Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol

Mapping barriers, enablers and implementation... | HRB Open Research dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); const cookieDomain = window.location.hostname; const tld = buildTLD(); function buildTLD() { const domainParts = cookieDomain.split('.'); while (domainParts.length > 2) { domainParts.shift(); } return domainParts.join('.'); } function deleteCookie(cookieName) { if (!cookieName) { return; } const cookiePath = (cookieName.startsWith('retraction_warning_') || cookieName.startsWith('version_warning_')) ? '/articles/' + cookieName : '/'; // Yes, these three slightly different ways to try and remove cookies are necessary document.cookie = cookieName + '=; path=' + cookiePath + '; domain=' + cookieDomain + '; expires=Thu, 01 Jan 1970 00:00:01 GMT;'; document.cookie = cookieName + '=; path=' + cookiePath + '; domain=.' + tld + '; expires=Thu, 01 Jan 1970 00:00:01 GMT;'; document.cookie = cookieName + '=; path=' + cookiePath + '; expires=Thu, 01 Jan 1970 00:00:01 GMT;'; } function deleteGroupCookies(group) { if (!group) { return; } const domainData = OneTrust.GetDomainData(), cookies = domainData.Groups.filter(cookieGroup => cookieGroup.OptanonGroupId === group)[0].Cookies; cookies.forEach(cookie => deleteCookie(cookie.Name)); } function OptanonWrapper() { const cookieConsentGroups = []; for (group of OneTrust.GetDomainData().Groups) { cookieConsentGroups.push(group.OptanonGroupId); } OneTrust.OnConsentChanged(function(e) { const cookieConsentActiveGroups = OnetrustActiveGroups.split(',').filter(activeGroup => activeGroup); cookieConsentGroups.forEach(group => { if (!cookieConsentActiveGroups.includes(group)) { deleteGroupCookies(group); }; }); }); } window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://hrbopenresearch.org/js/vendor/ckeditor/' window.reactTheme = 'HRB'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); Skip to content HRB Open Research file_upload Submit your research search clear search menu close clear Search Browse Gateways & Collections How to Publish Submit your Research My Submissions Article Guidelines Article Guidelines (New Versions) Data Guidelines Prepublication Checks Production Process Article Processing Charges Finding Article Reviewers About How it Works For Reviewers National Steering Group Policies Glossary FAQs Contact Blog My Account Submissions Content and Tracking Alerts My Details Sign In file_upload Submit your research { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://hrbopenresearch.org/articles/8-28" }, "headline": "Mapping barriers, enablers and implementation determinants to shared models of care for physical health and...", "datePublished": "2025-02-07T11:59:32", "dateModified": "2025-05-12T09:15:17", "author": [ { "@type": "Person", "name": "Allyson J Gallant" }, { "@type": "Person", "name": "John Paul Lyne" }, { "@type": "Person", "name": "Karen O'Connor" }, { "@type": "Person", "name": "Greg Sheaf" }, { "@type": "Person", "name": "Shaakya Anand-Vembar" }, { "@type": "Person", "name": "Donal O'Keeffe" }, { "@type": "Person", "name": "Caroline Wilson" }, { "@type": "Person", "name": "Yulia Kartalova- O'Doherty" }, { "@type": "Person", "name": "Louise Doyle" }, { "@type": "Person", "name": "Mary Cannon" }, { "@type": "Person", "name": "Leona Ryan" }, { "@type": "Person", "name": "Gary Donohoe" }, { "@type": "Person", "name": "David McEvoy" }, { "@type": "Person", "name": "David Cotter" }, { "@type": "Person", "name": "Olivia Longe" }, { "@type": "Person", "name": "Colm McDonald" }, { "@type": "Person", "name": "Agnes Higgins" }, { "@type": "Person", "name": "Rebecca Murphy" }, { "@type": "Person", "name": "Sara Burke" }, { "@type": "Person", "name": "Catherine D Darker" } ], "publisher": { "@type": "Organization", "name": "HRB Open Research", "logo": { "@type": "ImageObject", "url": "https://hrbopenresearch.org/img/AMP/HRB_image.png", "height": 566, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://hrbopenresearch.org/img/AMP/HRB_image.png", "height": 1200, "width": 127 }, "description": " Background Approximately one in eight people live with mental health difficulties, with onset commonly occurring in youth. It is critical to ensure care addresses all aspects of health, including physical health and sexual wellbeing needs, to achieve positive recovery outcomes. Connecting primary and secondary healthcare providers and service users through shared models of care is a critical aspect of this. The objectives of this scoping review will be to 1) identify and describe the implementation of shared models of care which address the mental health of young people and their physical health and/or sexual wellbeing needs, and 2) identify the determinants of implementing these models of care. Protocol Following Joanna Briggs Institute guidelines, studies will be included if they describe shared models of care for young people (aged 10–25) in any healthcare setting, specifically addressing mental health and physical health or sexual wellbeing needs. The review will employ the Consolidated Framework for Implementation Research (CFIR) to organise and assess findings. A librarian developed the search strategy, which will be applied to Web of Science, Medline, Embase, CINAHL, and PsycINFO databases. Two independent reviewers will screen titles, abstracts and full texts, followed by data extraction and critical appraisal of included studies. Discrepancies at all stages will be resolved through discussion or by a third reviewer. Screening results will be summarised in a PRISMA flow diagram. Narrative summaries, supported by tables and figures where applicable, will address the review’s objectives. Findings will undergo thematic analysis, with implementation determinants mapped deductively to CFIR. Discussion Findings will inform the adaptation of implementation strategies to support the implementation of policy for improving healthcare delivery to young people with mental health difficulties. Registration Open Science Framework (osf.io/rj783). " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-28/v2", "name": "Mapping barriers, enablers and implementation determinants to shared..." } } ] } Home Browse Mapping barriers, enablers and implementation determinants to shared... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Gallant AJ, Lyne JP, O'Connor K et al. Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.12688/hrbopenres.14032.