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

• Published in: Implementation science : IS 2021-11, Vol.16 (1), p.99-40, Article 99
• Main Authors: Chan, Paul Shing-Fong, Fang, Yuan, Wong, Martin Chi-Sang, Huang, Junjie, Wang, Zixin, Yeoh, Eng Kiong
• Format: Article
• Language: English
• Subjects: Alcohol screening; Alcohol use; Alcoholism; Barriers; Beliefs, opinions and attitudes; Brief intervention; Care and treatment; Consolidated Framework for Implementation Research; Counseling; Crisis Intervention; Diagnosis; Facilitators; Family physicians; Health Personnel; Humans; Interdisciplinary research; Intervention; Mass Screening; Medical personnel; Medical research; Medicine, Experimental; Mental health screening; Mixed methods research; Nurses; Primary care; Primary Health Care; Science; Systematic Review
• ISSN: 1748-5908; 1748-5908
• DOI: 10.1186/s13012-021-01170-8

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). 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. 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. 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. This systematic review was registered in PROSPERO ( CRD42021258833 ).