Abstract：
Background: Acupuncture is a widely practiced complementary and integrative health modality that has multiple clinical applications. The use of acupuncture in the United States is rapidly increasing. Although studies have shown the efficacy and effectiveness of acupuncture for various ailments, the integration of acupuncture into the U.S. health care system remains a challenge. Little is known about the factors affecting this integration. Objective: To provide a systematic review of the barriers and facilitators affecting the integration of acupuncture into the U.S. health care system. Methods: Four electronic databases were searched. Three independent reviewers were involved in the screening and data charting processes. Findings were synthesized and categorized into four levels based on the Social Ecological Model. Results: A total of 22 studies were included in the final review. The barriers and facilitators affecting the integration of acupuncture were mapped into four levels (individual, interpersonal, organizational, and policy). The most frequently reported barriers and facilitators were mapped into the Social Ecological Model constructs within the \"Individual\" level (i.e., beliefs and attitudes of acupuncture, and practical issues) and the \"Organizational\" level (i.e., credentialing, space and facility, referral system). Conclusion: This review has identified and synthesized the breadth of evidence on the barriers and facilitators to the integration of acupuncture into the U.S. health care system. Results of this review will guide future implementation studies to develop and test implementation strategies to integrate acupuncture into the U.S. health care system.
摘要：
背景：针灸是一种广泛实践的补充和综合健康方式，具有多种临床应用。针灸在美国的使用正在迅速增加。尽管研究表明针灸治疗各种疾病的功效和有效性，将针灸纳入美国医疗保健系统仍然是一个挑战。对影响这种整合的因素知之甚少。目的：对影响针灸融入美国医疗保健系统的障碍和促进因素进行系统回顾。方法:检索4个电子数据库。三名独立审稿人参与了筛选和数据制图过程。根据社会生态模型将研究结果综合并分为四个级别。结果：共有22项研究纳入最终综述。影响针灸整合的障碍和促进因素被映射到四个层面(个体，人际关系,组织，和政策）。最常报告的障碍和促进因素被映射到“个人”级别的社会生态模型构建中(即，针灸的信念和态度，和实际问题)和“组织”级别(即，认证，空间和设施，转诊系统)。结论：这篇综述已经确定并综合了将针灸纳入美国医疗保健系统的障碍和促进因素的广泛证据。本综述的结果将指导未来的实施研究，以制定和测试将针灸纳入美国医疗保健系统的实施策略。
