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Table 3 Cognitive Interviews Coding Framework

From: Improving the normalization of complex interventions: part 1 - development of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT)



‘Got it’

The participant shows good understanding of the question and answers appropriately and confidently, according to their role within the intervention


The participant queries a particular word or terminology within the question, e.g. unsure of meaning


The participant either suggests that another question in the toolkit is a ‘better’ question to ask; or that they ‘like’ a particular question over another (NB this is only relevant to duplicate questions that have similar wording)

Not Enough Information

The participant does not offer enough information to make a judgement on, for example, understanding or relevance of the question

Problem Of Relevance - ROLE

The participant does not consider the question ‘relevant’ to their role in the intervention e.g. something that is not applicable to them

Problem of relevance - TIMING

The participant does not consider the question ‘relevant’ to the timing of the intervention e.g. hasn’t happened yet


The participant has some trouble with ‘who’ the question is relating to e.g. themself, or others (and who the ‘others’ may be)

Multiple Interpretations - within

The participant offers a response from their own perspective/experience/role as well as that of others involved in the intervention

Multiple Interpretations - across

The participant offers a response which interprets the question as something different to what is being asked