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U.S. Citizenship and Immigration Services (USCIS) is updating the USCIS Policy Manual to address the proper mechanism for authorizing travel by temporary protected status (TPS) beneficiaries, and how such travel may affect their eligibility for adjustment of status under section 245(a) of the Immigration and Nationality Act (INA). USCIS is also updating the USCIS Policy Manual to reflect the decision of the U.S. Supreme Court in Sanchez v. Mayorkas, 141 S.Ct. 1809 (2021).

U.S. Citizenship and Immigration Services (USCIS) is updating policy guidance in the USCIS Policy Manual regarding whether temporary protected status (TPS) beneficiaries are eligible for adjustment of status under section 245(a) of the Immigration and Nationality Act (INA).

U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance in the USCIS Policy Manual to update and clarify when USCIS may adjust the status of an applicant whose conditional permanent resident (CPR) status was terminated.

U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance addressing the general policies and procedures of adjustment of status as well as adjustment under section 245(a) of the Immigration and Nationality Act (INA).

Normalization Process Theory (NPT) can be used to explain implementation processes in health care relating to new technologies and complex interventions. This paper describes the processes by which we developed a simplified version of NPT for use by clinicians, managers, and policy makers, and which could be embedded in a web-enabled toolkit and on-line users manual.

Between 2006 and 2010 we undertook four tasks. (i) We presented NPT to potential and actual users in multiple workshops, seminars, and presentations. (ii) Using what we discovered from these meetings, we decided to create a simplified set of statements and explanations expressing core constructs of the theory (iii) We circulated these statements to a criterion sample of 60 researchers, clinicians and others, using SurveyMonkey to collect qualitative textual data about their criticisms of the statements. (iv) We then reconstructed the statements and explanations to meet users' criticisms, embedded them in a web-enabled toolkit, and beta tested this 'in the wild'.

On-line data collection was effective: over a four week period 50/60 participants responded using SurveyMonkey (40/60) or direct phone and email contact (10/60). An additional nine responses were received from people who had been sent the SurveyMonkey form by other respondents. Beta testing of the web enabled toolkit produced 13 responses, from 327 visits to Qualitative analysis of both sets of responses showed a high level of support for the statements but also showed that some statements poorly expressed their underlying constructs or overlapped with others. These were rewritten to take account of users' criticisms and then embedded in a web-enabled toolkit. As a result we were able translate the core constructs into a simplified set of statements that could be utilized by non-experts.

Normalization Process Theory has been developed through transparent procedures at each stage of its life. The theory has been shown to be sufficiently robust to merit formal testing. This project has provided a user friendly version of NPT that can be embedded in a web-enabled toolkit and used as a heuristic device to think through implementation and integration problems.

Recent years have seen steadily more sophisticated approaches to the evaluation of complex interventions and technological innovations in health care. In particular, evaluation frameworks like that proposed by the UK Medical Research Council have emphasized the need to understand the complex components and contingent underpinnings of outcomes studies, especially clinical trials [1, 2]. At the same time, there have been calls for theory-driven approaches to such work [3, 4]. Theories are valuable in such work not because they provide clear and unambiguous solutions to outcomes problems, but because they can provide robust, generic, and transferable explanations of the processes that shape these outcomes. They perform the further useful function of making transparent the assumptions of researchers and others that underpin research questions, methodology, and explanations [5, 6].

Normalization Process Theory (NPT) [7], and its predecessor, the Normalization Process Model [8, 9] provides a conceptual framework to assist in understanding and explaining the dynamic processes that are encountered during the implementation of complex interventions and technological or organizational innovations in healthcare.

Robust social science theories already explain some important features of implementation and integration processes: individual differences in attitudes and intentions in relation to new technologies and practices (e.g. Theory of Planned Behavior [10]), the flow of innovations through social networks (e.g. Diffusion of Innovations Theory [11]), and reciprocal interactions between people and artifacts (e.g. Actor Network Theory [12]). NPT differs from these theories because it offers an explanatory model of the routine embedding of a classification, artefact, technique or organizational practice in everyday work. NPT focuses on the agentic contribution--the things that people do--of individuals and groups. It thus explains phenomena not well covered by existing theories.

NPT was initially developed as an applied theoretical model to assist clinicians and researchers to understand and evaluate the factors that promote and inhibit the routine incorporation of complex healthcare interventions in practice. It started from a set of empirical generalizations derived from secondary analyses of qualitative data collected in a wide variety of studies of complex interventions in healthcare. This resulted in the original constructs of the model [8]. The further empirical applications of the model showed that while it could explain factors that promote and inhibit collective action, how participants came to engage and support the practice and how they reflected on and evaluated it remained unexplained. Through the development of further constructs, accounting for how people make sense of a practice, participate in it and appraise what they do, the model became a theory. Over the past four years it has been developed as a middle-range theory of socio-technical change [7], which characterizes the mechanisms involved in the embedding of social practices within their immediate and broader social contexts.

The starting point of NPT is that to understand the embedding of a practice we must look at what people actually do and how they work [7]. NPT focuses on four theoretical constructs, which characterize mechanisms that are energized by investments made by participants.

Processes of individual and communal sense making that promote or inhibit the coherence of a complex intervention to its users. These processes are driven by investments of meaning made by participants.

Processes of individual and communal reflexive monitoring that promote or inhibit users' comprehension of the effects of a complex intervention. These processes are driven by investments in appraisal made by participants.

aid understanding of the findings of randomised controlled trials for psychosocial distress and nurse-led clinics for heart failure treatment [21], chronic constipation [22] and collaborative care for depression [23]

Theories of all kinds are formed through complex interpretive processes that lead to inherently abstract products. Abstraction is, in fact, a necessary condition of a theory, since it must be sufficiently context-independent to be applicable to the range of relevant cases that it might be required to explain [39]. The problem that users of a theory face, then, is translating the theory from its abstract context-independent form into a form that can be used to solve problems in everyday settings. NPT is no exception. Our aim in the work reported here, therefore, has been to translate NPT's constructs into a set of statements that can be used by managers, clinicians, and researchers to work through problems of design and implementation in relation to complex interventions and new health technologies. These simplified constructs were translated into a set of statements that form the basis of a toolkit for clinicians, managers and policy-makers interested in utilizing NPT in their work.

The purpose of this simplification work was to develop a set of generic statements that could be configured as the 'front end' of a web enabled toolkit for users of NPT. For this reason, we sought engagement and critique from NPT's user communities (Health Services Researchers, Clinical Researchers, and Social Scientists). The co-production of theories is normal in large scale investigations in the natural sciences but is much less common in the social and behavioural sciences. In such circumstances, peers are usually asked to test theories rather than collaborate in defining the means by which they are operationalized. We have sought to be as transparent as possible in the generation of the theory, and as inclusive as possible in its operationalization and stabilization in practice. Our view is that this continuous 'road testing' of basic constructs and components of the theory has done more than ensure construct validity. It has ensured that the theory is relevant to its users. In this paper we present a simplified set of 16 statements that express key elements of NPT but which can be applied without a detailed knowledge of the underlying theory. However, we must also offer a caveat. Our objective in this work was to simplify a set of theoretical constructs for heuristic purposes, and not to develop a set of validated questions that could be immediately embedded in quantitative research instruments or qualitative interview schedules. The purpose of this paper is to make transparent the process by which the 16 statements and explanations were generated, and thus be clear about the foundation of the claims we make about them. 041b061a72