Abstract
BackgroundAlcohol 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).MethodsWe 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.ResultsA 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.ConclusionsMost 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 registrationThis systematic review was registered in PROSPERO (CRD42021258833).
Highlights
This review provides the most up-to-date synthesis of findings of existing studies about facilitators or barriers of screening and brief intervention (SBI) implemented by health professionals in primary care settings
The studies examined the facilitators and/or barriers of alcohol screening or alcohol brief intervention implemented by healthcare professionals in primary care settings
Barriers refer to obstacles that hinder health professionals from performing SBI and facilitators refer to enabling factors for health professionals to perform SBI
Summary
Harmful use of alcohol is a known risk factor for more than 200 types of diseases and injuries [1]. Alcohol screening and brief intervention (SBI) techniques have been developed in a bid to rectify the situation that excessive alcohol use causes harm. The World Health Organization (WHO) stressed the need to increase coverage of SBI in order to enable early identification and intervention against hazardous/harmful drinking behaviour before serious consequences happen [3]. Primary care professionals are in a unique and privileged position to identify and intervene against hazardous/harmful drinking [4, 5]. Identification and secondary prevention of alcohol use disorder using SBI in primary care settings are strongly recommended by the WHO [2] and other national health authorities [7–9]. Alcohol screening and brief intervention (SBI) is recommended to be implemented in primary care settings to intervene against hazardous/harmful drinking. 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)
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