Table 1.
Cross-cutting theme | Subtheme | ± | Generalizability | Illustrative references | Recommendations |
---|---|---|---|---|---|
Collaboration/coordination/ relationships/links | Strong relationships between providers and stakeholders | ± | Strong: range of settings and programmes | (Dodds et al. 2004; UNAIDS, 2011; Odafe et al. 2013) | Programme design and staffing should allow sufficient opportunity to build formal and informal linkages and ensure patients well informed: named coordinators may be beneficial in certain circumstances and for complex needs |
Strong links, communication and collaboration between providers. | ± | Strong: range of settings and programmes | (Feingold and Slammon 1993; Andersen et al. 2003; Bouis et al. 2007) | ||
Coordination and case management of individual’s care—including coordination/navigation of care by an identified person (coordinator/advocate/nurse practitioner) | ± | Moderate: Particularly for complex needs around mental health or substance abuse, high-income settings | (Feingold and Slammon 1993; Finkelstein et al. 2011) | ||
Information sharing between staff/providers—including regulatory barriers to info sharing | ± | Moderate: several articles, | (Lombard et al. 2009; Inouye et al. 2011; Mwanahamuntu et al. 2011) | ||
Information for patients (including accounting for cultural issues) | ± | Strong: range of settings and programmes | (Ibrahim et al. 2009; Odafe et al. 2013; Khozaim et al. 2014) | ||
Health workers: trained, available, multidisciplinary, motivated, incentivized | Availability of human resources including specialist staff | ± | Strong: range of settings and programmes | (Wood, 2008; Egan et al. 2011, Edwards et al. 2015; Kumakech et al. 2015) | Resourcing should ensure adequate staff from the necessary disciplines, plus training and support as appropriate |
Staff education, training, expertise, skills and experience including ongoing support, supervision and training | ± | Strong: range of settings and programmes | (Altice et al. 2004; Clanon et al. 2005; Ibrahim et al. 2009; Huchko et al. 2011; Kieran et al. 2011; Nyabera et al. 2011; Horo et al. 2012; Moon et al. 2012; Ramogola-Masire et al. 2012; Hasin et al. 2013; Odafe et al. 2013; Khozaim et al. 2014; Martin et al. 2014; Kotwani et al. 2014; Anderson et al. 2015) | ||
Multidisciplinary teams | + | Strong: range of settings and programmes | (Wood, 2008; Edwards et al. 2015; Kumakech et al. 2015) | ||
Staff culture, interest, awareness, enthusiasm—ie whether or not the staff are motivated and want to engage | ± | Moderate: several articles, mostly US Substance Abuse | (Cheever et al. 2011; Curran et al. 2011) | ||
Financial incentives to take part (adopt models and training) | + | Weak: very limited number of articles | (Turner et al. 2005; Rothman et al. 2007; Mwanahamuntu et al. 2011) | ||
Institutional structures and infrastructure including financial resources and medical supplies | Location, setting (this includes both accessibility and appropriateness) | ± | Strong: range of settings and programmes | (Rothman et al. 2007; Dillard et al. 2010; Kumakech et al. 2015) | Careful consideration should be given to location(s), according to patient needs and circumstances |
funding to set up and sustain services | ± | Moderate: range of settings and programmes but limited number of articles | (Mccarthy et al. 1992; Stringari-Murray et al. 2003; Hennessy et al. 2007; Jonsson et al. 2011; Moon et al. 2012) | ||
Financing arrangements enabling access to (rather than being a barrier to) integrated services—according to country context e.g. insurance, free care | ± | Moderate: range of programmes mainly but not exclusively US, | (Stringari-Murray et al. 2003; Bouis et al. 2007; Finkelstein et al. 2011) | ||
Drug supply and availability; equipment | ± | Moderate: several articles, range of settings | (Cheever et al. 2011; Finkelstein et al. 2011; Grenfell et al. 2012) | ||
Leadership/stewardship/Procedures/ organizational culture | Leadership, Lesson-learning and scale up, commitment and buy in from senior leaders, Buy in/acceptance of model and treatment from front line managers and staff, Resistance to change—presence or lack | ± | Strong: range of settings and programmes | (Hoffman et al. 2004; Mwanahamuntu et al. 2011; UNAIDS, 2011; Moon et al. 2012) |
|
Structural and programme design facilitators and barriers: In/flexibility, availability, algorithms, checklists, Tools, guidelines and protocols including for referral and follow up; treatment regimen (simple vs complex); | ± | Moderate: several articles, range of settings | (Kobayashi and Standridge 2000; Clanon et al. 2005; Rothman et al. 2007; Adeyemi et al. 2009; Goodroad et al. 2010; Adams et al. 2011; Curran et al. 2011; UNAIDS 2011; Odafe et al. 2013; Edwards et al. 2015; Kumakech et al. 2015) | ||
Techniques and procedures/treatment (having or not having access to appropriate, timely, techniques) | ± | Strong: range of programmes and settings | (Turner et al. 2005; Tran et al. 2012) | ||
Different organizational culture (e.g. ‘behavioural vs medical’) | − | Weak: limited number of studies, mainly from USA in regards to mental health or substance misuse | (Cheever et al. 2011) |
‘+’, facilitator, ‘−’ barrier.