, and the Clinical
Encounter.’ In (eds.) ', in B. Pescosolido, J. A. Martin and A. Rogers
(eds) Handbook of the Sociology of Health, Illness, and Healing: A Blueprint for the 21st Century, New York: Springer.
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