Table 4:

Barriers and facilitators to implementation of Canadian Task Force on Preventive Health Care guideline

Perceived barrier	Year barrier reported
Perceived barrier	2014	2015	2016	2017	2018	2019	2020
Misalignment of guideline with patient expectations and preferences	X	X	X	X	X	X	X
Misalignment of task force guideline with other provincial or specialty guidelines or unsure which guideline to follow or use	X	X	X		X	X	X
Perceptions of evidence strength or lack of consensus among health care professionals about recommendation	X	X	X		X	X	X
Time constraints to implement guideline or recommendation	X	X	X			X	X
Complexity of guideline or tool or lack of clarity on how to implement recommendation	X			X		X	X
Lack of awareness of guideline or KT tools	X		X			X	X
Misalignment of task force recommendation and provincial or territorial health care coverage or fee-for-service billing scheme		X		X	X	X
Guideline out of date or not recently updated					X
Concern about overlooking a diagnosis		X			X
Unintended outcomes of reduced screening				X
Patient understanding of the value of screening (perceptions often shaped by the media, social media)				X	X	X	X
Lack of resources to facilitate screening (e.g., limited in Northern or remote communities)		X			X
Perceived facilitator	Year facilitator reported
Perceived facilitator	2014	2015	2016	2017	2018	2019	2020
Electronic prompts, EMR reminders or mobile apps for patients	X	X	X		X	X	X
Availability or awareness of updated guidelines or tools	X	X	X		X	X
Public or patient awareness of guideline recommendations	X				X	X
Consensus on recommendation among health care practitioners or colleagues	X				X	X
Financial incentive for screening	X					X
Ease of guideline use		X	X		X	X
Strength of guideline evidence		X			X	X	X

Note: EMR = electronic medical record, KT = knowledge translation, task force = Canadian Task Force on Preventive Health Care.