Development of a theory of implementation and integration: Normalization Process Theory

Carl R. May, Frances Mair, Tracy Finch, Anne MacFarlane, Christopher Dowrick, Shaun Treweek, Tim Rapley, Luciana Ballini, Bie Nio Ong, Anne Rogers, Elizabeth Murray, Glyn Elwyn, France Légaré, Jane Gunn, Victor Manuel Montori

Research output: Contribution to journalArticle

344 Citations (Scopus)

Abstract

Background. Theories are important tools in the social and natural sciences. The methods by which they are derived are rarely described and discussed. Normalization Process Theory explains how new technologies, ways of acting, and ways of working become routinely embedded in everyday practice, and has applications in the study of implementation processes. This paper describes the process by which it was built. Methods. Between 1998 and 2008, we developed a theory. We derived a set of empirical generalizations from analysis of data collected in qualitative studies of healthcare work and organization. We developed an applied theoretical model through analysis of empirical generalizations. Finally, we built a formal theory through a process of extension and implication analysis of the applied theoretical model. Results. Each phase of theory development showed that the constructs of the theory did not conflict with each other, had explanatory power, and possessed sufficient robustness for formal testing. As the theory developed, its scope expanded from a set of observed regularities in data with procedural explanations, to an applied theoretical model, to a formal middle-range theory. Conclusion. Normalization Process Theory has been developed through procedures that were properly sceptical and critical, and which were opened to review at each stage of development. The theory has been shown to merit formal testing.

Original languageEnglish (US)
Article number29
JournalImplementation Science
Volume4
Issue number1
DOIs
StatePublished - 2009

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Theoretical Models
Natural Science Disciplines
Social Sciences
Technology
Delivery of Health Care
Conflict (Psychology)

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Health Informatics

Cite this

Development of a theory of implementation and integration : Normalization Process Theory. / May, Carl R.; Mair, Frances; Finch, Tracy; MacFarlane, Anne; Dowrick, Christopher; Treweek, Shaun; Rapley, Tim; Ballini, Luciana; Ong, Bie Nio; Rogers, Anne; Murray, Elizabeth; Elwyn, Glyn; Légaré, France; Gunn, Jane; Montori, Victor Manuel.

In: Implementation Science, Vol. 4, No. 1, 29, 2009.

Research output: Contribution to journalArticle

May, CR, Mair, F, Finch, T, MacFarlane, A, Dowrick, C, Treweek, S, Rapley, T, Ballini, L, Ong, BN, Rogers, A, Murray, E, Elwyn, G, Légaré, F, Gunn, J & Montori, VM 2009, 'Development of a theory of implementation and integration: Normalization Process Theory', Implementation Science, vol. 4, no. 1, 29. https://doi.org/10.1186/1748-5908-4-29
May, Carl R. ; Mair, Frances ; Finch, Tracy ; MacFarlane, Anne ; Dowrick, Christopher ; Treweek, Shaun ; Rapley, Tim ; Ballini, Luciana ; Ong, Bie Nio ; Rogers, Anne ; Murray, Elizabeth ; Elwyn, Glyn ; Légaré, France ; Gunn, Jane ; Montori, Victor Manuel. / Development of a theory of implementation and integration : Normalization Process Theory. In: Implementation Science. 2009 ; Vol. 4, No. 1.
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