Table 4 Overview of results: Summary of barriers and facilitators across levels (patient, provider, and service) and theoretical component

Physical capability

Lack of training and skills

[55, 57, 60, 63, 64, 66, 69, 73]

Skills-based training

[56, 59, 60, 62, 64, 65, 67, 70, 73,74,75]

Receptionist involvement

[38, 40, 41, 44, 48, 66, 67, 69, 70, 74, 75]

Receptionist involvement

[38, 40, 41, 44, 48, 66, 67, 69, 70, 74, 75]

Practice nurse involvement

[58,59,60, 71]

Practice nurse involvement

[55, 58, 59, 63, 66, 69, 71]

Psychological capability

Lack of patient education, knowledge, and awareness

[51, 55, 60, 73]

Increase knowledge, education, and awareness

[37, 41, 43, 48, 49, 51, 54, 55, 61, 62, 64, 67, 68, 73]

Lack of provider knowledge and awareness

[55, 60, 63,64,65,66, 71, 75]

Increasing knowledge, awareness, and education

[54,55,56, 59, 62, 64, 65, 67, 70, 73, 75]

Lack of testing guidance

[64]

Prompts and reminders

[55, 66, 67, 70, 75]

Forgetfulness

[41, 48, 75]

Forgetfulness

[51, 52, 55, 60, 66, 68, 70, 75]

Lack of knowledge, education, and general awareness

[55, 60, 63,64,65,66, 71]

Testing guidelines

[55, 60]

Reflective motivation

Beliefs regarding perceived risk

[37, 41, 42, 44,45,46]

Beliefs that testing is responsible, mature, and healthy

[37, 38]

Assumptions and perceptions of patients

[53,54,55, 61, 66, 69, 70, 74, 75]

Increase confidence

[59, 62, 70]

Targets set too high

[70, 74]

Beliefs about consequences of offering

[54, 66, 69, 70, 73, 74]

Testing policy: new patients’ health checks

[64]

Automatic motivation

Embarrassment and shame

[37, 40,41,42,43, 48, 49, 55, 69, 70, 73] and [37, 38, 40, 42, 43]

Asymptomatic infection worries

[37, 44, 45]

Difficult to discuss

[52, 60,61,62, 64, 66, 68,69,70, 73, 75]

Testing policy: based on behaviour

[41, 48]

Reward and incentive programmes

[51, 55, 61, 62, 66,67,68,69, 74, 75]

Fear

[38, 41,42,43, 48, 50]

Feedback on efforts

[70, 74, 75]

Physical opportunity

Time constraints

[40, 41, 48]

PCP offering testing

[41, 47]

Time constraints

[51, 52, 55, 57,58,59,60,61,62,63,64, 66, 68,69,70,71,72,73,74,75]

Mode of testing

[55, 62, 64, 73, 75]

Time constraints

[40, 41, 48] and [51, 52, 55, 57,58,59,60,61,62,63,64, 66, 68,69,70,71,72,73,74,75]

Promotional materials

[54, 63, 70, 74, 75]

Receptionist involvement

[38, 40, 41, 44, 48, 66, 67, 69, 70, 74, 75]

Mode of testing

[39,40,41, 44, 48]

Receptionist involvement

[38, 40, 41, 44, 48, 66, 67, 69, 70, 74, 75]

Reception area

[38, 40, 41, 44, 48, 70] and [74, 75]

Testing policy: inclusion in other consultations

[48, 66, 67]

Written invitations

[61, 67]

System to record offers

[66]

Service cost to patient

[37, 39, 47, 60]

Simplified laboratory systems

[59, 62, 66, 68]

Absence of systems to record test offers

[66, 69]

Support for partner notification

[62, 64, 69]

Lack of support for partner notification

[55, 60, 62,63,64, 73]

Social opportunity

Stigma

[37, 38, 40,41,42,43, 55, 61, 71]

Normalisation

[38, 41,42,43, 61]

Practice social norms

[66, 73]

Normalisation

[54, 61, 66, 67, 70, 74]

Testing policy: women only

[37, 38, 69]

Normalisation

[52, 54, 55, 61, 63, 66, 67, 70]

Provider-patient relationship

[48, 55, 58, 59, 66, 74]

Consultation social context

[45, 55, 56, 61, 64, 67, 70, 73]

Cultural norms

[66, 73]

Testing policy: blanket testing

[38, 48]