Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale
{"title":"从理论到实践:使用规范化过程理论和理论领域框架来理解脱碳在一般实践中的实施。","authors":"Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale","doi":"10.1093/fampra/cmaf050","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Decarbonization in general practice is a critical step toward achieving a net zero healthcare system. Understanding the factors that facilitate or hinder the implementation of environmentally sustainable practices is essential for effective and equitable action. Hence, the overarching aim of this study is to advance understanding of the factors influencing decarbonization in general practice. This study's objective is to map and compare the application of the Normalization Process Theory (NPT) and Theoretical Domains Framework (TDF) in understanding the key factors and sub-factors related to decarbonization in general practice.</p><p><strong>Methods: </strong>Factors derived from a systematic review and narrative synthesis were mapped to NPT constructs and TDF domains by a multidisciplinary team of 10 coders, including academic general practitioners (GPs), researchers, and patient representatives. The mapping was conducted independently, and coder agreement was evaluated for consistency and reliability in categorization.</p><p><strong>Results: </strong>The study identifies key NPT ('Coherence', 'Collective Action', and 'Cognitive Participation') and TDF domains ('Environmental Context and Resources', 'Knowledge', and 'Social/professional role and identity') associated with factors identified in previous research as being associated with achieving decarbonization in general practice. A high intercoder reliability rate (73% for NPT, 84% for TDF) supports the consistency of the analysis, particularly for structured drivers such as financial incentives and policy support.</p><p><strong>Conclusions: </strong>The findings demonstrate that the NPT and TDF frameworks provide useful, though incomplete, insights into factors influencing decarbonization in general practice. Such factors require more attention when developing evidence-based strategies for promoting decarbonization, something that future research could evaluate.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214461/pdf/","citationCount":"0","resultStr":"{\"title\":\"From theory to practice: using the Normalization Process Theory and Theoretical Domains Framework to understand implementation of decarbonization in general practice.\",\"authors\":\"Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale\",\"doi\":\"10.1093/fampra/cmaf050\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Decarbonization in general practice is a critical step toward achieving a net zero healthcare system. Understanding the factors that facilitate or hinder the implementation of environmentally sustainable practices is essential for effective and equitable action. Hence, the overarching aim of this study is to advance understanding of the factors influencing decarbonization in general practice. This study's objective is to map and compare the application of the Normalization Process Theory (NPT) and Theoretical Domains Framework (TDF) in understanding the key factors and sub-factors related to decarbonization in general practice.</p><p><strong>Methods: </strong>Factors derived from a systematic review and narrative synthesis were mapped to NPT constructs and TDF domains by a multidisciplinary team of 10 coders, including academic general practitioners (GPs), researchers, and patient representatives. The mapping was conducted independently, and coder agreement was evaluated for consistency and reliability in categorization.</p><p><strong>Results: </strong>The study identifies key NPT ('Coherence', 'Collective Action', and 'Cognitive Participation') and TDF domains ('Environmental Context and Resources', 'Knowledge', and 'Social/professional role and identity') associated with factors identified in previous research as being associated with achieving decarbonization in general practice. A high intercoder reliability rate (73% for NPT, 84% for TDF) supports the consistency of the analysis, particularly for structured drivers such as financial incentives and policy support.</p><p><strong>Conclusions: </strong>The findings demonstrate that the NPT and TDF frameworks provide useful, though incomplete, insights into factors influencing decarbonization in general practice. Such factors require more attention when developing evidence-based strategies for promoting decarbonization, something that future research could evaluate.</p>\",\"PeriodicalId\":12209,\"journal\":{\"name\":\"Family practice\",\"volume\":\"42 4\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214461/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Family practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/fampra/cmaf050\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Family practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/fampra/cmaf050","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
From theory to practice: using the Normalization Process Theory and Theoretical Domains Framework to understand implementation of decarbonization in general practice.
Background: Decarbonization in general practice is a critical step toward achieving a net zero healthcare system. Understanding the factors that facilitate or hinder the implementation of environmentally sustainable practices is essential for effective and equitable action. Hence, the overarching aim of this study is to advance understanding of the factors influencing decarbonization in general practice. This study's objective is to map and compare the application of the Normalization Process Theory (NPT) and Theoretical Domains Framework (TDF) in understanding the key factors and sub-factors related to decarbonization in general practice.
Methods: Factors derived from a systematic review and narrative synthesis were mapped to NPT constructs and TDF domains by a multidisciplinary team of 10 coders, including academic general practitioners (GPs), researchers, and patient representatives. The mapping was conducted independently, and coder agreement was evaluated for consistency and reliability in categorization.
Results: The study identifies key NPT ('Coherence', 'Collective Action', and 'Cognitive Participation') and TDF domains ('Environmental Context and Resources', 'Knowledge', and 'Social/professional role and identity') associated with factors identified in previous research as being associated with achieving decarbonization in general practice. A high intercoder reliability rate (73% for NPT, 84% for TDF) supports the consistency of the analysis, particularly for structured drivers such as financial incentives and policy support.
Conclusions: The findings demonstrate that the NPT and TDF frameworks provide useful, though incomplete, insights into factors influencing decarbonization in general practice. Such factors require more attention when developing evidence-based strategies for promoting decarbonization, something that future research could evaluate.
期刊介绍:
Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries.
Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration.
The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.