Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese

Loch, Ana Paula; Finch, Tracy; Fonsi, Mylva; Soárez, Patrícia Coelho de

doi:10.1590/1806-9282.66.10.1383

Cited by 11 publications

(9 citation statements)

References 14 publications

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“…Although the questionnaire has demonstrated face and construct validity [ 5 ] and has been translated and adapted cross-culturally [ 16 – 18 ], evidence for the NoMAD’s psychometric properties is in its infancy. For example, information about its criterion-related validity and test–retest reliability is sparse [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The implementation and validation of the NoMAD during a complex primary care intervention

Lamarche

Clark

Parascandalo

et al. 2022

BMC Med Res Methodol

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Background Normalization process theory (NPT) has been widely used to better understand how new interventions are implemented and embedded. The NoMAD (Normalization Measurement Development questionnaire) is a 23-item NPT instrument based on NPT. As the NoMAD is a relatively new instrument, the objectives of this paper are: to describe the experience of implementing the NoMAD, to describe it being used as a feedback mechanism to gain insight into the normalization process of a complex health intervention, and to further explore the psychometric properties of the instrument. Methods Health TAPESTRY was implemented in six Family Health Teams (total of seven sites) across Ontario. Healthcare team members at each site were invited to complete the NoMAD, and three general questions about normalization, six times over a 12-month period. Each site was then provided a visual traffic light summary (TLS) reflecting the implementation of the Health TAPESTRY. The internal consistency of each sub-scale and validity of the NoMAD were assessed. Learnings from the implementation of the NoMAD and subsequent feedback mechanism (TLS) are reported descriptively. Results In total, 56 diverse health care team members from six implementation sites completed the NoMAD. Each used it at least once during the 12-month study period. The implementation of the NoMAD and TLS was time consuming to do with multiple collection (and feedback) points. Most (60%) internal consistency values of the four subscales (pooled across site) across each collection point were satisfactory. All correlations were positive, and most (86%) were statistically significant among NoMAD subscales. All but one correlation between the NoMAD subscales and the general questions were positive, and most (72%) were significant. Generally, scores on the subscales were higher at 12-month than baseline, albeit did not follow a linear pattern of change across implementation. Generally, scores were higher for experienced sites compared to first-time implementors. Conclusion Our experience would suggest fewer collection points; three timepoints spaced out by several months are adequate, if repeated administration of the NoMAD is used for feedback loops. We provide additional evidence of the psychometric properties of the NoMAD. Trial Registration Registered at ClinicalTrials.gov: NCT03397836.

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Section: Introductionmentioning

confidence: 99%

The implementation and validation of the NoMAD during a complex primary care intervention

Lamarche

Clark

Parascandalo

et al. 2022

BMC Med Res Methodol

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“…After exclusion of three items, the four-factor model could be successfully replicated and the four factors yielded good internal consistency (0.78 ≥ Cronbach's alpha ≤ 0.83) (18). Further NoMAD translations into Brazilian Portuguese (19) and Chinese (20) demonstrated good internal consistency for all constructs, con rming that translations into other languages are possible while maintaining the psychometric properties.…”

Section: Nomad Questionnairementioning

confidence: 85%

Validation of the German Normalization Process Theory Measure G-NoMAD: Translation, Adaptation, and Pilot Testing

