Abstract
Background: The United Nations 2023 assessment report highlighted stalled progress towards the Sustainable Development Goals agenda of 2030. The World Health Organization describes primary health care as the cornerstone for achieving universal health coverage and health-related Sustainable Development Goals, however, reviews over the past decade on integrated multi-sectoral primary care initiatives have identified high-level gaps in reporting on implementation strategies. Approach: As a quality improvement professional, insights gained previously through discussions with patients, healthcare professionals, and social care providers revealed a need for healthcare to better collaborate with sectors outside health (i.e., housing, employment, education) to address people’s needs. Given the existing reporting gaps, and the highlighted need from key stakeholders mentioned above, this scoping review aimed to understand specific reporting gaps on implementation strategies in literature of multi-sectoral primary health services through a scoping review. Six data bases were searched between 2019-2024 for peer-reviewed studies with MeSH and keywords such as multi-sectoral collaboration, integrated care, and primary care. The inclusion criteria for the scoping review were studies that examined the effectiveness and/or implementation of interventions integrating primary health care services with non-health services, such as housing, education, employment. Studies focusing solely on public health interventions or primary care specialities, such as palliative care, were excluded. Results: The data extraction form uses elements from the Consolidated Framework for Implementation Research. The intervention elements and implementation strategies will be assessed, and reporting gaps will be identified. Preliminary results indicate that multi-sectoral collaborations are poorly described and their context is not well reported. Proportionally, more studies focus on the health outcomes and intervention with little focus on the dissemination of implementation strategies. These early results demonstrate that the landscape of the literature has a higher focus on intervention effectiveness rather than implementation strategies and process. Implications: With the Sustainable Development Goal targets reaching their end in 2030, and concerted global efforts in strengthening integrated multi-sectoral primary care, there is a policy and practice window of opportunity. Regardless of whether the Sustainable Development Goals are reached, there will be a number of promising integrated multi-sectoral primary care interventions. Given the reporting gap on implementation strategies of integrated multi-sectoral approaches to primary care, translating research into practice will prove to be difficult. By shining a spotlight on these promising practices, and ensuring the implementation strategies are well understood and researched, these promising interventions can be adopted and adapted at other sites, contributing to the scaling up of said interventions. Following this scoping review, the team will conduct further research to understand why these gaps exist and will develop support tools for dissemination, design, and implementation of integrated multi-sectoral primary care. The suite of work will contribute to knowledge, practice and policy improvements that will result an increase in integrated multi-sectoral care that addresses service user needs.