Page - 186 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

3.2. Generating research questions using NPT. Figure 3.Worked example use of NPT in nutrition screening and care planning scenario. In Figure 3, we can see how a table might be used to identify questions relevant to the Coherence domain of NPT (see also Appendix). Note that wording of questions preserves the emphasis on action; for example, the planning question linked to the Differentiationcomponent reads: ‘Howwill information provided by the implementation team help HCPs distinguish the new procedure from current working practices?’. The ‘how’ is important here because while procedural differences between the two may seem obvious, it is possible that participants may interpret this process as a different way of doing the same thing (that is, they may not immediately see the benefits that those developing the intervention have in mind). Accounting for how these differences are made visible thus relates to an important part of the work necessary for successful implementation. For example, Ross et al’s experience of implementing the HeLP- Diabetes intervention (discussed in section 2.1) indicates that discussions with HCPs, in addition to written information sources, were important in identifying and addressing questions about how the new procedure differed from existing practice [11]. Focus on action is also preserved in the example evaluation question (also linked to Differentiation): ‘Do community HCPs see the new procedure as different from existing ways of working, and if so how?’ (see Figure 3). In both planning and evaluation, framing of the question will also affect further discussions about methods (i.e. a focus purely on belief or sentiment may suggest methods, such as attitudinal surveys using scale measures, that fail to capture processes relevant to understanding implementation which may better be investigated by, for example, interviews or in-person observations). M.BracherandC.R.May / ImplementingandEmbeddingHealth InformaticsSystems186