PDF(Pubmed)
Abstract：
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 ).
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 ).
摘要：
建议在初级保健机构中实施酒精筛查和短暂干预（SBI），以干预危险/有害饮酒。然而,研究表明，许多地区/国家的吸收率很低。这项系统审查介绍了初级保健机构中卫生专业人员使用实施研究综合框架（CFIR）实施SBI的促进者和障碍的最新发现。
我们包括定性的，定量,以及通过四个电子数据库(PubMed，MEDLINE,PsycInfo,和WebofScience）从成立到2020年6月。所包含的条款必须解决履行机构实施的障碍和促进者，并提供足够的细节，以便可以识别CFIR领域，并使用标准化的提取表抽象数据。
最终分析和总结了1985年至2019年发表的74项研究。最常见的促进者是关于SBI（个人特征）和可用资源（内在环境）的知识和积极信念。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(个体特征)的负面信念，以及在实施SBI时缺乏自我效能感(个体特征)。可以观察到，与个体的内在环境和特征有关的因素得到了广泛的研究，而该过程受到的关注最少。
大多数促进者和障碍都是可修改的。此外,大多数文献都集中在实施SBI的各种可用资产上。为了促进履行机构执行工作的普及，需要对实施过程进行更多高质量的研究。这一系统审查可以作为卫生当局制定战略以改善履行机构在初级保健环境中的执行的参考框架。
本系统评价在PROSPERO（CRD42021258833）中注册。
我们包括定性的，定量,以及通过四个电子数据库(PubMed，MEDLINE,PsycInfo,和WebofScience）从成立到2020年6月。所包含的条款必须解决履行机构实施的障碍和促进者，并提供足够的细节，以便可以识别CFIR领域，并使用标准化的提取表抽象数据。
最终分析和总结了1985年至2019年发表的74项研究。最常见的促进者是关于SBI（个人特征）和可用资源（内在环境）的知识和积极信念。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(个体特征)的负面信念，以及在实施SBI时缺乏自我效能感(个体特征)。可以观察到，与个体的内在环境和特征有关的因素得到了广泛的研究，而该过程受到的关注最少。
大多数促进者和障碍都是可修改的。此外,大多数文献都集中在实施SBI的各种可用资产上。为了促进履行机构执行工作的普及，需要对实施过程进行更多高质量的研究。这一系统审查可以作为卫生当局制定战略以改善履行机构在初级保健环境中的执行的参考框架。
本系统评价在PROSPERO（CRD42021258833）中注册。
