Testing normalization process theory in a randomized trial of mental health clinics implementing digital measurement-based care.

ABSTRACT:

Background

Normalization process theory (NPT) is one of the most highly cited implementation theories that explains the mechanisms by which new complex health interventions become embedded and sustained in healthcare settings; however, few of its predictions have been subjected to inferential hypothesis testing. In this theory-driven, ancillary analysis of a large hybrid type 3 effectiveness-implementation trial, we tested two NPT predictions: (1) its generative mechanisms of coherence, cognitive participation, collective action, and reflexive monitoring are modifiable in response to deliberate change efforts, and (2) greater enactment of these mechanisms predicts greater future sustainment of complex health interventions.

Methods

The trial tested two strategies to improve t

SUBMITTER: Williams NJ 

PROVIDER: S-EPMC12918388 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature