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

Paul Shing-Fong Chan; Yuan Fang; Martin Chi-Sang Wong; Junjie Huang; Zixin Wang; Eng Kiong Yeoh

doi:10.1186/s13012-021-01170-8

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

Implement Sci. 2021 Nov 20;16(1):99. doi: 10.1186/s13012-021-01170-8.

Authors

Paul Shing-Fong Chan¹, Yuan Fang², Martin Chi-Sang Wong¹, Junjie Huang¹, Zixin Wang^#^{3

4

5}, Eng Kiong Yeoh^#^{1

6}

Affiliations

¹ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
² Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China.
³ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. wangzx@cuhk.edu.hk.
⁴ 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.
⁵ Room 508, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China. wangzx@cuhk.edu.hk.
⁶ 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.

^# Contributed equally.

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 ).

Keywords: Alcohol screening; Barriers; Brief intervention; Consolidated Framework for Implementation Research; Facilitators; Health professionals; Primary care.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Counseling
Crisis Intervention*
Health Personnel
Humans
Mass Screening
Primary Health Care*