Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).M...Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.展开更多
目的综述实施科学整合框架(Consolidated Framework for Implementation Research,CFIR)在循证护理实践中的应用现状,以为相关研究提供参考。方法采用JBI范围综述方法,系统检索PubMed、CINAHL、Embase、MEDLINE、Cochrane Library、Web ...目的综述实施科学整合框架(Consolidated Framework for Implementation Research,CFIR)在循证护理实践中的应用现状,以为相关研究提供参考。方法采用JBI范围综述方法,系统检索PubMed、CINAHL、Embase、MEDLINE、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台和中国生物医学文献数据库。检索时间为2009年8月1日至2024年8月20日。结果共纳入37项研究,涵盖老人、产妇和儿童等多类人群,痴呆、肿瘤和脑血管疾病等多个病种以及医院、社区和家庭等多个场所。研究多采用定性设计,CFIR常被用于指导实施各阶段的数据收集和(或)分析。CFIR各结构领域及其具体要素的使用还存在一定差异,少数研究符合CFIR的预期应用效果。结论CFIR具有推进证据临床转化的潜力,并广泛应用于定性研究中,促进了不同研究间的比较和不同理论框架的融合。建议将CFIR作为因素清单指导定性数据的收集与分析,并在研究方法中阐明选择CFIR各领域及其要素的理由和逻辑。展开更多
目的分析整合式慢性病社区健康管理模式实施的促进和障碍因素,区分模式服务量高覆盖率组和低覆盖率组在实施性研究的整合性理论框架(consolidated framework for implementation research,CFIR)上的结构差异,为政府部门提供政策建议。...目的分析整合式慢性病社区健康管理模式实施的促进和障碍因素,区分模式服务量高覆盖率组和低覆盖率组在实施性研究的整合性理论框架(consolidated framework for implementation research,CFIR)上的结构差异,为政府部门提供政策建议。方法结合CFIR对22名专家进行半结构化访谈,采用定性结构评级法对13家社区卫生服务中心受访者评分,利用NVivo 12软件编码。结果高覆盖率组和低覆盖率组的相对优势、外部政策与激励、实施准备度、反思和评价、领导个人特质5个CFIR结构有差异。促进因素包括:测量数据更加精准,提高了高血压和糖尿病患者的异常检出率和控制率;模式实现了服务、技术、数据“三整合”,优化管理流程,提供管理抓手;基础性和个性化服务结合吸引患者到基层就诊;模式与我国政策背景,初级卫生保健工作和以患者为中心理念兼容;数字化工具的应用减轻医护人员工作负担;领导重视是基础,利益方间的通力合作是重要保障。障碍因素包括:宏观层面缺少卫生行政机构的支持性政策,组织架构和运行机制尚未建立,建设、投入主体以及具体工作规范和流程有待明确;缺乏监督管理机制和质量评估小组;模式推广目标模糊;缺乏规范化系统性的培训计划;为不同群体提供服务存在挑战,缺乏有效的社会面宣传;模式仍须提高需方获得感;社区布局限制了模式的服务提供。结论卫生行政部门应明确模式的建设、运行、投入主体,完善组织架构并明确各利益方的功能定位和职责分工,进一步制定工作规范和工作流程;建立信息反馈机制和质量控制小组并进行定期评估;制定清晰的目标;加大宣传教育,扩大宣传面;利用数字化工具形成良性医患互动机制。展开更多
文摘Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.
文摘目的综述实施科学整合框架(Consolidated Framework for Implementation Research,CFIR)在循证护理实践中的应用现状,以为相关研究提供参考。方法采用JBI范围综述方法,系统检索PubMed、CINAHL、Embase、MEDLINE、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台和中国生物医学文献数据库。检索时间为2009年8月1日至2024年8月20日。结果共纳入37项研究,涵盖老人、产妇和儿童等多类人群,痴呆、肿瘤和脑血管疾病等多个病种以及医院、社区和家庭等多个场所。研究多采用定性设计,CFIR常被用于指导实施各阶段的数据收集和(或)分析。CFIR各结构领域及其具体要素的使用还存在一定差异,少数研究符合CFIR的预期应用效果。结论CFIR具有推进证据临床转化的潜力,并广泛应用于定性研究中,促进了不同研究间的比较和不同理论框架的融合。建议将CFIR作为因素清单指导定性数据的收集与分析,并在研究方法中阐明选择CFIR各领域及其要素的理由和逻辑。
