Table 3 Data extraction table
Authors | Year of study | Study type | Population/study setting/condition | Intervention | Use of NPT | Insight generated in the use of NPT | Author (of the included study) critique of NPT |
|---|---|---|---|---|---|---|---|
Drew et al. [42] | 2015 | Qualitative, semi-structured interviews | Population the intervention targets: no specific population described other than ‘hip fracture patients’ Setting: Secondary care, UK (11 hospitals) Condition: hip fractures | Secondary fracture prevention service | Implementation Authors describe the aim of using extended NPT is to ‘Understand how and why secondary fracture prevention services can be implemented in secondary care’ Extended NPT was described to be used to support the development of the topic guide and analysis of the interview data (codes transposed onto the four constructs) | Four constructs of Extended NPT: (1) Capacity (2) Potential (3) Capability (4) Contribution No insight gained into the use of extended NPT. The authors only related the interview data to each of the four constructs | 3 challenges in the application of extended NPT are described: 1) The overlapping nature of the constructs meaning that data could be coded into more than one construct 2) Being certain that data was categorised into the ‘correct’ construct 3) Potential for tension with undertaking an abductive analysis whilst ensuring data are not forced into pre-defined constructs |
2020 | Foster et al.—RCT with nested qualitative study Saunders et al.—qualitative, semi-structured interview data presented from Foster et al., RCT | Population the intervention targets: individuals with sciatica. RCT population: mean age 52.1 years, n = 476 (50% female) Setting: primary care, community physiotherapy and spinal interface services between primary and secondary care, UK Condition: Sciatica | Stratified care approach for sciatica (combines information on the risk of persistent disability with information about sciatica clinical severity) | Implementation NPT used alongside the ‘boundary objects concepts’ to guide qualitative study (the influence of both theoretical frameworks was clearly explained) The concept of ‘coherence’ was used as a lens to interpret the interview findings. Themes were described to be mapped onto this construct | Only ‘coherence’ construct used. No new insight gained into this construct | The authors report that the use of NPT (and boundary objects concepts) enabled the team to develop a more robust understanding of the identified issues | |
Gilbert et al. (1) [45] | 2018 | Qualitative, semi-structured interviews | Population the intervention targets: patients aged over 18 Setting: Tertiary orthopaedic hospital, UK Condition: Shoulder pain/dysfunction | Multiple Joint (MUJO) system (rehabilitation device) | Implementation NPT was used to explore the underlying reasons behind the MUJO System’s acceptability The interview schedule was described to be developed in ‘accordance with NPT’ A Direct Content Analysis was undertaken to organise the qualitative data against the NPT constructs | Four constructs used (extended NPT): (1) Capacity (2) Potential (3) Capability (4) Contribution No insight gained into construct use | Nil |
Gilbert et al. (2) [46] | 2019 | Qualitative, semi-structured interviews | Population the intervention targets: patients over 18, attending the hospital for shoulder rehabilitation for shoulder instability Setting: Tertiary orthopaedic hospital, UK Condition: Atraumatic shoulder instability | Videoconferencing | Implementation The interview structure was based on the constructs of NPT A directed content analysis was undertaken analysing the factors in accord with NPT Coding of data was undertaken using a previously published NPT coding framework | Four constructs used (extended NPT): (1) Capacity (2) Potential (3) Capability (4) Contribution No insight gained into construct use | The authors state that ‘the use of supplementary theoretical models or a combination of open and directed content analysis might have gleaned additional data which could have informed the results’; however, no direct critique of NPT was offered |
Gilbert et al. (3) [47] | 2022 | Qualitative, semi-structured interviews | Population the intervention targets: patients over age 18 years, attending the specialist orthopaedic hospital for physiotherapy or occupational therapy for an orthopaedic/musculoskeletal condition Setting: Tertiary orthopaedic hospital, UK Condition: Any orthopaedic/musculoskeletal condition | Virtual consultations (VC) | Implementation NPT used to underpin the line of enquiry into the implementation of VC. Preference theory also used but the use of NPT is clearly explained The interview schedule and coding frame was developed based on NPT | Four concepts used: (1) Coherence (2) Cognitive participation (3) Collective action (4) Reflexive monitoring | The authors state that ‘the use of normalisation process theory provided focused attention towards key implementation factors that feed into the formation of preference’. No other critique of the theory itself was offered |
