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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jun 10, 2025
Date Accepted: Oct 23, 2025

The final, peer-reviewed published version of this preprint can be found here:

Implementation of Reference Framework for Preventive Care for Older Adults: Cross-sectional Qualitative Study

Zhong CC, Chen M, Lo CY, YIM MK, Zhang X, Huang J, Wong MC

Implementation of Reference Framework for Preventive Care for Older Adults: Cross-sectional Qualitative Study

J Med Internet Res 2026;28:e78814

DOI: 10.2196/78814

PMID: 41780921

Implementation of Reference Framework for Preventive Care for Older Adults: A Cross-sectional Qualitative Study

  • Claire Chenwen Zhong; 
  • Mingtao Chen; 
  • Chung Yi Lo; 
  • Man Kin YIM; 
  • Xiaoshu Zhang; 
  • Junjie Huang; 
  • Martin CS Wong

ABSTRACT

Background:

The Hong Kong Government developed the Reference Framework for Preventive Care for Older Adults (RF) to provide evidence-based recommendations for preventive care in the primary care setting. However, no study has systematically evaluated the adoption and awareness of this framework among primary care physicians (PCPs).

Objective:

This study aimed to explore PCPs' perceptions of the RF and identify barriers and facilitators to its adoption in primary care settings.

Methods:

This qualitative study involved interviews with 40 PCPs in Hong Kong to assess their views on the RF’s adoption and implementation. The Consolidated Framework for Implementation Research (CFIR) was used to guide the analysis, focusing on five domains: intervention characteristics, outer setting, inner setting, individual characteristics, and implementation process.

Results:

Participants acknowledged the RF's evidence-based foundation and comprehensive design, appreciating its potential to improve care for older adults. However, barriers included the complexity and limited personalization of the RF, competing clinical priorities, time constraints, and resource limitations. Government support and policy initiatives facilitated engagement, but clearer integration into existing workflows and stronger promotion were needed. Tailored updates, user feedback, and technological enhancements were seen as essential for improving the RF’s usability and ensuring its relevance in clinical practice.

Conclusions:

This study highlights that while the RF has potential to improve preventive care in Hong Kong’s primary care setting, its adoption is constrained by systemic, organizational, and individual barriers. To ensure its successful integration, flexible implementation, institutional support, tailored incentives, and enhanced clinician and patient engagement are essential.


 Citation

Please cite as:

Zhong CC, Chen M, Lo CY, YIM MK, Zhang X, Huang J, Wong MC

Implementation of Reference Framework for Preventive Care for Older Adults: Cross-sectional Qualitative Study

J Med Internet Res 2026;28:e78814

DOI: 10.2196/78814

PMID: 41780921

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