关键词: 结直肠癌, 筛查, 促进因素, 障碍因素, 实施研究综合框架, 混合方法, 社区护理

Abstract:

Objective To identify facilitators and barriers to colorectal cancer screening in community healthcare and propose effective implementation strategies. Methods From February to July 2024，a survey based on the consolidated framework for implementation research（CFIR） was conducted in 8 community health centers in Harbin，using purposive and convenience sampling to select 108 nurses and 550 residents. Binary logistic regression was used to analyze factors affecting nurses’ screening knowledge and residents’ behaviors. Semi-structured interviews with 21 nurses and 23 residents were analyzed using inductive-deductive methods. Results In the innovation domain，clear goals and free screening facilitated the implementation，while complex processes and resource shortages were barriers. Externally，policy support，funding，and collaboration promoted the screening，but funding gaps and poor communication hindered it. Internally，organizational culture and leadership were positive，while nurse training and teamwork were insufficient. Mixed-method results showed that motivation，ability，opportunity，and needs of nurses and residents significantly impacted screening. Regular feedback and teamwork aided the implementation，but complexity and communication gaps remained obstacles. Conclusion This study analyzed the facilitators and barriers to the screening implementation from the perspectives of community nurses and participants. Recommendations include simplifying processes，optimizing tools and policies，strengthening nurse training and health education，improving communication feedback，and improve outcomes，thereby increasing the participation rate of residents in colorectal cancer screening.

Key words: Colorectal Cancer, Screening, Facilitators, Barriers, Consolidated Framework for Implementation Research, Mixed Methods, Community Nursing