Page 111 - Demo

Implementation interventions through the lens of Normalisation Process Theory1094align their actions. Our observations align with studies conducted from the perspective of Normalisation Process Theory in long-term care for the elderly. Implementation of monitoring technology appeared to be enhanced by involving stakeholders within discussions and decisions (i.e., consensus processes) (Hall et al., 2017). In a study by Resnick et al. (2004) involving %u2018committed champions%u2019 (i.e., local opinion leaders) as part of a support team facilitated implementation and motivated care teams to learn new skills (Resnick et al., 2004). Woo et al. (2017) also identified the use of %u201cchampions, who foster and reinforce changes for improvement%u201d (i.e., local opinion leaders) as the most effective implementation intervention (Woo et al., 2017). Client-Related Interventions appeared to be key in motivating support staff to implement a new method requiring behavioural change. This is in line with the findings of Johnson and May (2015). Moreover, recent studies in longterm care for people with intellectual disabilities also show the importance of involving client%u2019s opinions concerning choices and evaluations of methods or treatment interventions (Wolkorte et al., 2019). In identifying barriers to implementation processes and composing implementation strategies engagement of clients is also valuable (van Rooijen et al., 2021). Johnson and May (2015) ranked implementation interventions in order of effectiveness based on their systematic review. In the present study interventions were ranked in order of frequency of use by the coordinating researcher and the MDET-experts. They used interventions which they assumed to be effective in long-term intellectual disability care based on their tacit knowledge or previous experiences with implementation. In developing an NPT-EPOC framework adapted for MDET, we found that frequently used implementation interventions tended to initiate a large number of social mechanisms described by Normalisation Process Theory (May et al., 2009), especially when relative to the NPT-EPOC framework by Johnson and May (2015). Ten (out of sixteen) social mechanisms of NPT were observed to be activated by the implementation intervention Consensus Processes, and eight by Local Opinion Leaders. Thus, we identified these interventions to have a broad effect on social mechanisms of implementation, in contrast to the more narrow effects that Johnson and May identified on three or less social mechanisms.