Time spent with friends

I've been really fortunate to have spent a good deal of time in the company of old friends lately. Last week, in particular, I visited Edinburgh for the second meeting of our NIHR Peer Learning Set for Normalization Process Theory. Last year we met to discuss how we were going to progress the theory, and one of the objectives that we set ourselves was that we would begin to develop an on-line 'users manual' for NPT. Day one of the meeting involved us in reviewing two studies that have pushed the bounds of the theory - work on the experience of depression, led by Chris Dowrick, and Cathy Pope's study of the implementation of NHS Pathways systems for telephone triage. These were important presentations, in part because they suggested how NPT could be a launching point for new conceptual models of processes that are supposed to be well understood, but which are actually much more opaque than we would like to believe. What united these two very different presentations was the way that they touched on the practices - the work - of social construction. This is one of the interesting features of NPT, and it's also one of the problems. Keeping the enterprise within reasonable bounds is a problem for theories of change - in part because change itself raises questions about levels and units of analysis. This is becoming an important focus for the final chapter of the book, Normalizing Health Technologies, that Tracy Finch and I are co-writing. Day one also included a detailed discussion of draft chapters for the NPT on-line users' manual, which is being supported by the ESRC as part of its 'follow-on' funding programme. Shaun Treweek, Tim Rapley, and Frances Mair presented their drafts on clinical trials, qualitative research and systematic reviews, respectively. This was a really congenial day, followed by a good dinner. Day two involved a detailed presentation by Tracy Finch on the operationalization of NPT's constructs, and the development of survey items to measure them. The discussion that followed was important, and our collective work has begun to open up new ways in which NPT can be usefully applied.

As we were having our Edinburgh meeting, the NPM/NPT papers published on-line in BMC Journals passed 20,000 accesses. This is interesting in itself, and I wonder how academic publishing is going to respond to the development of Web 2.0 technologies for dissemination. Or whether it can. One important feature of this is that impact will come to be measured in more than citation counts. These are a really narrow way of assessing engagement with an article or presentation. It also assumes that it is the article that actually matters, when down the line it might be the blog of the article, or the embedded video, or embedded powerpoint, of the article, that are actually the important routes by which research ideas and results are disseminated. Ac

Speaking of dissemination, on 18 November I am giving a seminar at King's College, London. I shall be speaking about problems of implementation and integration of new health technologies, and probably trying out some ideas from the forthcoming book. It's a while since I was last in London, so I'm looking forward to it.