Abstract：
To identify barriers and facilitators of clinical practice guidelines (CPGs) implementation, and map those factors to the theoretical domains framework (TDF) and behavior change wheel (BCW).
We conducted an umbrella review of systematic reviews. PubMed, Embase, and the Cochrane Library were searched. Two investigators independently screened the studies, extracted the data, and assessed the methodological quality. The identified barriers and facilitators of CPG implementation were categorized and mapped to the TDF domains and BCW components.
Thirty-seven studies were included, and 193 barriers and 140 facilitators were identified. Intrinsic aspects (35 barriers and 28 facilitators) mainly included the CPGs\' impracticality, complexity, and inaccessibility. Extrinsic aspects (158 barriers and 113 facilitators) mainly included lack of resources, training, funding, or awareness of CPG content in barriers; audits and feedback; strong leadership and management support; and educating and training about CPGs in facilitators. Environmental context and resources (n = 97, 19.48%) were the most reported barriers in TDF domains. Physical opportunity and social opportunity were the most frequently mentioned models in BCW.
Multiple barriers and facilitators for healthcare CPG implementation are identified, with further links to TDF and BCW. Future knowledge translation strategies should be developed accordingly in specified health care settings.
We conducted an umbrella review of systematic reviews. PubMed, Embase, and the Cochrane Library were searched. Two investigators independently screened the studies, extracted the data, and assessed the methodological quality. The identified barriers and facilitators of CPG implementation were categorized and mapped to the TDF domains and BCW components.
Thirty-seven studies were included, and 193 barriers and 140 facilitators were identified. Intrinsic aspects (35 barriers and 28 facilitators) mainly included the CPGs\' impracticality, complexity, and inaccessibility. Extrinsic aspects (158 barriers and 113 facilitators) mainly included lack of resources, training, funding, or awareness of CPG content in barriers; audits and feedback; strong leadership and management support; and educating and training about CPGs in facilitators. Environmental context and resources (n = 97, 19.48%) were the most reported barriers in TDF domains. Physical opportunity and social opportunity were the most frequently mentioned models in BCW.
Multiple barriers and facilitators for healthcare CPG implementation are identified, with further links to TDF and BCW. Future knowledge translation strategies should be developed accordingly in specified health care settings.
摘要：
目的：确定临床实践指南（CPGs）实施的障碍和促进者，并将这些因素映射到理论域框架(TDF)和行为变化轮(BCW)。
方法：我们对系统评价进行了综述。PubMed,Embase,搜索了Cochrane图书馆.两名研究人员独立筛选了这些研究，提取数据，并评估了方法学质量。已确定的CPG实施的障碍和促进者进行了分类，并映射到TDF域和BCW组件。
结果：纳入了37项研究，确定了193个障碍和140个促进者。内在方面(35个障碍和28个促进者)主要包括CPG的不切实际性，复杂性和不可访问性。外在方面(158个障碍和113个促进者)主要包括缺乏资源，培训,资金,或对障碍中CPG内容的认识；审计和反馈，强有力的领导和管理支持，以及在主持人中对CPG进行教育和培训。环境背景和资源（n=97，19.48％）是TDF领域中报道最多的障碍。身体机会和社交机会是BCW中最常提到的模型。
结论：通过与TDF和BCW的进一步联系，确定了医疗保健CPGs实施的多个障碍和促进因素。应在指定的医疗保健环境中相应地制定未来的知识翻译策略。
方法：我们对系统评价进行了综述。PubMed,Embase,搜索了Cochrane图书馆.两名研究人员独立筛选了这些研究，提取数据，并评估了方法学质量。已确定的CPG实施的障碍和促进者进行了分类，并映射到TDF域和BCW组件。
结果：纳入了37项研究，确定了193个障碍和140个促进者。内在方面(35个障碍和28个促进者)主要包括CPG的不切实际性，复杂性和不可访问性。外在方面(158个障碍和113个促进者)主要包括缺乏资源，培训,资金,或对障碍中CPG内容的认识；审计和反馈，强有力的领导和管理支持，以及在主持人中对CPG进行教育和培训。环境背景和资源（n=97，19.48％）是TDF领域中报道最多的障碍。身体机会和社交机会是BCW中最常提到的模型。
结论：通过与TDF和BCW的进一步联系，确定了医疗保健CPGs实施的多个障碍和促进因素。应在指定的医疗保健环境中相应地制定未来的知识翻译策略。
