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BMC Primary Care
Published in: BMC Primary Care 1/2007

Open Access 01-12-2007 | Research article

Process evaluation for complex interventions in primary care: understanding trials using the normalization process model

Authors: Carl R May, Frances S Mair, Christopher F Dowrick, Tracy L Finch

Published in: BMC Primary Care | Issue 1/2007

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Abstract

Background

The Normalization Process Model is a conceptual tool intended to assist in understanding the factors that affect implementation processes in clinical trials and other evaluations of complex interventions. It focuses on the ways that the implementation of complex interventions is shaped by problems of workability and integration.

Method

In this paper the model is applied to two different complex trials: (i) the delivery of problem solving therapies for psychosocial distress, and (ii) the delivery of nurse-led clinics for heart failure treatment in primary care.

Results

Application of the model shows how process evaluations need to focus on more than the immediate contexts in which trial outcomes are generated. Problems relating to intervention workability and integration also need to be understood. The model may be used effectively to explain the implementation process in trials of complex interventions.

Conclusion

The model invites evaluators to attend equally to considering how a complex intervention interacts with existing patterns of service organization, professional practice, and professional-patient interaction. The justification for this may be found in the abundance of reports of clinical effectiveness for interventions that have little hope of being implemented in real healthcare settings.
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Metadata
Title
Process evaluation for complex interventions in primary care: understanding trials using the normalization process model
Authors
Carl R May
Frances S Mair
Christopher F Dowrick
Tracy L Finch
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2007
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-8-42

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