Table 2 Barriers identified through interviews
Situation of barrier/challenge | CFIR construct (domain) | Specific barriers/issues discussed | Source | Example quote |
|---|---|---|---|---|
Intervention | Complexity (study characteristicsa) | Complexity of research protocol | PRCs | … having them [patients] sit there and be patient through all these questions [before providing services] … they are starting to get annoyed. (PRC) |
Culture (inner setting) | ED staff lack SUD knowledge | PRCs, supervisors, researchers | [ED staff] were not well educated on how to work with opioid use disorder … we have actually had physicians come to our coaches asking how they should treat a patient. (Researcher) | |
Patient needs and resources (outer setting) | Lack of community referral resources | PRCs, supervisors, researchers | … there’s still just a disconnect between the resources [in the community], and it takes a long time to get someone in somewhere … (PRC) | |
Research | Personal attributes (characteristic of individuals) | PRCs are better at study recruitment | PRCs, supervisors, researchers | … the research assistants were not … being visible in that area [the ED] as what they needed to be” (supervisor) |
Intervention and research | Complexity (intervention characteristics) | Timing of intervention delivery | PRCs, supervisors | … it’s inherently difficult [to speak with patients] … you deal with people who were again, highly sedated, often times. (PRC) |
Networks and communication (inner setting) | Ineffective communication with ED staff | PRCs, supervisors, researchers | … [nurses] are so busy and there is so much information coming at them … there is no time for meetings throughout the day {to get] in front of them for a half hour and kind of explain what we do and who is appropriate [for the study]. (PRC) | |
Structure (inner setting) | ED lacks privacy | PRCs, supervisors | … a lot of our patients are in the hallway … they say the entire ED is a private area but when you are talking to someone … being asked questions about their drug use … can be a little off-putting for some people. (PRC) | |
Culture (inner setting) | Fast-paced ED setting | PRCs, supervisors, researchers | … to get [patients] to do the study itself … they had to have a discharge order, and so you had a very tight window to get in there and engage …. (PRC) | |
Patient needs and resources (outer setting) | Patients’ limited resources | PRCs, researchers | … I’d have that initial intervention there in the ED and then a huge barrier was follow-up … a lot of them did not have working phones, you know there was no family support that you could contact (PRC) |