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Revised Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] Allyson J Gallant https://orcid.org/0000-0002-2933-7470 1 , John Paul Lyne 2 , Karen O'Connor 3 , [...] Greg Sheaf https://orcid.org/0000-0003-1571-1772 4 , Shaakya Anand-Vembar https://orcid.org/0000-0002-9315-1865 4 , Donal O'Keeffe https://orcid.org/0000-0001-6541-996X 2,5,6 , Caroline Wilson 2 , Yulia Kartalova- O'Doherty https://orcid.org/0009-0009-3260-3459 4 , Louise Doyle https://orcid.org/0000-0002-0153-8326 4 , Mary Cannon 2 , Leona Ryan https://orcid.org/0000-0003-2385-3439 7 , Gary Donohoe 7 , David McEvoy https://orcid.org/0000-0001-8230-8727 2 , David Cotter 2 , Olivia Longe https://orcid.org/0009-0009-1072-7709 4 , Colm McDonald 8 , Agnes Higgins https://orcid.org/0000-0002-0631-1884 4 , Rebecca Murphy 9 , Sara Burke https://orcid.org/0000-0001-9419-1642 1 , Catherine D Darker https://orcid.org/0000-0002-1561-7076 1 Allyson J Gallant https://orcid.org/0000-0002-2933-7470 1 , John Paul Lyne 2 , [...] Karen O'Connor 3 , Greg Sheaf https://orcid.org/0000-0003-1571-1772 4 , Shaakya Anand-Vembar https://orcid.org/0000-0002-9315-1865 4 , Donal O'Keeffe https://orcid.org/0000-0001-6541-996X 2,5,6 , Caroline Wilson 2 , Yulia Kartalova- O'Doherty https://orcid.org/0009-0009-3260-3459 4 , Louise Doyle https://orcid.org/0000-0002-0153-8326 4 , Mary Cannon 2 , Leona Ryan https://orcid.org/0000-0003-2385-3439 7 , Gary Donohoe 7 , David McEvoy https://orcid.org/0000-0001-8230-8727 2 , David Cotter 2 , Olivia Longe https://orcid.org/0009-0009-1072-7709 4 , Colm McDonald 8 , Agnes Higgins https://orcid.org/0000-0002-0631-1884 4 , Rebecca Murphy 9 , Sara Burke https://orcid.org/0000-0001-9419-1642 1 , Catherine D Darker https://orcid.org/0000-0002-1561-7076 1 PUBLISHED 12 May 2025 Author details Author details 1 Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Leinster, Ireland 2 Department of Psychiatry, Royal College of Surgeons in Ireland 26 York Street Campus, Dublin, Leinster, Ireland 3 University College Cork, Cork, County Cork, Ireland 4 School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Leinster, Ireland 5 Mental Health Ireland, Dublin, Ireland 6 ARCHES Recovery College, Dublin, Ireland 7 School of Psychology, University of Galway, Galway, County Galway, Ireland 8 School of Medicine, University of Galway, Galway, County Galway, Ireland 9 Dublin City University School of Nursing Psychotherapy and Community Health, Dublin, Leinster, Ireland Allyson J Gallant Roles: Data Curation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing John Paul Lyne Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Karen O'Connor Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Greg Sheaf Roles: Data Curation, Investigation, Methodology, Resources, Software, Writing – Review & Editing Shaakya Anand-Vembar Roles: Methodology, Writing – Review & Editing Donal O'Keeffe Roles: Conceptualization, Funding Acquisition, Methodology, Writing – Review & Editing Caroline Wilson Roles: Project Administration, Writing – Review & Editing Yulia Kartalova- O'Doherty Roles: Methodology, Writing – Review & Editing Louise Doyle Roles: Conceptualization, Funding Acquisition, Methodology Mary Cannon Roles: Conceptualization, Funding Acquisition, Methodology Leona Ryan Roles: Methodology, Writing – Review & Editing Gary Donohoe Roles: Conceptualization, Funding Acquisition, Methodology David McEvoy Roles: Methodology, Writing – Review & Editing David Cotter Roles: Conceptualization, Funding Acquisition, Methodology, Project Administration Olivia Longe Roles: Methodology, Writing – Review & Editing Colm McDonald Roles: Conceptualization, Funding Acquisition, Methodology Agnes Higgins Roles: Conceptualization, Funding Acquisition, Methodology Rebecca Murphy Roles: Conceptualization, Funding Acquisition, Methodology Sara Burke Roles: Conceptualization, Funding Acquisition, Methodology Catherine D Darker Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Approximately one in eight people live with mental health difficulties, with onset commonly occurring in youth. It is critical to ensure care addresses all aspects of health, including physical health and sexual wellbeing needs, to achieve positive recovery outcomes. Connecting primary and secondary healthcare providers and service users through shared models of care is a critical aspect of this. The objectives of this scoping review will be to 1) identify and describe the implementation of shared models of care which address the mental health of young people and their physical health and/or sexual wellbeing needs, and 2) identify the determinants of implementing these models of care. Protocol Following Joanna Briggs Institute guidelines, studies will be included if they describe shared models of care for young people (aged 10–25) in any healthcare setting, specifically addressing mental health and physical health or sexual wellbeing needs. The review will employ the Consolidated Framework for Implementation Research (CFIR) to organise and assess findings. A librarian developed the search strategy, which will be applied to Web of Science, Medline, Embase, CINAHL, and PsycINFO databases. Two independent reviewers will screen titles, abstracts and full texts, followed by data extraction and critical appraisal of included studies. Discrepancies at all stages will be resolved through discussion or by a third reviewer. Screening results will be summarised in a PRISMA flow diagram. Narrative summaries, supported by tables and figures where applicable, will address the review’s objectives. Findings will undergo thematic analysis, with implementation determinants mapped deductively to CFIR. Discussion Findings will inform the adaptation of implementation strategies to support the implementation of policy for improving healthcare delivery to young people with mental health difficulties. Registration Open Science Framework ( osf.io/rj783 ). READ ALL READ LESS Keywords Adolescent, CFIR, delivery of healthcare, general health, implementation science, mental health, review, sexual health Corresponding Author(s) Catherine D Darker ( [email protected] ) Close Corresponding author: Catherine D Darker Competing interests: No competing interests were disclosed. Grant information: This study is funded by the Health Research Board Ireland- Applied Programme Grant 2023 (reference: 9610). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Gallant AJ et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Gallant AJ, Lyne JP, O'Connor K et al. Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.12688/hrbopenres.14032.2 ) First published: 07 Feb 2025, 8 :28 ( https://doi.org/10.12688/hrbopenres.14032.1 ) Latest published: 12 May 2025, 8 :28 ( https://doi.org/10.12688/hrbopenres.14032.2 ) Revised Amendments from Version 1 We have prepared a table of responses to all comments and queries raised by the two reviewers, which is included with our resubmission. We have revised the manuscript with the feedback of our two reviewers to set the sexual health & wellbeing component of our work in a more global context, in addition to addressing the root issues of physical health among those with mental health difficulties and minor typos. Changes in the manuscript were noted with track changes. Upon further reflection since our submission in January 2025, and in addition to the revisions suggested by our reviewers, we have made two updates to the eligibility criteria to be used in our review: - Studies which include young adult and adult populations will be considered for inclusion should the younger adult findings be presented separately from adult data or when at least 60% of the sample population is comprised of our eligible age group - Conference abstracts will now be an excluded evidence source, given the limited details which can be provided in the word count We have prepared a table of responses to all comments and queries raised by the two reviewers, which is included with our resubmission. We have revised the manuscript with the feedback of our two reviewers to set the sexual health & wellbeing component of our work in a more global context, in addition to addressing the root issues of physical health among those with mental health difficulties and minor typos. Changes in the manuscript were noted with track changes. Upon further reflection since our submission in January 2025, and in addition to the revisions suggested by our reviewers, we have made two updates to the eligibility criteria to be used in our review: - Studies which include young adult and adult populations will be considered for inclusion should the younger adult findings be presented separately from adult data or when at least 60% of the sample population is comprised of our eligible age group - Conference abstracts will now be an excluded evidence source, given the limited details which can be provided in the word count See the authors' detailed response to the review by Ellie Brown See the authors' detailed response to the review by Anna E Kågesten READ REVIEWER RESPONSES Background Mental health difficulties are prevalent in society, with the World Health Organisation (WHO) estimating one in eight people globally live with a mental health condition 1 , 2 . Mental health difficulties are dynamic and can occur across the life course; however, onset typically occurs by age 25, with over half of those experiencing symptoms before age 15 3 , 4 . Recent studies have indicated an even higher prevalence of general mental health difficulties in young people; for example, data from Ireland in 2019 found 63% of young people aged 10–24 years experienced anxiety and depression, with 21% of those aged 10–14 years having experienced a mental health difficulty (e.g., anxiety, conduct disorders) 5 . As adolescence and early adulthood are periods of transition, ensuring this cohort has access to timely, adequate and quality mental healthcare is essential to supporting short-term and long-term health outcomes. However, provision of mental healthcare is often fragmented, resulting in poor patient outcomes and ineffective health system use 6 – 8 . The COVID-19 pandemic had detrimental effects on mental health, with an estimated 25% global increase in anxiety and depression in 2020, and with 30% of young people across Europe reporting the pandemic had negative effects on their mental health and wellbeing 9 , 10 . As the prevalence of mental health difficulties is a growing global health concern, it is essential to support prevention, early intervention, and resiliency, particularly among young people 11 . As a young person adjusts to the symptoms of their mental health difficulties and/or diagnosis, attention is needed to their holistic health, including their physical health and sexual wellbeing. Physical health is the “ condition of your body, taking into consideration everything from the absence of disease to fitness level ” 12 . Physical health among those with mental health difficulties can be negatively affected by both individual lifestyle factors (e.g., smoking status, poor diet quality, sedentary behaviours) and treatment plans (e.g., medications) 13 . For example, those with severe mental health difficulties (e.g., schizophrenia, bipolar disorder) are particularly vulnerable to several physical conditions as antipsychotic medications can contribute to the development of chronic illnesses such as premature cardiovascular disease 14 , 15 . Young people taking antipsychotics for at least six months are more likely to experience increases in weight, fasting glucose, cholesterols, and triglyceride levels compared to adults on the same medication 16 , putting them at risk for chronic diseases, including obesity, cardiovascular disease and type 2 diabetes 17 , 18 . Despite the higher risk for these physical comorbidities, there is inadequate screening or monitoring for these conditions in young people across primary and secondary care 19 – 21 . Recent research highlighted young people with mental health difficulties often have limited knowledge of the effects their mental health treatments can have on their physical health, and felt inadequately informed by their healthcare providers 14 . These unmet physical health needs may contribute to the “scandal of premature mortality,” 22 where those with mental health difficulties experience a reduced life expectancy by 15–20 years compared to the general population 17 , 23 , 24 . In addition to mental and physical health, the sexual wellbeing of young people with mental health difficulties should be addressed 25 . As emerging mental health symptoms and diagnoses can coincide with the onset of puberty, sexual wellbeing should be considered a priority for this population. Sexual health and wellbeing are interrelated concepts in public health, with the focus sexual health on fertility management, prevention and management of sexually transmitted infection (STI) and prevention of sexualised violence, while sexual wellbeing encompasses key factors such as sexual self-esteem, comfort with sexuality and sexual safety 26 . Common sexual health concerns among youth globally include access and use of contraception, unintended pregnancy and contracting or transmitting STIs 27 . Young people with mental health difficulties are at an increased risk of engaging in these high-risk sexual behaviours compared to their peers 28 – 30 . Collaboration is needed within and across the health system to improve overall health outcomes among young people experiencing mental health difficulties, with particular attention to their physical health needs and sexual wellbeing. A shared model