ArticleImplementation science communications2025
Psychometric evaluation of the NoMAD instrument in cancer care settings: assessing factorial validity, measurement invariance, and differential item functioning.
Article in Implementation science communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 5 papers.
What it found
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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.
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.
SIMPRO Research Center: Integration and Implementation of PROs for Symptom Management in Oncology Practice
Enhanced, EHR-Facilitated Cancer Symptom Control (E2C2) Trial
Implementation and Evaluation of an Expanded Bilingual Electronic Symptom Management Program Across a Multi-site, Fully-integrated Comprehensive Cancer Center
Who cites it
5 citing papers in PubMed.
- Testing normalization process theory in a randomized trial of mental health clinics implementing digital measurement-based care.Implementation science : IS · 2026Trial
- Assessing PRISM context domains and RE-AIM outcomes: data from use of the iterative PRISM webtool.Implementation science communications · 2026Article
- Article
- Impact of COVID-19 on early identification of protein-energy malnutrition in the cancer care setting: a repeated cross-sectional survey of cancer care professionals.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Assessing PRISM context domains and RE-AIM outcomes: Data from use of the Iterative PRISM Webtool.Research square · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundThe Normalization MeAsure Development (NoMAD) questionnaire is used to assess implementation processes based on Normalization Process Theory (NPT). However, its psychometric properties have not been extensively evaluated. This study aimed to examine the factorial validity, internal consistency, and measurement invariance at both scale and item levels of the NoMAD across three hybrid effectiveness-implementation studies determining the impact of routine symptom surveillance and guideline-based symptom management interventions in ambulatory oncology care settings.
methodsA cross-sectional survey was conducted with 328 healthcare personnel (74.% clinicians) participating in the Improving the Management of SymPtoms during And following Cancer Treatment (IMPACT) Research Consortium between 2019 and 2024. Confirmatory factor analysis (CFA) tested the hypothesized four-factor structure (coherence, cognitive participation, collective action, reflexive monitoring). Internal consistency was assessed with McDonald's omega and Cronbach's alpha coefficients (> 0.70 acceptable). Measurement invariance was tested across research centers, professional roles, and years in current roles using multi-group CFA. Model fit was defined by standard fit indices (Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) values ≥ 0.95, Root Mean Square Error of Approximation (RMSEA) values ≤ 0.06, and Standardized Root Mean Square Residual (SRMR) values ≤ 0.08. Differential item functioning (DIF) was evaluated using ordinal logistic regression and item response theory methods (ΔR2 ≥ 0.02 indicative of meaningful DIF).
resultsThe four-factor model demonstrated good fit to the data (CFI = 0.97, TLI = 0.96, RMSEA = 0.06, SRMR = 0.05). All factor loadings were statistically significant (p < 0.001), ranging from 0.606 to 0.871. Internal consistency was satisfactory for all four constructs (Omega range: 0.789-0.864, Cronbach's alpha range: 0.782-0.863). The NoMAD exhibited configural, metric, and scalar invariance across research centers, roles, and years in the current role. One item ("The staff agree that the intervention is worthwhile") showed uniform DIF across healthcare systems (ΔR2 = 0.047), but no DIF was found by role or years in the current role.
conclusionsThis study supports the factorial validity, internal consistency, and measurement invariance of the NoMAD across three oncology implementation efforts. The presence of DIF in one item provides an opportunity for refinement in this healthcare context. Researchers and practitioners can use the NoMAD to assess and compare implementation processes, informing the development and evaluation of implementation strategies.
trial registration(ClinicalTrials.gov ID NCT03850912, NCT03892967, NCT03988543).
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Registered trials
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 OpenQuestion graph.