Of these, 754 did not fit the inclusion criteria for the review. This left 884 articles for full-text screening. Of these, 101 were excluded because they did not fit the inclusion criteria for the review. We show that after eliminating 2337 duplicates and broken or junk URLs, 985 were screened as titles and abstracts.

A structured data extraction instrument was used, and data were analysed qualitatively. We searched Web of Science, Scopus and Google Scholar for articles with empirical data in peer-reviewed journals that cited either key papers presenting and developing NPT, or the NPT Online Toolkit ( We included in the review only articles that used NPT as the primary approach to collection, analysis or reporting of data in studies of the implementation of healthcare techniques, technologies or other interventions. MethodsĪ qualitative systematic review was conducted.

The aims of this review were to review this literature to identify and characterise the uses and limits of NPT in research on the implementation and integration of healthcare interventions and to explore NPT’s contribution to understanding the dynamics of these processes. A large body of literature that employs NPT to inform feasibility studies and process evaluations of complex healthcare interventions has now emerged. Normalization Process Theory (NPT) identifies, characterises and explains key mechanisms that promote and inhibit the implementation, embedding and integration of new health techniques, technologies and other complex interventions.

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