of care is the collaboration between primary care (e.g., general practitioners) and secondary care (e.g., specialist mental health services) to support patient referrals, assessments and diagnoses, treatment and monitoring, and discharge planning 31 , 32 . This approach to care can exist across a continuum, from patient care coordination to full physical integration of services and shared electronic patient medical records 31 , 33 . Shared models of care have been associated with improvements in young people’s clinical and quality of life outcomes, and engagement with treatment from patients and their families 34 . Additional organisational and health system level outcomes include cost-effective care and improved access to, and provision of, quality healthcare 35 , 36 . Therefore, many of the underlying factors associated with the “scandal of premature mortality” could be addressed using shared models of care. A consistent recommendation in Ireland’s national mental health policies for over a decade has been the use of shared models of care between primary and specialist secondary care to address individuals’ mental illness and accompanying health needs 11 , 32 , 37 ; however this model has yet to be implemented. With a strong evidence base to support the use of shared model of care and the positive effects on individual, organisational and system-level outcomes, it is worth investing in this approach to healthcare coordination and continuity of care. Yet translating this policy recommendation into practice has remained a challenge in the country. Implementation science is a growing field of applied research to improve the uptake of evidence into practice 38 , and offers a route to support the delivery of shared models to address the physical health and sexual wellbeing needs of young people with mental health difficulties. Central to implementation science is identifying barriers and enablers to adopting best practice interventions 39 – 41 , and developing tailored, context-specific strategies to address recognised barriers and leverage enablers to facilitate the adoption of new clinical practice 42 – 44 . A range of frameworks have been used to guide implementation science research, including the theoretical domains framework (TDF) 45 , the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) 46 and the reach, efficacy, adoption, implementation, and maintenance (RE-AIM) framework 47 . One of the most popular frameworks is the consolidated framework for implementation research (CFIR) 48 , a determinants framework comprised of 39 constructs under five domains: innovation (e.g., trialability, cost), outer setting (e.g., local conditions, external pressures), inner setting (e.g., culture, available resources), individuals (e.g., mid or high-level leaders, innovation recipients) and implementation process (e.g., engaging, adapting) 48 . Utilising implementation science may enhance our understanding of determinants to shared models of care for young people with mental health difficulties to inform the delivery of care in Ireland and internationally. Rationale & review aims Previous reviews have synthesised the literature regarding youth mental health 49 , shared models of care 50 – 52 , and addressing physical health or sexual health needs among populations with mental illness 53 – 57 . Two recent reviews synthesised effective intervention components to integrating youth mental healthcare in community settings 35 , 36 , with a meta-analysis identifying shared models of care were associated with a small but significant improvement in youth’s depression symptoms 35 . However, to our knowledge, there has yet to be a review of these shared models of care to address the physical and sexual healthcare needs for young people with mental health difficulties. A search of Open Science Framework (OSF), Joanna Briggs Institute (JBI) and Cochrane registries on the 7 th October, 2024 did not identify any current or completed reviews on this topic. When sexual wellbeing has been included in previous reviews, it has often been consolidated under general physical health concerns and has not been synthesised independently 35 , 36 . Our proposed scoping review aims to bring an implementation science lens, through the use of CFIR, to synthesise the body of literature to identify and describe 1) shared models of care which address the physical health and/or sexual wellbeing of young people with mental health difficulties, and 2) the determinants to implementing these models. Protocol Methods This scoping review is the foundation step for a mixed methods study aimed at implementing Shared Care fOr Physical and sExual health (SCOPE for HEALTH) in young people with mental health difficulties in Ireland. This work is part of the broader research programme, VISTA (Vision To Action for Promoting Mental Health and Recovery – An Implementation Science Approach to “Sharing the Vision”), designed to use novel methods to develop implementation blueprints to action a range of recommendations from ‘Sharing the Vision’, Ireland’s national mental health policy 58 , 59 . We are seeking to conduct a scoping review to summarise existing relevant literature on shared models of care as this evidence synthesis approach is well suited to our aims and as we anticipate a high degree of heterogeneity among the included evidence sources 60 . Review methods have been informed by JBI and protocol reporting has been guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) standards 61 , 62 . The protocol was registered prospectively with OSF on 16 th October, 2024 ( https://osf.io/xyq9c ). Research ethical approval is not required to conduct this review. Eligibility criteria Eligibility criteria is summarised in Table 1 . The typical population, intervention, comparator, outcome (PICO) framework is not well suited to this review as we will not have parameters regarding study interventions or outcomes; therefore, we selected the population, concept, context, and type of evidence source framework provided by JBI as it aligns with our review objectives 61 . Table 1. Summary of eligibility criteria. Include Exclude Population • Young people (ages 10 up to and including 25 years) with mental health difficulties (e.g., symptoms and/or diagnosed concerns) • Mental health difficulties as defined by ICD-11 • Adults >26 years • Animal studies • Young people without mental health difficulties • Young people with substance use/abuse issues • Young people with Autism spectrum or other neurodevelopmental disorders without a mental health comorbidity Concept • Studies which focus on mental health difficulties as the primary concern, and secondary effects on physical health and/or