Freund

Piotrowski

Bührmann

et al. 2023

Preprint

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Background Implementation of evidence-based healthcare practices (EBPs) is a complex endeavour and is often lagging behind research-informed decision processes. Understanding and systematically improving implementation using implementation theory can help bridge the gap between research findings and practice. This study aims to translate, pilot and validate the German version of the NoMAD questionnaire (G-NoMAD), an instrument derived from Normalization Process Theory, to be used to explore the implementation of EBPs. Methods Survey data has been collected in four German research projects and subsequently combined into a validation data set. Two versions of the G-NoMAD existed, independently translated from the original English version by two research groups. A measurement invariance analysis was conducted comparing latent scale structures between groups of respondents to both versions. After determining the baseline model, the questionnaire was tested for different degrees of invariance (configural, metric, scalar, and uniqueness) across samples. A confirmatory factor analysis for three models (a four factor, a unidimensional, and a hierarchical model) was used to examine the theoretical structure of the G-NoMAD. Finally, psychometric results were discussed in a consensus meeting and the final instructions, items, and scale format were agreed. Results A total of 539 health care professionals completed the questionnaire. The results of the measurement invariance analysis showed configural, partial metric and partial scalar invariance indicating that the questionnaire versions are comparable. Internal consistency ranged from acceptable to good (0.79 ≤ α ≤ 0.85) per subscale. Both the four factor and the hierarchical model achieved a better fit than the unidimensional model, with indices from acceptable (SRMR = 0.08) to good (CFI = 0.97; TLI = 0.96). However, the RMSEA values were only close to acceptable (four-factor model: χ2164 = 1029.84, RMSEA = 0.10; hierarchical model: χ2166 = 1073.43, RMSEA = 0.10). Conclusions The G-NoMAD provides a reliable and promising tool to measure the degree of normalization among individuals involved in implementation activities. Since the fit was similar in both the four factor and the hierarchical model, priority should be given to the practical relevance of the hierarchical model which includes a total score and four subscale scores. The findings of this study support the further usage of the G-NoMAD in German implementation settings. Trial registration Both the AdAM project (No. NCT03430336, 06/02/2018) and the EU-project ImpleMentAll (No. NCT03652883, 29/08/2018) were registered on ClinicalTrials.gov. The ImplementIT study was registered at the German Clinical Trial Registration (No. DRKS00017078, 18/04/2019). The G-NoMAD validation study was registered at the Open Science Framework (No7u9ab, 17/04/2023).

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“…Professionals' perspectives of the implementation. Professionals' perspectives and subjective changes before and after implementation were obtained through responses to the NoMAD questionnaire [14,15]. The questionnaire, which evaluated professionals' perception regarding the CCM, presents 20 items on a five-point Likert scale, ranging from "1 -strongly disagree" to "5 -strongly agree."…”

Section: Plos Onementioning

confidence: 99%

Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach

Loch¹,

Rocha²,

Fonsi³

et al. 2021

PLoS ONE

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Objective To evaluate the impact of an intervention improving the continuum of care monitoring (CCM) within HIV public healthcare services in São Paulo, Brazil, and implementing a clinical monitoring system. This system identified three patient groups prioritized for additional care engagement: (1) individuals diagnosed with HIV, but not receiving treatment (the treatment gap group); (2) individuals receiving treatment for >6 months with a detectable viral load (the virologic failure group); and (3) patients lost to follow-up (LTFU). Methods The implementation strategies included three training sessions, covering system logistics, case discussions, and development of maintenance goals. These strategies were conducted within 30 HIV public healthcare services (May 2019 to April 2020). After each training session, professionals shared their experiences with CCM at regional meetings. Before and after the intervention, providers were invited to answer 23 items from the normalization process theory questionnaire (online) to understand contextual factors. The mean item scores were compared using the Mann–Whitney U test. The RE-AIM implementation science framework (evaluating reach, effectiveness, adoption, implementation, and maintenance) was used to evaluate the integration of the CCM. Results In the study, 47 (19.3%) of 243 patients with a treatment gap initiated treatment, 456 (49.1%) of 928 patients with virologic failure achieved suppression, and 700 of 1552 (45.1%) LTFU patients restarted treatment. Strategies for the search and reengagement of patients were developed and shared. Providers recognized the positive effects of CCM on their work and how it modified existing activities (3.7 vs. 4.4, p<0.0001, and 3.9 vs. 4.1, p<0.05); 27 (90%) centers developed plans to sustain routine CCM. Conclusion Implementing CCM helped identify patients requiring more intensive attention. This intervention led to changes in providers’ perceptions of CCM and care and management processes, which increased the number of patients engaged across the care continuum and improved outcomes.

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Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese

Cited by 11 publications

References 14 publications

The implementation and validation of the NoMAD during a complex primary care intervention

The implementation and validation of the NoMAD during a complex primary care intervention

Validation of the German Normalization Process Theory Measure G-NoMAD: Translation, Adaptation, and Pilot Testing

Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach

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