2018 2014 | Hay et al.—mixed methods study NPT used in workstream 2: qualitative evaluation—observations and interviews Ong et al.—description of the conceptual underpinning of the approach in the MOSAIC study (commentary) | Population the intervention targets: ≥ 45 years old Setting: primary care, UK Condition: osteoarthritis | Model osteoarthritis consultation (MOSAIC) | Implementation The authors describe the use of NPT in 2 ways: 1) To provide a structure to identify factors facilitating implementation and overcoming barriers to delivering the intervention 2) To provide a framework for analysing and evaluating the process of intervention implementation a. Coherence construct used as an ‘organising device’ for group interviews with GPs and nurses who had undertaken intervention training b. Themes developed from data analysis were compared to the NPT construct of coherence | Although NPT is referenced to be used with all four constructs described, in the paper by Ong et al., the construct of 'coherence' is the only one mentioned | Nil | |
Judge et al. [50] | 2016 | Mixed methods study NPT used in Objective 2—Qualitative, semi-structured interviews | Population the intervention targets: ' hip fracture patients', no specific age given Setting: Secondary care (11 hospitals), UK Condition: hip fracture | Secondary fracture prevention service | Implementation The authors describe to have used extended NPT in 2 ways: 1) Interview topic guide based on four core elements 2) Codes from interview data were transposed onto the four constructs | Four constructs used (extended NPT): (1) Capacity (2) Potential (3) Capability (4) Contribution No insight gained into construct use | The authors discussed the challenge of analysing data using extended NPT with a concern of coding data into the theories constructs whilst ensuring they are not ‘forced’ into pre-defined categories. They explained to have avoided this problem by performing an initial step of inductive analysis prior to transposing the developed codes into the theory. They explained to feel that this meant any factors that did not ‘fit’ within the theory would have been identified but also felt that the theory was able to account for all of the issues relating to service implementation |
Peng et al. [51] | 2020 | Process evaluation—qualitative, semi-structured interviews and observations | Population the intervention targets: ‘older hip fracture patients’, no specific age given Setting: Orthopaedic hospital, China Condition: hip fracture | Multidisciplinary co-management programme | Implementation The authors describe to have used NPT in 2 ways: 1) Interview guide based on NPT 2) Key themes were mapped onto the NPT constructs | Four concepts used: (1) Coherence (2) Cognitive participation (3) Collective action (4) Reflexive monitoring | The authors describe to have found the use of NPT helpful in systematically identifying barriers to implementation which allowed for consistent responses to be collected across interviews |
Sanders, Foster and Ong [52] | 2011 | Qualitative, semi-structured interviews | Population the intervention targets: ‘back pain patients’ Setting: Primary care, UK Condition: back pain | Subgrouping tool | Implementation The authors describe the use of NPT in 3 ways: 1) Semi-structured interviews 'organised' around the 4 NPT dimensions 2) NPT used as a guiding theoretical framework for emerging themes and concepts 3) Key themes from the analysis of second stage interviews were mapped onto the 'coherence' construct | All four concepts were described to be used, with a focus on the concept of ‘coherence’. No insight generated into NPT use | The authors state to have found very little evidence that the constructs of collective action, cognitive participation and reflexive monitoring accurately reflected the behaviours and attitudes of their study population (GPs) |
Saunders et al. (2) [53] | 2022 | Qualitative, semi-structured interviews and focus groups | Population the intervention targets: no clear description other than ‘employed patients consulting an FCP with MSK pain’ Setting: Primary care Condition: MSK pain | Vocational advice | Implementation 1) Mapping interview themes onto the four components (themes were then explored in relation to how well they ‘fit’ the four NPT components) | Four concepts used: (1) Coherence (2) Cognitive participation (3) Collective action (4) Reflexive monitoring | The authors describe the use of NPT to enable them to develop a more robust understanding of the implementation potential. Further, a strong level of ‘fit’ was described between the authors’ themes and the NPT components (i.e. none of the findings fell outside of the parameters of NPT, and the identified themes could be usefully explained through the lens of NPT) |
Wylde et al. [54] | 2018 | Mixed methods study NPT used in stage 4—online questionnaire | Population the intervention targets: people with chronic knee pain after total knee replacement Setting: Secondary, UK Condition: Total knee replacement | Assessment clinic—STAR care pathway | Implementation 1) NoMAD instrument used to measure implementation processes from the perspectives of stakeholders | NoMAD instrument used (23-item instrument with 20 core construct items that reflect the four core constructs of NPT) | Nil |
Volkmer et al. [55] | 2021 | Qualitative, semi-structured interviews | Population the intervention targets: postoperative hip fracture patients Setting: Secondary care, UK Condition: Hip fracture | Postoperative physiotherapy | Implementation 1) NPT drawn upon to aid interpretation of interview findings (themes) | Four concepts used: (1) Coherence (2) Cognitive participation (3) Collective action (4) Reflexive monitoring | Nil |