Full
Outline
To systematically analyze key barriers and facilitators to the implementation of community-based atrial fibrillation (AF) screening using the consolidated framework for implementation research (CFIR), thereby informing the optimization of implementation strategies for community-based AF screening in primary care.
From September to December 2024, purposive sampling was used to recruit 26 healthcare workers from Yuexiu District, Guangzhou, including 24 primary healthcare workers and 2 cardiologists from tertiary hospitals, for semi-structured interviews. A hybrid analytical strategy was adopted, combining CFIR-guided directed content analysis with frequency counts of CFIR constructs and their subdimensions, distinguishing barrier and facilitator attributes. The top 10 most frequently mentioned factors were identified separately among barriers and facilitators as key determinants of community AF screening implementation.
The barriers to implementing community-based AF screening were primarily identified at the individual level (5 factors) and in the inner setting (3 factors). The top 3 most frequently cited barriers were: insufficient primary care workforce, inadequate AF-related knowledge among primary care providers and residents’ low preference for community-based healthcare services. The facilitators primarily emerged in the inner setting (5 factors). The top 3 most frequently cited facilitators were: performance-linked incentives for screening teams, enhanced diagnostic and treatment capacity and confidence in AF management through support from tertiary hospitals, and clear delineation of responsibilities within screening teams.
The successful implementation of community AF screening is influenced by multiple factors. Implementation strategies should be developed based on the local context and targeted at key influencing factors.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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