运用规范化进程理论评估复杂干预措施和卫生技术：简化方法和网络工具包的开发。
Evaluating complex interventions and health technologies using normalization process theory: development of a simplified approach and web-enabled toolkit.
机构信息
Faculty of Health Sciences, University of Southampton, UK.
出版信息
BMC Health Serv Res. 2011 Sep 30;11:245. doi: 10.1186/1472-6963-11-245.
BACKGROUND
Normalization Process Theory (NPT) can be used to explain implementation processes in health care relating to new technologies and complex interventions. This paper describes the processes by which we developed a simplified version of NPT for use by clinicians, managers, and policy makers, and which could be embedded in a web-enabled toolkit and on-line users manual.
METHODS
Between 2006 and 2010 we undertook four tasks. (i) We presented NPT to potential and actual users in multiple workshops, seminars, and presentations. (ii) Using what we discovered from these meetings, we decided to create a simplified set of statements and explanations expressing core constructs of the theory (iii) We circulated these statements to a criterion sample of 60 researchers, clinicians and others, using SurveyMonkey to collect qualitative textual data about their criticisms of the statements. (iv) We then reconstructed the statements and explanations to meet users' criticisms, embedded them in a web-enabled toolkit, and beta tested this 'in the wild'.
RESULTS
On-line data collection was effective: over a four week period 50/60 participants responded using SurveyMonkey (40/60) or direct phone and email contact (10/60). An additional nine responses were received from people who had been sent the SurveyMonkey form by other respondents. Beta testing of the web enabled toolkit produced 13 responses, from 327 visits to http://www.normalizationprocess.org. Qualitative analysis of both sets of responses showed a high level of support for the statements but also showed that some statements poorly expressed their underlying constructs or overlapped with others. These were rewritten to take account of users' criticisms and then embedded in a web-enabled toolkit. As a result we were able translate the core constructs into a simplified set of statements that could be utilized by non-experts.
CONCLUSION
Normalization Process Theory has been developed through transparent procedures at each stage of its life. The theory has been shown to be sufficiently robust to merit formal testing. This project has provided a user friendly version of NPT that can be embedded in a web-enabled toolkit and used as a heuristic device to think through implementation and integration problems.
背景
规范化进程理论（NPT）可用于解释与新技术和复杂干预措施相关的医疗保健实施过程。本文描述了我们为临床医生、管理人员和政策制定者开发简化版 NPT 的过程，该版本可嵌入到网络工具包和在线用户手册中。
方法
在 2006 年至 2010 年间，我们完成了四项任务。（一）我们在多个研讨会、研讨会和演讲中向潜在和实际用户介绍了 NPT。（二）根据这些会议的结果，我们决定创建一套简化的陈述和解释，以表达理论的核心结构。（三）我们使用 SurveyMonkey 将这些陈述分发给 60 名研究人员、临床医生和其他人员的标准样本，以收集关于他们对陈述的批评的定性文本数据。（四）然后，我们根据用户的批评意见重新构建陈述和解释，将其嵌入到一个网络工具包中，并进行了“野外”测试。
结果
在线数据收集是有效的：在四周的时间内，使用 SurveyMonkey（40/60）或直接电话和电子邮件联系（10/60）回复了 50/60 名参与者。另外还有 9 份回复是通过其他受访者发送 SurveyMonkey 表格的人收到的。对网络工具包的测试产生了 13 个回复，有 327 人访问了 http://www.normalizationprocess.org。对这两组回复的定性分析表明，这些陈述得到了高度支持，但也表明有些陈述表达其潜在结构较差或与其他陈述重叠。我们对这些陈述进行了重写，以考虑到用户的批评意见，然后将其嵌入到一个网络工具包中。因此，我们能够将核心结构转化为一套简化的陈述，供非专家使用。
结论
规范化进程理论在其生命的每个阶段都通过透明程序进行了开发。该理论已经被证明足够强大，值得进行正式测试。该项目提供了一个用户友好的 NPT 版本，可以嵌入到一个网络工具包中，并作为一种启发式工具来思考实施和整合问题。
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