Table 1.

Cross-cutting themes

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)	An important precondition for implementing integration is the presence of high level commitment from the start, effective management structures and processes that are able to adapt and buy-in from front line users. Promoting change of organizational culture through dialogue, training, relationship building and appropriate use of knowledge and protocols will be important. Constant adaptation and lesson learning is essential to ensure that integration policy is fit for purpose.(this can be through monitoring and evaluation, reflection or other tools for systems (rather than programme) assessment)
	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.