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Updated: Jul 19, 2025

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Dissemination and implementation of clinical practice guidelines: a longitudinal, mixed-methods evaluation of the
Christine Fahim1, Anupa Jyoti Prashad2, Kyle Silveira2
1Knowledge Translation Program (Fahim, Prashad, Silveira, Chandraraj, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Faculty of Medicine (Thombs, Theriault), McGill University; Lady Davis Institute for Medical Research (Thombs), Jewish General Hospital, Montréal, Que.; Cumming School of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Department of Medicine (Grad), McGill University, Montréal, Que.; Department of Family Medicine (Riva), McMaster University, Hamilton, Ont.; Department of Occupational Science and Occupational Therapy (Colquhoun), University of Toronto, Toronto, Ont.; Public Health Agency of Canada (Rodin, Subnath, Rolland-Harris); Canadian Medical Association Journal (Barnhardt), Ottawa, Ont.; Department of Medicine, Faculty of Medicine (Straus), University of Toronto, Toronto, Ont. Christine.fahim@unityhealth.to.
Background:
The Canadian Task Force on Preventive Health Care (task force) develops evidence-based preventive health care guidelines and knowledge translation (KT) tools to facilitate guideline dissemination and implementation. We aimed to determine practitioners' awareness of task force guidelines and KT tools and explore barriers and facilitators to their use.
Methods:
The task force's KT team completed annual evaluations using surveys and interviews with primary care providers in Canada from 2014 to 2020, to assess practitioners' awareness and determinants of use of task force guidelines and tools. We transcribed interviews verbatim and double-coded them using a framework analysis approach.
Results:
A total of 1284 primary care practitioners completed surveys and 183 participated in interviews. On average, 79.9% of participants were aware of the task force's 7 cancer screening guidelines, 36.2% were aware of the other 6 screening guidelines and 18.6% were aware of the 3 lifestyle or prevention guidelines. Participants identified 13 barriers and 7 facilitators to guideline and KT tool implementation; these were consistent over time. Participants identified strategies at the public and patient, provider and health systems levels to improve uptake of guidelines.
Interpretation:
Canadian primary care practitioners were more aware of task force cancer screening guidelines than its other preventive health guidelines. Over the 6-year period, participants consistently reported barriers to guideline uptake, including misalignment with patient preferences and other provincial or specialty guideline organizations. Further evaluations will assess tailored strategies to address the barriers identified.
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