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충실도 구현 척도 (Fidelity Implementation Scale)×Normalization Process Theory (NPT)×
분야실행과학실행과학
계열Process / pipelineProcess / pipeline
기원 연도20072009
창시자Carroll, C.; Patterson, M.; and colleagues; Goodman, C.; and othersCarl R. May, PhD; Elena Murray, PhD; and colleagues at University of Sydney and UCL
유형Observational and performance-based assessmentTheoretical framework with qualitative and mixed-methods assessment
원전Goodman, C., & Evans, C. (2010). Audit of the use of the Measure of Processes by Area Teams (MOPAT) in the acute hospital setting. Journal of Clinical Nursing, 19(11-12), 1514–1524. link ↗Murray, E., Treweek, S., Pope, C., MacFarlane, A., Ballini, L., Dowrick, C., ... & May, C. R. (2010). Normalizing adoption of new health care innovations: A systematic review of empirical studies. American Journal of Health Promotion, 24(4), e5–e15. link ↗
별칭Fidelity Scale, Implementation Fidelity, Fidelity MeasurementNPT, Normalization Process Theory, NPT Framework, Normalisation Process Theory
관련55
요약Fidelity of Implementation refers to the degree to which an evidence-based practice or intervention is delivered as originally designed and intended. The Fidelity of Implementation Scale (or fidelity assessment framework) operationalizes this concept by specifying the core components of an intervention, defining each component precisely, and then assessing whether practitioners deliver each component when appropriate. Fidelity is distinct from adoption (whether staff use the innovation) and outcomes (whether the innovation produces the intended benefit). An innovation can be widely adopted but delivered with low fidelity (incorrectly or incompletely), often resulting in poor outcomes. Conversely, perfect fidelity without adaptation may fail in some contexts. Fidelity monitoring is essential in implementation science to understand whether implementation failures stem from ineffective interventions (true lack of efficacy) or ineffective delivery (low fidelity despite effective intervention). Fidelity assessment uses observation, checklist, and record review methods tailored to the intervention type.Normalization Process Theory (NPT) is a framework developed by May, Murray, and colleagues (2009) to explain how new practices, technologies, and innovations become embedded and sustained in everyday organizational and clinical work. Rather than viewing implementation as a one-time adoption event, NPT conceptualizes implementation as a process of normalization—the gradual transition from 'new and unusual' to 'normal, routine work integrated into standard processes.' NPT identifies four normalization mechanisms: Coherence (shared understanding of the intervention's purpose and value), Cognitive Participation (staff engagement and involvement in learning and using the intervention), Collective Action (the work required to implement, including workflow changes and resource allocation), and Reflexive Monitoring (ongoing reflection on impacts, benefits, and needed adaptations). NPT has become influential in implementation science research, particularly in health technology implementation and complex intervention studies, and provides a theoretical lens for understanding why some innovations become normalized while others are abandoned.
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