Zixin Wang1,2,3, Eng Kiong Yeoh4,5, Paul Shing-Fong Chan4, Yuan Fang6, Martin Chi-Sang Wong4, Junjie Huang4. 1. JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. wangzx@cuhk.edu.hk. 2. Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. wangzx@cuhk.edu.hk. 3. Room 508, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China. wangzx@cuhk.edu.hk. 4. JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 5. Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 6. Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China.
Abstract
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 ).
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 ).
Authors: Peter M Miller; Ruth Stockdell; Lynne Nemeth; Chris Feifer; Ruth G Jenkins; Paul J Nietert; Andrea Wessell; Heather Liszka; Steven Ornstein Journal: Subst Abus Date: 2006-06 Impact factor: 3.716
Authors: Byron J Powell; Thomas J Waltz; Matthew J Chinman; Laura J Damschroder; Jeffrey L Smith; Monica M Matthieu; Enola K Proctor; JoAnn E Kirchner Journal: Implement Sci Date: 2015-02-12 Impact factor: 7.327
Authors: Julia M Lemp; Supa Pengpid; Doungjai Buntup; Till W Bärnighausen; Pascal Geldsetzer; Karl Peltzer; Jürgen Rehm; Bundit Sornpaisarn; Charlotte Probst Journal: Prev Med Rep Date: 2022-08-19