sexual wellbeing • Any physical health concern(s) • Any sexual wellbeing concern(s) • Can address either physical and/or sexual health concerns • Studies focused solely on other aspects of young people’s health (e.g., cognitive, emotional, or social development without explicit links to physical or sexual health) • Studies with a primary focus on young people’s physical health and/or sexual wellbeing, with mental health as a secondary concern Context • Shared models of care between primary care and secondary care • No limitations on setting(s) Types of evidence sources • Quantitative • Qualitative • Mixed methods • Theses • Conference abstracts • Grey literature • Epidemiological studies • Reviews • Protocols • Text and opinion • Book chapters Studies should include young people, defined as those aged ten and up to, and including, 25 years. This aligns with the definition used to inform ‘Sharing the Vision,’ Ireland’s national mental health policy 11 . Studies which include young adult and adult populations will be considered for inclusion should the younger adult findings be presented separately from adult data, or when at least 60% of the sample is comprised of the eligible age group 63 . Studies focused on adults, older adults or animal studies will be excluded. Studies including healthcare providers involved in the provision of mental health, physical health and/or sexual wellbeing care (e.g., general practitioners, psychiatrists, psychologists, practice nurses) will be eligible for inclusion. We use the term ‘mental health difficulty’ throughout our review to encompass “ the full range of mental health difficulties that might be encountered, from the psychological distress experienced by many people, to severe mental disorders that affect a smaller population " as described in ‘Sharing the Vision.’ 11 This terminology was also preferred by the public and patient representatives on the review team. Mental or behavioural difficulties included in the International Classification of Diseases- 11 th Revision (ICD-11) which affect young people will be eligible for inclusion 64 . Neurodevelopmental conditions as classified by the ICD-11 (e.g., intellectual disabilities, autism spectrum disorder) will be included if they are coupled with a mental or behavioural difficulty. Studies focused solely on substance use or abuse will also be excluded. There will be no limits on the types of physical health or sexual wellbeing concerns identified in the literature. Studies describing shared models of care between primary and secondary care will be included in the review. Studies will be eligible for inclusion if mental health concerns are the priority focus and physical health and/or sexual wellbeing are secondary concerns. Studies which solely address the effects physical health and sexual wellbeing on mental health will be excluded. There will be no limitations to the types of settings the shared models of care are offered (e.g., sexual health clinics, community or in-patient settings). The review will consider all published and unpublished literature which address our review objectives. We will consider all study designs, including quantitative, qualitative, and mixed methods designs. Relevant theses will be eligible for inclusion, while conference abstracts, editorials, commentaries and other evidence syntheses will be excluded; however, the reference lists of any related reviews will be hand searched to identify any additional studies to include in our review. Grey literature will be considered where appropriate, and we will contact experts in the field to identify any unpublished research. Search strategy & information sources A comprehensive approach has been used to develop the review search strategy. We initially compiled a list of relevant words associated with the concepts included in the review (i.e., young people, mental health, physical health, sexual wellbeing, models of care and implementation science). The study librarian selected the most relevant terms to include in the development of preliminary search strings in Web of Science (Core Collection) electronic database on 21 st October, 2024 ( https://osf.io/xyq9c ). This initial search will undergo database-specific modifications and be applied to MEDLINE (EBSCOhost), Embase (Elsevier), PsycINFO (EBSCOhost), and CINAHL (EBSCOhost) databases. No geographical, language or time limitations will be placed on the search to ensure all potentially relevant studies are included in the review. Finally, the reference lists of included studies will be hand searched by a team member to identify any additional literature to include in the review. Any non-English literature identified will be translated using DeepL Translate, an online translation aid. All search findings will be imported into Covidence, an online review management platform, to undergo de-duplication and screening (Veritas Health Innovation, Melbourne, Australia). Grey literature searching will be conducted to complement the electronic database searches. Targeted searches of national health organisation websites and think tanks will be searched by a team member to identify reports, white papers and/or guidance documents which meet our review eligibility criteria. Sites from Australia (e.g., Orygen Institute), Canada (e.g., The Centre for Addictions and Mental Health), the United States (e.g., The Gates Institute for Population and Reproductive Health), the United Kingdom (e.g., The Prince’s Trust), and Scandinavian countries (e.g., Danish Health Authority) will be prioritised as these countries and regions are active in this area of applied research 65 . Grey literature findings will also be imported into Covidence for further review and data extraction. Screening procedures Title and full-text screening will be conducted by two independent reviewers. Relevant titles and abstracts will have their corresponding full texts imported into Covidence to undergo further review. Full texts will be reviewed again against the eligibility criteria by two reviewers, with reasons for exclusion at this stage noted for the PRISMA flow diagram. Conflicts at each of these stages will be addressed through discussion or with a third team member. Included articles will undergo data extraction. Data extraction A modified version of the JBI extraction template will be used to extract relevant data from included studies to address our review objectives ( https://osf.io/tcj2s ). Extracted items will include descriptive study details (e.g., authors and year of publication, country, study design, aim), population details (e.g., characteristics of young people, mental illness, sample size) and concept (e.g., physical health and/or