Evidence mapPaperPMID 40600301Full record

SynthesisFamily practice2025

From theory to practice: using the Normalization Process Theory and Theoretical Domains Framework to understand implementation of decarbonization in general practice.

Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale

Abstract readSystematic Review
In one paragraph

Synthesis in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ana Raquel NunesWarwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7AL, United Kingdom.ORCID 0000-0002-3709-3760
Helen AthertonSchool of Primary Care, University of Southampton, University Road, Southampton, SO16 5ST, United Kingdom.ORCID 0000-0002-7072-1925
Frederik DahlmannWarwick Business School, University of Warwick, Scarman Road, Coventry, CV4 7AL, United Kingdom.
Abi EcclesNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford. OX2 6GG, United Kingdom.
Olivia GeddesWarwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Michael GreggPPI co-investigator, GPNET-0 Study, United Kingdom.
Florence KarabaWarwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Rachel SpencerWarwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Helen TwohigSchool of Medicine, David Weatherall building University Road, Keele University, Staffordshire, ST5 5BG, United Kingdom.ORCID 0000-0001-8781-1268
Jeremy DaleWarwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7AL, United Kingdom.

Funding

Health and Social Care Delivery Research NIHR153231National Institute for Health and Care Research
6 · The paper itself

Abstract

backgroundDecarbonization 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.

methodsFactors 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.

resultsThe 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.

conclusionsThe 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.

Indexed as

General PracticeGeneral PractitionersHumansbehaviour changeclimate actiondecarbonizationemissions reductionenvironmental sustainabilitynet zero healthcareplanetary healthsustainability

Identifiers

PMID40600301
PMCPMC12214461

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.