Table 1.

Operationalization of Normalization Process Theory for the Present Study

NPT ConstructsDefinition and Examples31Related Interview Questions
CoherenceProcess of understanding the intervention
  • Understand new practice and its purpose

  • Understand roles and responsibilities

  • Understand utility of intervention

  • Tell us about HL among your patients.

  • What are your clinic’s goals with regard to HL for your patients?

  • Walk us through how the HL prompt showed up in your clinic.

  • How has your clinic’s approach to HL changed since this prompt launched?

Cognitive participationProcess of engaging team members in intervention
  • Involve key participants

  • Support teamwork and group engagement

  • Develop ways to sustain teamwork

  • How do you interact with the prompt?

  • To what degree is everyone on board with the prompt? Why, or why not?

Collective actionProcess of carrying out the intervention
  • Interact in real-life settings

  • Build confidence in intervention and team

  • Assign work to team members

  • Manage resources and policies

  • How was the prompt launched? How did that go? What was changed, and how?

  • How do you interact with the prompt?

  • How do you, and your team, handle the prompt in your workflow?

Reflexive monitoringProcess of evaluating the intervention and how it impacts team members
  • Determine effectiveness

  • Assess value

  • Evaluate effects on team members

  • Adapt intervention practices

  • How do you balance the priority of HL against other patient needs?

  • How were problems detected and addressed?

  • What is your sense of how the prompt supports what needs to be done to care for patients with HL?

  • HL = hearing loss; NPT = Normalization Process Theory.

  • Note: Interview questions may relate to more than 1 NPT construct. Questions appear in the final interview guide in a different order than listed here.