sexual wellbeing concerns), context (e.g., description and setting of shared model of care). Content related to implementation as described by CFIR (e.g., inner setting, outer setting, intervention characteristics, characteristics of the individual, and process) will be extracted when possible. The template will be pilot tested prior to extraction by two of the reviewers using three included studies. Reviewers will agree on the extraction process and resolve discrepancies and any issues with the template. Any revisions made to the template will be described in the final review manuscript. The reviewers will use the updated template to complete data extraction for the remaining included studies. If any essential content is not reported in the study, the research team will email the corresponding author(s) of these studies for supplemental information. Critical appraisal of individual sources of evidence Included studies will undergo critical appraisal using the mixed methods appraisal tool (MMAT) 66 . The MMAT is a validated tool which allows for the methodological appraisal of quantitative, qualitative and mixed methods studies, and was selected as we anticipate a high level of heterogeneity across included studies 66 . Each MMAT criterion response is coded as ‘yes’, ‘no’ or ‘can’t tell’ 66 . Two reviewers will pilot test MMAT coding with three of the included studies and compare results. Any discrepancies will be resolved through consensus discussions. Following pilot testing, the reviewers will continue to complete appraisals independently, with conflicts resolved regularly through consensus discussions. All studies which undergo appraisals will be included in the review, regardless of their methodological quality rating. Data synthesis & presentation To address our first review objective, we will conduct reflexive thematic analysis 67 . Following an initial review of the included studies and extracted data, two team members will derive key codes and subcodes in the data which reflect critical concepts of shared models of care and their implementation. Developed codes and subcodes will be categorised into an overarching thematic framework. Extracted study data will then be indexed to the framework and relevant categories. To address the second review objective, we will deductively map identified implementation determinants to relevant domains from CFIR 48 . Review findings will be presented according to the PRISMA-ScR reporting checklist 62 . Data will be aggregated and summarised narratively to address the review objectives, with figures and tables used to support narratives, when appropriate. MMAT appraisals will be presented using a table of aggregated criterion ratings with a supporting narrative. A PRISMA flow diagram will also be included in the findings manuscript to synthesise the review screening process 68 . Discussion Strengths of this review include using rigorous JBI methods and PRISMA reporting standards for the protocol and finding manuscripts. Registering and publishing the protocol a priori reduces the risk of research duplication and bias, while increasing transparency and replication of our review methods 69 . Placing no geographical, language or time limiters on the search strategy also helps ensure we identify all relevant literature and will allow us to track changes in characteristics to shared models of care over time. Conducting the optional critical appraisal step in our scoping review will also add rigour to our findings. Limitations may include introducing bias by combining evidence sources, including studies regardless of their quality, and not identifying all relevant sources to include in our review. Findings from this review will improve our understanding of shared models of care, and barriers, enablers and determinants to implementing these models to support a holistic approach to improving health outcomes among young people. Identifying key characteristics of established shared models of care to address mental, physical health and/or sexual wellbeing needs between primary and secondary care will provide elements to consider replicating in future studies. Mapping review findings to CFIR will highlight key factors influencing implementation and outcomes and uncover potential gaps in the literature. Findings and identified gap(s) in the literature will be used to inform upcoming quantitative and qualitative data collection in our broader mixed methods research study. Finally, findings will inform the tailoring of implementation strategies and health policies for vulnerable populations, thereby supporting more effective delivery of healthcare. Ethics and consent Ethics and consent were not required for this study. Abbreviations CFIR: Consolidated Framework for Implementation Research ICD-11: International Classification of Diseases- 11 th Revision i-PAHRIS: integrated-Promoting Action on Research Implementation in Health Services JBI: Joanna Briggs Institute MMAT: Mixed Methods Appraisal Tool OSF: Open Science Framework PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses RE-AIM: Reach, Efficacy, Adoption, Implementation, and Maintenance SCOPE for HEALTH: Shared Care fOr Physical and sExual HEALTH in young people with mental health difficulties ScR: Scoping Review STI: Sexually Transmitted Infection WHO: World Health Organisation Data availability Underlying data No data are associated with this article. Extended data Open Science Framework: Scope for Health PRISMA ScR Checklist. https://osf.io/hwnua/ 70 . This project contains the following extended data: draft data extraction.docx Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication). Reporting guidelines Open Science Framework: PRISMA-ScR checklist for “Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the consolidated framework for implementation research: A scoping review protocol”. https://osf.io/hwnua/ 70 . Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication). Faculty Opinions recommended References 1. Institute for Health Metrics and Evaluation: Global burden of disease results. Washington, United States: University of Washington; 2024; [cited 2024 Sep 12]. Reference Source 2. World Health Organization: Fact sheets: mental disorders. 2022; [cited 2024 Sep 12]. Reference Source 3. Colizzi M, Lasalvia A, Ruggeri M: Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? Int J Ment Health Syst. 2020; 14 (1): 23. PubMed Abstract | Publisher Full Text | Free Full Text 4. Jones PB: Adult mental health disorders and their age at onset. Br J Psychiatry Suppl. 