运用实施研究综合框架调查初级保健卫生专业人员实施酒精筛查和简短干预的促进因素和障碍：系统评价。
Using Consolidated Framework for Implementation Research to investigate facilitators and barriers of implementing alcohol screening and brief intervention among primary care health professionals: a systematic review.
机构信息
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China.
出版信息
Implement Sci. 2021 Nov 20;16(1):99. doi: 10.1186/s13012-021-01170-8.
BACKGROUND
Alcohol screening and brief intervention (SBI) is recommended to be implemented in primary care settings to intervene against hazardous/harmful drinking. However, studies showed that the uptake rate was low in many regions/countries. This systematic review presented current findings on the facilitators and barriers of SBI implemented by health professionals in primary care settings using the Consolidated Framework for Implementation Research (CFIR).
METHODS
We included qualitative, quantitative, and mixed-method studies identified through four electronic databases (PubMed, MEDLINE, PsycInfo, and Web of Science) from inception to June 2020. Included articles had to address barriers and facilitators of SBI implementation and provide sufficient details that the CFIR domains could be identified and data were abstracted using a standardized extraction form.
RESULTS
A total of 74 studies published from 1985 to 2019 were finally analysed and summarized. The most common facilitators were knowledge and positive beliefs about SBI (characteristics of the individuals) and available resources (inner setting). In contrast, the most common barriers were cost related to implementing SBI (intervention characteristics), negative beliefs about SBI (characteristics of the individuals), and lack of self-efficacy in implementing SBI (characteristics of the individuals). It could be observed that factors related to the inner setting and characteristics of individuals were extensively studied whilst the process received the least attention.
CONCLUSIONS
Most of the facilitators and barriers are modifiable. Additionally, most literature focused on various kinds of available assets to implement SBI. To promote the spread of SBI implementation, more high-quality studies on the implementation process are needed. This systematic review could serve as a reference framework for health authorities to devise strategies for improving the implementation of SBI in primary care settings.
TRIAL REGISTRATION
This systematic review was registered in PROSPERO ( CRD42021258833 ).
背景
酒精筛查和简短干预（SBI）被建议在初级保健环境中实施，以干预危险/有害饮酒。然而，研究表明，在许多地区/国家，吸收率都很低。本系统评价使用实施研究综合框架（CFIR）呈现了目前在初级保健环境中由卫生专业人员实施 SBI 的促进因素和障碍的研究结果。
方法
我们纳入了从成立到 2020 年 6 月通过四个电子数据库（PubMed、MEDLINE、PsycInfo 和 Web of Science）识别的定性、定量和混合方法研究。纳入的文章必须解决 SBI 实施的障碍和促进因素，并提供足够的详细信息，以便确定 CFIR 领域并使用标准化提取表提取数据。
结果
共分析和总结了 1985 年至 2019 年发表的 74 项研究。最常见的促进因素是对 SBI 的知识和积极信念（个体特征）以及可用资源（内部环境）。相比之下，最常见的障碍是与实施 SBI 相关的成本（干预特征）、对 SBI 的负面信念（个体特征）以及在实施 SBI 方面缺乏自我效能感（个体特征）。可以观察到，与内部环境和个体特征相关的因素得到了广泛研究，而过程则受到的关注最少。
结论
大多数促进因素和障碍都是可以改变的。此外，大多数文献都侧重于实施 SBI 可用的各种资产。为了促进 SBI 实施的推广，需要更多关于实施过程的高质量研究。本系统评价可以作为卫生当局制定策略的参考框架，以改善初级保健环境中 SBI 的实施。
试验注册
本系统评价已在 PROSPERO（CRD42021258833）中注册。
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