Determinants influencing the implementation of child abuse and neglect and domestic violence guidelines: A systematic review

Introduction: Despite ongoing effort, the implementation of child abuse and neglect, as well as domestic violence guidelines by care professionals, remains challenging. Various determinants influence guideline implementation, which may vary depending on research methods, guideline objectives, and contextual factors such as organization type or discipline of the implementer. The primary aim of this systematic review is to identify determinants influencing the implementation of child abuse and neglect and domestic violence guidelines. The secondary aim is to identify (differences in) determinants across specific contexts, guideline objectives, and research methods. Furthermore, we aim to assess the relative importance of identified determinants. Method: Seven electronic databases were searched for papers on determinants influencing child abuse and neglect as well as domestic violence guidelines implementation by care professionals Data extraction was guided by the Consolidated Framework for Implementation Research. We utilized a star score system and evidence index to evaluate the relative importance of identified determinants. Results: Sixteen papers met the inclusion criteria, with nine employing quantitative research methods, six using qualitative methods, and one employing a mixed-method approach. Overall, the quality of the included papers was moderate. Due to the diverse organization types and disciplines represented in the studies, creating meaningful comparable groups was challenging. Furthermore, within the studies, data from various perspectives were combined during the analysis, which made it challenging to stratify and explore contextual differences. We stratified the results by guideline objective and research method. Availability of resources, knowledge about the innovation, self-efficacy and skills, complexity, and interorganizational networks were identified as the most important determinants influencing guideline implementation. Conclusions: Our findings emphasize the need for further research on contextual differences, as they are rarely considered. The determinants identified differed between quantitative and qualitative methods. Mixed methods are needed to better understand which determinants, in which contexts, and to what extent, influence guideline implementation. Understanding what influences guideline implementation is an essential step toward developing tailored implementation strategies, which, in turn, may improve implementation performance.