2013; 202 (s54): s5–10. PubMed Abstract | Publisher Full Text 5. Government of Ireland: The mental health of children and young people in Ireland. (Statistical Spotlight). Report No.: 10. Dublin, Ireland: Department of Children, Equality, Disability, Integration and Youth, 2023; 67, [cited 2024 Sep 17]. Reference Source 6. Newman D, O’Reilly P, Lee SH, et al. : Mental health service users’ experiences of mental health care: an integrative literature review. J Psychiatr Ment Health Nurs. 2015; 22 (3): 171–82. PubMed Abstract | Publisher Full Text 7. McGorry PD, Mei C, Chanen A, et al. : Designing and scaling up integrated youth mental health care. World Psychiatry. 2022; 21 (1): 61–76. PubMed Abstract | Publisher Full Text | Free Full Text 8. Ådnanes M, Steihaug S: ”You never know what happens next” - young adult service users’ experience with mental health care and treatment through one year. Int J Integr Care. 2016; 16 (3): 5. PubMed Abstract | Publisher Full Text | Free Full Text 9. Brunier A: COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. World Health Organization, 2022; 1. Reference Source 10. World Health Organization, Regional Office for Europe: Coping through crisis: COVID-19 pandemic experiences and adolescent mental health and well-being in the WHO European Region. (Impact of the COVID-19 pandemic on young people’s health and well-being from the findings of the HBSC survey round 2021/2022). Report No.: WHO/EURO: 2023-7680-47447-69735. Switzerland: World Health Organization, 2023; 18, [cited 2024 Sep 17]. Reference Source 11. Ireland’s Department of Health: Sharing the vision: a mental health policy for everyone. Dublin, Ireland: Government of Ireland, 2021; 120, [cited 2024 Nov 9]. Reference Source 12. European Patients’ Academy on Therapeutic Innovation: Physical health - EUPATI Toolbox. [cited 2024 Nov 13]. Reference Source 13. DE Hert M, Correll CU, Bobes J, et al. : Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011; 10 (1): 52–77. PubMed Abstract | Publisher Full Text | Free Full Text 14. Chee GL, Wynaden D, Heslop K: The physical health of young people experiencing first-episode psychosis: mental health consumers’ experiences. Int J Ment Health Nurs. 2019; 28 (1): 330–338. PubMed Abstract | Publisher Full Text 15. Libowitz MR, Nurmi EL: The burden of antipsychotic-induced weight gain and metabolic syndrome in children. Front Psychiatry. 2021; 12 : 623681. PubMed Abstract | Publisher Full Text | Free Full Text 16. Kryzhanovskaya LA, Xu W, Millen BA, et al. : Comparison of long-term (at least 24 weeks) weight gain and metabolic changes between adolescents and adults treated with Olanzapine. J Child Adolesc Psychopharmacol. 2012; 22 (2): 157–65. PubMed Abstract | Publisher Full Text 17. Firth J, Siddiqi N, Koyanagi A, et al. : The Lancet psychiatry commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019; 6 (8): 675–712. PubMed Abstract | Publisher Full Text 18. Correll CU, Robinson DG, Schooler NR, et al. : Cardiometabolic risk in patients with first-episode schizophrenia spectrum disorders: baseline results from the RAISE-ETP study. JAMA Psychiatry. 2014; 71 (12): 1350–63. PubMed Abstract | Publisher Full Text 19. Coughlin M, Goldie CL, Tregunno D, et al. : Enhancing metabolic monitoring for children and adolescents using second-generation antipsychotics. Int J Ment Health Nurs. 2018; 27 (3): 1188–1198. PubMed Abstract | Publisher Full Text 20. Ward T, Wynaden D, Heslop K: Who is responsible for metabolic screening for mental health clients taking antipsychotic medications? Int J Ment Health Nurs. 2018; 27 (1): 196–203. PubMed Abstract | Publisher Full Text 21. Bozymski KM, Whitten JA, Blair ME, et al. : Monitoring and treating metabolic abnormalities in patients with early psychosis initiated on antipsychotic medications. Community Ment Health J. 2018; 54 (6): 717–724. PubMed Abstract | Publisher Full Text 22. Thornicroft G: Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry. 2011; 199 (6): 441–2. PubMed Abstract | Publisher Full Text 23. Machado MO, Veronese N, Sanches M, et al. : The association of depression and all-cause and cause-specific mortality: an umbrella review of systematic reviews and meta-analyses. BMC Med. 2018; 16 (1): 112. PubMed Abstract | Publisher Full Text | Free Full Text 24. Hjorthøj C, Stürup AE, McGrath JJ, et al. : Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry. 2017; 4 (4): 295–301. PubMed Abstract | Publisher Full Text 25. Brown E, Lo Monaco S, O’Donoghue B, et al. : Improving the sexual health of young people (under 25) in high-risk populations: a systematic review of behavioural and psychosocial interventions. Int J Environ Res Public Health. 2021; 18 (17): 9063. PubMed Abstract | Publisher Full Text | Free Full Text 26. Mitchell KR, Lewis R, O’Sullivan LF, et al. : What is sexual wellbeing and why does it matter for public health? Lancet Public Health. 2021; 6 (8): e608–e613. PubMed Abstract | Publisher Full Text | Free Full Text 27. Marcell AV, Burstein GR, COMMITTEE ON ADOLESCENCE: Sexual and reproductive health care services in the pediatric setting. Pediatrics. 2017; 140 (5): e20172858. PubMed Abstract | Publisher Full Text 28. Vickers ML, Choi YK, Eriksson L, et al. : Sexual and reproductive health in adolescents and young adults with psychotic disorders: a scoping review. Schizophr Bull. 2023; 49 (1): 108–35. PubMed Abstract | Publisher Full Text | Free Full Text 29. Adan Sanchez AY, McMillan E, Bhaduri A, et al. : High-risk sexual behaviour in young people with mental health disorders. Early Interv Psychiatry. 2019; 13 (4): 867–73. PubMed Abstract | Publisher Full Text 30. Liang CS, Bai YM, Hsu JW, et al. : The risk of sexually transmitted infections following first-episode schizophrenia among adolescents and young adults: a cohort study of 220 545 subjects. Schizophr Bull. 2020; 46 (4): 795–803. PubMed Abstract | Publisher Full Text | Free Full Text 31. Wiener JC, Rodrigues R, Reid JNS, et al. : Models of shared care for the management of psychotic disorder after first diagnosis in Ontario. Can Fam Physician. 2023; 69 (12): 859–66. PubMed Abstract | Publisher Full Text | Free Full Text 32. McHugh P, Byrnes M, Vision for Change Mental, et al. : Advancing the shared care approach between primary & specialist mental health servies: a guidance paper. Dublin, Ireland: Health Service Executive; 2012; 34, [cited 2024 Sep 23]. Reference Source 33. Hodgins M, McHugh C, Hu N, et al. : Review of integrated care in Youth Mental Health. Commissioned by headspace Youth National Mental Health Foundation Ltd. Sydney: Australia. Sydney, Australia: Youth National Mental Health Foundation Ltd; 2022; 32. Reference Source 34. Fusar-Poli P, McGorry PD, Kane JM: Improving outcomes of first-episode psychosis: an overview. World Psychiatry. 