3 Barriers and facilitators reviews are often highly cited and published in high-ranking health and medical journals (eg, References 4- 6). The concepts “barrier” and “facilitator” have been invoked in health services research to study, for example, the uptake by health professionals of complex social interventions, 1 factors influencing various health-promoting behaviors, 2 and predictors of adherence to prescribed treatment regimens. Further, conceptualizing factors as barriers and facilitators to such desirable outcomes implies that efforts can be made to overcome identified barriers and to promote facilitating factors-an attractive prospect for policy audiences. This type of review appeals to researchers and practitioners, in that it enables an overview of factors related to, for example, intervention uptake and implementation, patient recruitment, treatment, and access to care. The recommendations provided in this review may inform barriers and facilitators reviews beyond health services research.Īn increasing number of systematic reviews published in health journals set out to identify and synthesize research on barriers to and facilitators of the achievement of various outcomes.The findings suggest that authors attempting reviews of this kind should engage critically with, and clearly define, the concepts of “barrier” and “facilitator.”.Conclusionīarriers and facilitators reviews should (a) clearly operationally define “barrier” and “facilitator,” (b) explicitly describe how factors are extracted and subsequently synthesized, and (c) provide critical reflection on the contextual variability and reliability of identified factors.
These tended to be either conceptual/definitional (eg, ideas about interrelationships and overlap between factors) and methodological/practical (eg, challenges related to aggregating heterogeneous research). Analysis of the subsample of reviews that explicitly discussed the barriers and facilitators approach revealed some common issues.
Although several reviews highlighted the “complexity” of barriers and facilitators, this was usually not analyzed systematically. The findings echo common critiques of this review type, including concerns about the reduction of complex phenomena to simplified, discrete factors. We found a high degree of variation in the synthesis practices used in these reviews, with the majority employing aggregative (rather than interpretive) approaches.
We searched 11 databases over a 13-month period (1 November 2017-30 November 2018) using an exhaustive list of search terms for “barrier(s),” “facilitator(s),” and “systematic review.” Results MethodsĪll English-language peer-reviewed systematic reviews that synthesized research on barriers and facilitators in a health services context were eligible for inclusion. The aims of this review are to appraise, analyze, and discuss the reporting and synthesis practices used in recently published barriers and facilitators reviews in health services research. It will help you the next time these letters, B A R R I E R come up in a word scramble game.Systematic reviews cataloguing the barriers to and facilitators of various outcomes are increasingly popular, despite criticisms of this type of review on philosophical, methodological, and practical grounds. How is this helpful? Well, it shows you the anagrams of barrier scrambled in different ways and helps you recognize the set of letters more easily. The different ways a word can be scrambled is called "permutations" of the word.Īccording to Google, this is the definition of permutation:Ī way, especially one of several possible variations, in which a set or number of things can be ordered or arranged. According to our other word scramble maker, BARRIER can be scrambled in many ways.
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