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Table 2 Coding framework for analysis

From: Implementation of cardiovascular disease prevention in primary health care: enhancing understanding using normalisation process theory

Coherence (sense making work) Cognitive participation (Relationship work) Collective action (Enacting work) Reflexive monitoring (Appraising work)
Differentiation Enrolment Interactional workability Reconfiguration
Were staff and patients clear on their roles regarding the intervention?
Were staff and patients clear on other’s roles regarding the intervention?
Did staff engage with other staff around the intervention?
Did patients engage with the practice for the intervention?
Who initiated the engagement?
Who did and who didn’t ‘buy-in’ to the intervention?
How was the intervention enacted by staff, Lifestyle Advisors and patients?
How did the intervention fit with existing work of all stakeholders?
How did patients, staff and lifestyle advisors adapt to the introduction of the intervention?
What effect did the intervention have on usual practice?
Has the approach to CVD prevention in the practices been adapted based on the intervention experience? If so, how?
Has the patients approach to their CVD risk changed based on the intervention experience? If so, how?
Individual specification Initiation Relational integration Individual appraisal
Did the staff and patients know what the intervention was?
Was the intervention easy for the staff and patients to describe?
What benefits did the intervention bring, and to whom?
Who was engaged in the intervention?
What organisational skills did staff use to contribute to the intervention?
Were staff prepared to invest time, energy and work to the intervention? If so, what did they do?
Were patients prepared to invest time, energy and work into the intervention? If so what did they do?
What organisation skills did they use?
How did the intervention affect trust and confidence between all parties (i.e. patients, staff, lifestyle advisors)?
How did the intervention affect the relationships between all stakeholders?
How did all stakeholders work to maintain relationships?
Was it clear to staff and patients what effects the intervention has had?
Did patients and staff make efforts to reflect on and appraise the intervention? If so, how?
Has appraisal work informed whether the intervention was advantageous for patients and staff?
Communal specification Activation Skill set workability Communal appraisal
Did the staff have a shared sense of purpose around the intervention?
Did staff and patients have a shared sense of purpose around the intervention?
Who thought the intervention was a good idea? Who did not?
Were the benefits of the intervention valued by all patients and all staff?
Did the intervention fit with the overall goals and activity of the general practice?
Did the patients and staff undertake work to arrange a shared contribution to the implementing the intervention? If so, what is this work?
How did the intervention feature in practice meetings?
How did the practice communicate with patients about the intervention?
How was the intervention work distributed within the patients and staff?
What impact did the introduction of the intervention have on the distribution/division of labour, resources, power and responsibility?
Was the work for the intervention devolved to others not usually doing the work? If so, how and for what reason?
Was there alignment in the intervention approach throughout the patients and staff?
Did the introduction of the intervention alter the awareness of the work done by other members within a practice team?
How did patients and staff know that the intervention approach is being carried out?
Did staff and patients contribute/share feedback about the intervention with others? If so, what was discussed?
Has appraisal work informed whether the intervention approach is advantageous for patients and staff?
Internalisation Legitimation Contextual integration Systematisation
Was there an understanding by staff of how to learn to implement the intervention approach?
Did the patients relate their CVD risk and their need to seek support to the intervention?
Did staff have the time to learn to understand and carry out the intervention approach?
Was there work undertaken to ensure that participating in the intervention was viewed by patients and staff as the right thing to do? If so, what was this work?
Did staff have the permission to use the intervention approach?
How was the intervention resourced?
Did patients bring their own resources to the intervention? Could they integrate lifestyle changes into their everyday life?
Are tasks compatible with existing work practices?
Was the intervention linked to, and resourced through, organisational structures (e.g. clinical information systems, decision support tools)?
How did the intervention affect the relationship with existing structures?
Has the practice developed ways of keeping patients and staff up to date with best practice approaches to CVD prevention?