Exploring the barriers and facilitators of implementing family-focused child development programmes in real-world...

Services and supports for early childhood development can enhance overall caregiver well-being, reduce stress and increase caregiver confidence in parenting a child with disabilities or developmental differences. Numerous programmes have been developed that provide access to child development supports and services for young children and their families. Despite their proven efficacy, implementing these as programmes beyond a research setting remains challenging. The objective of this scoping review was to explore factors that influence the real-world implementation of family-focused programmes designed to support early childhood development.

This scoping review followed Arksey and O'Malley's (2005) six-step process. Eight electronic databases were searched using keywords and controlled vocabulary based on the sample, phenomenon of interest and design. To be included in this review, articles must have clearly described, defined or categorised barriers/facilitators to implementation of a family-focused programme designed to support early childhood development (0-8 years). Barriers and facilitators were mapped to the Consolidated Framework for Implementation Research (CFIR).

20 521 citations were retrieved, 12 151 were screened for titles/abstracts after removing duplicates. A total of 129 full-text articles were screened, yielding 31 included articles. 26 programmes were identified across the included articles. A cumulative total of 204 barriers and 183 facilitators were identified and mapped onto the CFIR. Opportunity among programme recipients, stemming from the individual characteristics domain (n=22), was identified as the construct representing the greatest barriers. Design from the innovation characteristics domain (n=22) was identified as the greatest facilitator.

Findings highlight the importance of early and ongoing assessment of contextual factors, particularly those influencing families' opportunity to engage. By examining barriers and facilitators reported in existing implementation science and practice literature, this manuscript sheds light on important multi-level implementation determinants for researchers, healthcare organisations and policymakers to tailor and improve implementation efforts of child development programmes in their respective contexts.