Enablers and Barriers to Implement COVID-19 Measures in Long-Term Care Facilities: A Mixed Methods Implementation Science Assessment in Chile

Abstract

BackgroundThe COVID-19 affected disproportionately older people, and particularly people living in long-term care facilities. Considering this problem, the Chilean government issued a series of guidelines and protocols to prevent and manage COVID-19 outbreaks in these facilities. MethodsThis study aims to identify barriers and enablers that affect the implementation of these prevention and management measures. For the analysis, we used an implementation science approach and a mixed-method strategy—survey to facilities’ managers and interviews to carers—, classifying enablers and barriers into four categories: agreement with the intervention’s goals, financial resources to implement the measures, technical needs of the intervention, and cultural factors in the facilities.ResultsResults highlight the importance of the four aforementioned factors in the implementation of COVID-19 guidelines and protocols. Managers and caregivers differ in their view of the main enablers and barriers for implementation. However, they both identify the knowledge about the measures and availability of personal protective equipment as enablers and human resources as a potential barrier. ConclusionsThe identification of several factors related to goals and culture highlights the need to adopt a broad implementation approach when designing intervention for long-term care facilities, avoiding restricting the discussion to resources availability.