Summary of Commonly Discussed Facilitators and Barriers and the Number of Studies They Were Identified In
| Facilitators of implementation [related CFIR domains (and constructs)] | Number of studies | Barriers of implementation [related CFIR domains (and constructs)] | Number of studies |
|---|---|---|---|
| Engagement of clinic team, leadership team and partners [Implementation process (engaging) and internal setting (implementation readiness)] | 9 | Limited time of clinic team to commit new project [Internal setting (implementation readiness)] | 8 |
| Priority or motivation to improve CRCS rates and recognizing benefits of new interventions [Internal setting (culture and implementation climate) and characteristics of individuals involved (knowledge and beliefs about the intervention)] | 7 | Challenges or unavailability of getting accurate and timely data to implement interventions and evaluate the progress or intervention [Implementation process (reflection and evaluating)] | 6 |
| Use of EMR system [Internal setting (implementation readiness)] | 7 | EMR-related challenges due to limited skills and supports and time-consuming [Internal setting (implementation readiness)] | 5 |
| Resources- staff's time, knowledge, skills, and training, availability of well-packaged materials in place [Intervention characteristics (design quality and packaging), internal setting (implementation readiness), and implementation process (executing)] | 6 | Communication challenges with clinics/organizations regarding FIT intervention program, disconnect between clinic team members, and lack of role clarity of clinic team [Internal setting (networking and communication) and implementation process (engaging)] | 5 |
| Continuous monitoring, feedback and reflection system of performance for improvement [Implementation process (reflection and evaluating)] | 6 | Patient-related barriers: includes cost, low health literacy, fear, not speaking English language, limited access (due to transportation), hesitancy of certain population to talk about or collect poo [Outer setting (patients' needs and resources] | 5 |
| Communication and coordination between clinic team [Internal setting (networking and communication)] | 6 | Process barriers due to lack of standard workflow, cumbersome workflow, or not following the process; delays from vendors [Implementation process (planning and executing)] | 4 |
| Clinics having autonomy to try new innovation and flexibility to adapt intervention/implementation process [Intervention characteristics (adaptability), internal setting (implementation climate), and implementation process (executing)] | 5 | Organizational structure changes, lack of leadership engagement, and leadership turnover [Internal setting (implementation readiness)] | 4 |
Abbreviations: CRCS, colorectal cancer screening; CFIR, consolidated framework for implementation research; EMR, electronic medical records; FIT, Fecal Immunochemical Test.