NoMAD questions grouped by relationship to NPT constructs as statements for evaluation (Q1 response variables: Still feels very new, 0–10, Feels completely familiar. Q2 and Q3 response variables: Not at all, 0; Somewhat, 5; Completely, 10. Q4—23 response variables: Strongly agree, 1–5, Strongly disagree; Not relevant to my role—6; Not relevant at this stage—7; Not relevant to screening and treatment for malnutrition—8.) (Questions 4–7 mapped to the construct ‘coherence’ and were not included at T0; Questions 1–3 explore general feelings of familiarity and normalisation, and are not reported in this article)44
| NPT construct | Question (NPT component) | NPT construct | Question (NPT component) |
| Questions not linked to specific constructs | Q1— When you screen and treat patients for malnutrition, how familiar does it feel? |
Collective action:
‘The operational work that people do to enact a set of practices, whether these represent a new technology or complex healthcare intervention’ |
Q12—I can easily integrate screening and treatment for malnutrition into my existing work
(Interactional workability) |
| Q2— Do you feel that screening and treatment for malnutrition is currently a normal part of your work? |
Q13—Screening and treatment for malnutrition disrupts working relationships
(Relational integration) | ||
| Q3— Do you feel that screening and treatment for malnutrition will become a normal part of your work? |
Q14—I have confidence in other people’s ability to screen and provide treatment for malnutrition
(Relational integration) | ||
|
Coherence:
‘The sense-making work that people do individually and collectively when they are faced with the problem of operationalizing some set of practices’ |
Q4—I can see how the new procedure for screening and treatment of malnutrition differs from usual ways of working
(Differentiation) |
Q15—Work is assigned to those with skills appropriate to screening and treatment for malnutrition
(Skill set workability) | |
|
Q5—Staff in this organisation have a shared understanding of the purpose of new procedure for screening and treatment of malnutrition
(Communal specification) |
Q16—Sufficient training is provided to enable staff to implement screening and treatment for malnutrition
(Skill set workability) | ||
|
Q6—I understand how new procedure for screening and treatment of malnutrition affects the nature of my own work
(Individual specification) |
Q17—Sufficient resources are available to support screening and treatment for malnutrition
(Contextual integration) | ||
|
Q7—I can see the potential value of new procedure for screening and treatment of malnutrition for my work
(Internalisation) |
Q18—Management adequately supports screening and treatment for malnutrition
(Contextual integration) | ||
| Cognitive participation: ‘The relational work that people do to build and sustain a community of practice around a new technology or complex intervention’ |
Q8—There are key people who drive screening and treatment for malnutrition forward and get others involved
(Initiation) |
Reflexive monitoring:
‘The appraisal work that people do to assess and understand the ways that a new set of practices affect them and others around them’ |
Q19—I am aware of reports about the effects of screening and treatment for malnutrition
(Systematisation) |
|
Q9—I believe that participating in screening and treatment for malnutrition is a legitimate part of my role
(Enrolment) |
Q20—The staff agree that screening and treatment for malnutrition is worthwhile
(Communal appraisal) | ||
|
Q10—I’m open to working with colleagues in new ways to screen and treat for malnutrition
(Legitimation) |
Q21—I value the effects that screening and treatment for malnutrition has had on my work
(Individual appraisal) | ||
|
Q11—I will continue to support screening and treatment for malnutrition
(Activation) |
Q22—Feedback about screening and treatment for malnutrition can be used to improve it in the future
(Reconfiguration) | ||
| Q23—I can modify how I work with tools and/or procedures for screening and treatment for malnutrition
(Reconfiguration) |
NPT, normalisation process theory.