Background: Guideline implementation is a complex process that is often hindered by a variety of barriers. Stakeholder-related barriers and facilitators are important factors influencing guideline implementation, and understanding stakeholder perspectives, conducting organized stakeholder dialogues, and identifying promising implementation strategies can effectively promote guideline implementation. Dozens of studies have been conducted to understand the current statement of guideline translation and implementation in obstetrics. However, the findings of determinants surveys are overly complex, span multiple disciplines (such as economics and social sciences), and there has been limited attention to, or a lack of detailed descriptions of, stakeholders' perspectives. Further research is needed to understand how stakeholder engagement is conducted in obstetric guideline implementation.
Objectives: To explore the barriers and facilitators to guideline implementation in the obstetric field from the stakeholders' perspectives, to facilitate the translation of evidence and its integration into clinical practice.
Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched to identify studies on stakeholder-related barriers and facilitators in obstetric guideline implementation. Paired reviewers independently screened titles and abstracts, reviewed full-text, and extracted data from eligible documents: research characteristics, characteristics of research implementation, guideline description, and barriers and facilitators. The barriers and facilitators of guideline implementation were divided into: doctors, midwives, managers, policymakers, and pregnant or post-partum women. We selected the Theoretical Domains Framework (TDF), coded the results and mapped them onto the 14 domains of the TDF, through which barriers and facilitators related to implementation have been categorized into cognitive, affective, social, and environmental domains. We calculated the proportion selected by each barrier by dividing the total number of people selected by each barrier by the total number of people included in the corresponding survey.
Results & Conclusions: There is still a great potential to improve determinants surveys as well as to emphasize the role of stakeholders, to understand these perceptions and identify promising implementation strategies to enhance the adoption, implementation, and sustainability of obstetric guidelines. This study is ongoing, and results will be presented at the Summit as available.