 Dyna maith gyda Naomi i wnaeth, rym ni yn bwysig ar gwaith ymlaenwy gradd sy'n gynyddiant nioglŷr o'i tympledoedd yn hollumser. Dw i wneud o'n rhai iechyd ddim yn rhai i jechyd fel mae'r gwyllai mewn gwirionedd y Gwn Ddweud byd i'r gwerthag hwn. Roeddwn i'r cyhoeddiad neu ddiddordeb sy'n gyfeirio'r wlaeth i gael ymlaenwyr yn obi councils. Yn yr arddangos gynnig sy'n cyffredin nioglŷr, fe oedd gennynny'n cyflym iawn dda i gael cyllidau ein sicr ar lefel yma. pan oedd y wneud bod nhw'n deallu hyn yn sicr ffordd â ddaeth ar yr hyn o'r ffordd a model ac ar ol yng Ngheirio NPD? Yn ymelltwyd cyhoedd eu ddifwyl, o hyd yn gweithio cyffredinol yn y model o ddod yr hyn yn gweithio cyhoedd cyhoedd enny'n yn ymryddu scenyfrigol, ond hynny'n gallu defnyddio'r holl y pethau'n ei ddarparu sy'n ddim yn ystod i'r maefyniadau, a finding yw hyn o'r Theori in the range theory which has been really used to understand how implementation comes to be and actually how complex interventions come to be imbedded and routinised into day to day work of people in a health system. This is a great paper for anyone that's interested in this is by Nilsen from 2015. And so I'd encourage you to look at that if you're interested in learning more about this and N.p.t really at the heart of it actually recognizes that health systems are really complex systems with the a ddweud yn iawn cyfosteithio cyfosidol sydyn nhw, siwethaf dweud amgylchedd honno, ond ond ond byw'r cyfransion c אחד. Mae'n cael cyfransion cyfransion cyfransion chedryd y gallwn ar gyfer ac y sydd efallai cynnig iawn. A wnaeth i digwydd eich cyfosidol yw'r cyfransion cyfosidol i'ch cyfransion cyfosidol sydd eich cyfransion cyfransion cyfransion cyfosidol yma. o'r cyllidau cyfwysgol, sy'n biteswch anodd gyda'ch gwaes y gysylltu ddechrau'r plwy yn y system, a'r gynnig sydd yn gallu yn gyfan i'r gydiglu cymaint sydd wedi'i gwneud o'i lemlion oherwydd — dim ond ei hyn yn ôl yn y pandemi, sy'n ei wneud i gydiglu'r Gysylltu'r Cyngorolったeth ddiwedd a gydiglu'r Cyngorol ar y byth yn gynnig yn mynd i'r gysylltu'n gwybod. yn ffordd o'r interventio cydnod o'r cydnod ymryd hwnnw, ar hyn o un pethau o'r dyfodol, o'i allun o hyry o'r mьяi ein interventio, sy'n lle'r lle'r cydnod, yng Nghymru sy'n credu ddeifrif a'r atwydau yn y cydnod. Gwi'n teimlo'n fyddion o'r interventio, o'r gond어� o unig yw interventio. A dyno'n adnod yw'r gondod o ein atyn yn y boedd ac yndyn nhw'n gwertho, o'r cydnod yw'r interventio o'r gondod And NPT focuses on that last aspect which is the actions that people take. And it's not about how people feel towards the intervention or what they intend to do, but what do they actually do, an it looks at both individual actors within the health system and also the collective actions of people within the health system as well so it's really a theory of action. An it looks at activity on three different levels of activity at the micro-level it can look at how dywedig iawn, ac mae'n rhanio'r cymdeithasol yn ymryd. A'r unrhyw yna'r dioled ag ymddangos, y gallwn yn ei gallu gweithio'r gwaith, a yn ymweld y celfwyr, mae'n fawr yn ei fawr yn ei wneud o'r cyfeisio erbyn y celfwyr o'r cyfeisio. A oedd y celfwyr yn ei fawr i'r fawr, mae'n dweud y celfwyr o'r cyfeisio'r gweithio'r cyfeisio'r cyfeisio. mecanismi ar y dyfodol y gallu cyfryd yn lleolodau a'u cyfrannu hwn. Dydyn ni'n ffordd cyfrannu o cael ei wneud o gyfrannu o clywedau ymweld, nad yw ychydig ar hyn o'r cyfrannu, nad yw'n digwydd y gallwn yn fath o'r cyfrannu, nad yw'n hynod i'w ddwylo sydd y gallu ffyrwyd o'r fwyfyr o'i ddwylo, a'r ddwylo'r fforddau o'r cyfrannu. A mae ydych yn dod o'r cerddau oherwydd ym mhwy fydd yw'r cyfrannu, i'r language ond nesaf. Mi'n bwch chi'n cael ei ffion ddiwedd fel ddiwedd yn fwy o'r rhain ymarfer i'ch gael gwellan. A'i gwneud y cwmfyrdd ddim yn tryn o'r swyddiadau oherwydd chi wedi chefnol bydd ymateb oherwydd y gallai gweld iawn. Dwi'n ddigwydd o'r byw syniadau oherwydd y dgylch pepperon ac y bwysigai cynnig o gyfnod dwybod y cyflwyd odd. ac mae'r ddau gwelwch yn ymddi'r gwyliaeth. A raddol ddim yn windfynu ein bod yn dda, i'r cymuned â'r ddau. Mae'n ddefnyddu'r cymryddiol yn ddigon o weithio mae cofyn yn bewyd iawn i ddim yn gwybodaeth i'u gyd. Pan ddim yn rhywbethol bod ddim yn dysgu cymryd ffordd hynny i ddim yn ddau a'i ddim yn ddigon o ran gwaith ac yn ddweiyng – cadw i'n ddigon i ddim yn ddweud i'r ddigon i ddim i ddim yn ddweud it fabricates, It requires constant commitment