Louie Eva, Giannopoulos Vicki, Baillie Andrew, Uribe Gabriela, Wood Katie, Teesson Maree, Childs Steven, Rogers David, Haber Paul S, Morley Kirsten C
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Front Health Serv. 2021 Nov 24;1:785391. doi: 10.3389/frhs.2021.785391. eCollection 2021.
We have previously reported that the Pathways to Comorbidity Care (PCC) training program for alcohol and other drug (AOD) clinicians improved identification of comorbidity, self-efficacy, and attitudes toward screening and monitoring of comorbidity. We aimed to identify barriers and facilitators of implementation of the PCC training program in drug and alcohol settings. The PCC training program was implemented across 6 matched sites in Australia as per (1), and 20 clinicians received training. PCC training included seminar presentations, workshops conducted by local "clinical champions," individual clinical supervision, and access to an online information portal. We examined barriers and facilitators of implementation according to the Consolidated Framework for Implementation Research. Barriers included inner setting (e.g., allocated time for learning) and characteristics of individuals (e.g., resistance). Facilitators included intervention characteristics (e.g., credible sources), inner setting (e.g., leadership), and outer setting domains (e.g., patient needs). Clinical champions were identified as an important component of the implementation process. Barriers included limited specific allocated time for learning. A credible clinical supervisor, strong leadership engagement and an active clinical champion were found to be facilitators of the PCC training program.
我们之前曾报道，针对酒精及其他药物（AOD）临床医生的共病护理途径（PCC）培训项目改善了共病识别、自我效能以及对共病筛查和监测的态度。我们旨在确定在药物和酒精环境中实施PCC培训项目的障碍和促进因素。根据（1），PCC培训项目在澳大利亚的6个匹配地点实施，20名临床医生接受了培训。PCC培训包括研讨会演讲、由当地“临床冠军”主持的工作坊、个人临床督导以及访问在线信息门户。我们根据实施研究的综合框架研究了实施的障碍和促进因素。障碍包括内部环境（例如，分配的学习时间）和个人特征（例如，抵触情绪）。促进因素包括干预特征（例如，可靠的信息来源）、内部环境（例如，领导力）和外部环境领域（例如，患者需求）。临床冠军被确定为实施过程的一个重要组成部分。障碍包括分配的特定学习时间有限。一名可靠的临床督导、强有力的领导参与以及积极的临床冠军被发现是PCC培训项目的促进因素。
