Action & Context
I've had a great summer: NPT workshops in Melbourne, Australia; Prato, Italy; E2P14 at the King's Fund in London, and in Newcastle in the UK have been really successful, and we've had the opportunity to talk through some of the really interesting complexities of implementation with healthcare providers - clinicians and managers - as well as researchers. In conversation, they have articulated three important needs: to have rigorous conceptual models of the adoption, implementation, and embedding of innovations that are (a) relatively comprehensive; (b) that are linked to actual experiences of the organization and delivery of healthcare; and (c) that can be operationalized through practical tools for understanding and ‘thinking through’ implementation processes. So this is an exciting prospect for the next stage of developing from NPT a useful set of policy and practice tools. We already have plans to revamp the NPT website and add the NPT questionnaires that Tracy Finch and colleagues are developing, but some new opportunities are coming on stream too. I'll keep you posted.
Some really interesting questions about the role of context have been coming up in discussions about applying NPT. Elizabeth Murray and colleagues have undertaken an important systematic review of implementation studies that points to the shaping effects of different aspects of implementation contexts. The big question is how to integrate 'action' and 'context' in studies. Mandy Stijnen and colleagues at Maastricht have done a really nice job in a recently published paper that describes a complex intervention to improve health-related quality of life and reduce disability among potentially frail community-dwelling older people in the Netherlands. Importantly, they show how NPT constructs were used to frame specific research questions. It's pretty cool, so check it out.
I'm really interested in the ways that we understand action in context - the fundamental social science question that I'm interested in is about how we understand the dynamics of human agency in conditions of constraint - and I'm contemplating hosting an expert seminar on this topic in 2015. If you'd be interested in attending or contributing to a meeting like that, please let me know, Use the comments box below.