of those people in the health system to keep of those people develop the disability system to help keep delivering the intervention. So NPD can be used to support intervention design in order to understand the context, so it can actually feed in to that human-centred design approach as well. I can use them to process evaluation of trials to explain implementation o'r pwylltion rhywunol o'r rhannwyr cyrraedd yn cael ei ddeithasol, ac mae'n mynd i'ch gweithio'r ysgolion cyfnodau sydd o'r hynny o'r ffordd o'r ddyddol. Mae'n gwneud bod y ddweud hwnnw ymlaenwyr yn ei ddweud, ein ddysgu sydd o'r ddweud, of qualitative data, but also as an option of doing a theory-led analysis using both deductive and inductive elements as well. So, I used NPT in the context of a study in rural India in two very diverse states in India, and this was a complex health system. It worked with high-risk pregnant women in the villages, as well as their families, community health workers, primary care doctors at the primary health centre, and also obstetricians. So, this was a very complex dynamic environment across two different states in India, and this was part of my default work. So, I designed and developed a complex intervention, went on to pilot that in a cluster randomized control trial of 200 pregnant women, and I used NPT as part of the process evaluation of the study. The intervention in itself was really complex because it had multiple components, and it involved actually training community health workers called ASHAs to learn new skills such as point of care testing for hemoglobin and blood pressure, and also involved a technology component where the ASHAs were provided with mobile clinical decision support to be able to do these tests at home in the home environment and screen and refer council women in their homes. And this was across three different time points during a woman's antinatal and postnatal care. So, with this complex intervention, I then looked at in the process evaluation how it was implemented using NPT, and actually NPT helped to explain how the ASHAs understood the differences between their previous ways of working where they were really just in home visits and just checking in on women to now doing actual point of care testing at home and being able to give counselling and advice, and also it changed the relationships between the ASHAs and the other health care workers, but also with the community. So, at the beginning of the study, people in the community didn't feel that ASHAs had the legitimacy to actually do these tests because they only had a secondary school education, but by the end of the study, they'd really achieved quite a lot of social and professional recognition from the community and their peers. And so, the relationships between different health care providers started to change as well. And in terms of how they actually delivered the intervention, they had to renegotiate their roles with other community health workers known as ANMs. And so, the hierarchical structure of the health system between these different carders of health care workers actually started to flatten in terms of professional hierarchies. And there was a renegotiation of roles. And then a really interesting thing was that they actually started to reflect upon what they did and form peer groups. So, they were able to support themselves and actually did home visits together and problem solved together. And as a result of all of this, they integrated the intervention into their day to day work. And they didn't feel it was a big obligation because they got quite a lot of trade-off in terms of social and professional recognition from this. So, that's how it explained some of the ways in which it was implemented and integrated. So, NPT, I thought, was a really good theory for this because it actually helped to explain a lot of the micro-meso and macro-level factors that contributed to the normalisation of this intervention. It did also explain some of the changes in organisational culture within the health system. And it explained a lot of the factors involved in the acceptability of the intervention. It also helped me to understand the actual work that was done by Arshares and the other health care workers within the health system and how this actually came to be routinised into their day to day lives. So, I felt it was a good fit for this type of study. So, thank you very much. And if there's any questions, please ask.