2017; 16 (3): 251–65. PubMed Abstract | Publisher Full Text | Free Full Text 35. McHugh C, Hu N, Georgiou G, et al. : Integrated care models for Youth Mental Health: a systematic review and meta-analysis. Aust N Z J Psychiatry. 2024; 58 (9): 747–59. PubMed Abstract | Publisher Full Text | Free Full Text 36. Hodgins M, McHugh C, Eapen V, et al. : Creation of the youth integration project framework: a narrative synthesis of the Youth Mental Health integrated care literature. Int J Integr Care. 2024; 24 (3): 5. PubMed Abstract | Publisher Full Text | Free Full Text 37. McHugh P, Byrnes M, Subgroup V for CMH in PCI: Profile of the shared care activities of mental health teams in Ireland. Health Service Executive (HSE); 2013; [cited 2024 Sep 23]. Reference Source 38. Eccles MP, Mittman BS: Welcome to implementation science . Implement Sci. 2006; 1 (1): 1. Publisher Full Text 39. Darker CD, Nicolson GH, Carroll A, et al. : The barriers and facilitators to the implementation of National Clinical Programmes in Ireland: using the MRC framework for process evaluations. BMC Health Serv Res. 2018; 18 (1): 733. PubMed Abstract | Publisher Full Text | Free Full Text 40. Darker CD, Nicolson G, Reddon H, et al. : Barriers and facilitators to the implementation of an early intervention in psychosis service in three demonstration sites in Ireland. BMC Health Serv Res. 2023; 23 (1): 653. PubMed Abstract | Publisher Full Text | Free Full Text 41. O’Connell N, O’Connor K, McGrath D, et al. : Early Intervention in psychosis services: a systematic review and narrative synthesis of the barriers and facilitators to implementation. Eur Psychiatry. 2021; 65 (1): e2. PubMed Abstract | Publisher Full Text | Free Full Text 42. Bauer MS, Kirchner J: Implementation science: what is it and why should I care? Psychiatry Res. 2020; 283 : 112376. PubMed Abstract | Publisher Full Text 43. Hamilton AB, Finley EP: Qualitative methods in implementation research: an introduction. Psychiatry Res. 2019; 280 : 112516. PubMed Abstract | Publisher Full Text | Free Full Text 44. Gallant AJ, Steenbeek A, Halperin SA, et al. : Operationalizing the behaviour change wheel and APEASE criteria to co-develop recommendations with stakeholders to address barriers to school-based immunization programs. Vaccine. 2024; 42 (23): 126226. PubMed Abstract | Publisher Full Text 45. Atkins L, Francis J, Islam R, et al. : A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implement Sci. 2017; 12 (1): 77. PubMed Abstract | Publisher Full Text | Free Full Text 46. Harvey G, Kitson A: Implementing evidence-based practice in healthcare: a facilitation guide. London & New York: Routledge; 2015; 41. Reference Source 47. Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999; 89 (9): 1322–7. PubMed Abstract | Publisher Full Text | Free Full Text 48. Damschroder LJ, Reardon CM, Widerquist MAO, et al. : The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022; 17 (1): 75. PubMed Abstract | Publisher Full Text | Free Full Text 49. Clarke AM, Kuosmanen T, Barry MM: A systematic review of online Youth Mental Health promotion and prevention interventions. J Youth Adolesc. 2015; 44 (1): 90–113. PubMed Abstract | Publisher Full Text 50. Lisy K, Kent J, Piper A, et al. : Facilitators and barriers to shared primary and specialist cancer care: a systematic review. Support Care Cancer. 2021; 29 (1): 85–96. PubMed Abstract | Publisher Full Text 51. Kelly BJ, Perkins DA, Fuller JD, et al. : Shared care in mental illness: a rapid review to inform implementation. Int J Ment Health Syst. 2011; 5 (1): 31. PubMed Abstract | Publisher Full Text | Free Full Text 52. Bomhof-Roordink H, Gärtner FR, Stiggelbout AM, et al. : Key components of shared decision making models: a systematic review. BMJ Open. 2019; 9 (12): e031763. PubMed Abstract | Publisher Full Text | Free Full Text 53. Hortal-Mas R, Moreno-Poyato AR, Granel-Giménez N, et al. : Sexuality in people living with a serious mental illness: a meta-synthesis of qualitative evidence. J Psychiatr Ment Health Nurs. 2022; 29 (1): 130–46. PubMed Abstract | Publisher Full Text 54. Barker LC, Vigod SN: Sexual health of women with schizophrenia: a review. Front Neuroendocrinol. 2020; 57 : 100840. PubMed Abstract | Publisher Full Text 55. Stevens M, Ratheesh A, Watson A, et al. : Rates, types and associations of sexual risk behaviours and Sexually Transmitted Infections in those with severe mental illness: a scoping review. Psychiatry Res. 2020; 290 : 112946. PubMed Abstract | Publisher Full Text 56. McCloughen A, Foster K, Huws-Thomas M, et al. : Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature. Int J Ment Health Nurs. 2012; 21 (3): 274–88. PubMed Abstract | Publisher Full Text 57. Happell B, Davies C, Scott D: Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: a systematic review. Int J Ment Health Nurs. 2012; 21 (3): 236–47. PubMed Abstract | Publisher Full Text 58. VISTA: VISion To Action for promoting mental health and recovery. An Implementation Science approach to ‘Sharing the Vision’ - Ireland’s national mental health policy. HRB, Health Research Board. Reference Source 59. McEvoy D, Wilson C, Healy C, et al. : Identifying personally modifiable factors for self-harm recovery in young people: a protocol for a systematic review [version 1; peer review: awaiting peer review]. HRB Open Res. 2025; 8 : 48. Publisher Full Text 60. Munn Z, Peters MDJ, Stern C, et al. : Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018; 18 (1): 143. PubMed Abstract | Publisher Full Text | Free Full Text 61. Peters MDJ, Marnie C, Tricco AC, et al. : Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18 (10): 2119–2126. PubMed Abstract | Publisher Full Text 62. Tricco AC, Lillie E, Zarin W, et al. : PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169 (7): 467–473. PubMed Abstract | Publisher Full Text 63. Ash T, Agaronov A, Young T, et al. : Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis. Int J Behav Nutr Phys Act. 2017; 14 (1): 113. PubMed Abstract | Publisher Full Text | Free Full Text 64. World Health Organization: International Classification of Diseases, Eleventh Revision (ICD-11). 2019; [cited 2024 Sep 27]. Reference Source 65. Australian Institute of Health and Welfare: A working guide to international comparisons of health, PDF report table of contents. Canberra, 2012; 27, [cited 2024 Sep 27]. Reference Source 66. Hong QN, Fàbregues S, Bartlett G, et al. : The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information. 2018; 34 (4): 285–291. Publisher Full Text 67. Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006; 3 (2): 77–101. Publisher Full Text 68. Page MJ, McKenzie JE, Bossuyt PM, et al. : The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372 : n71. PubMed Abstract | Publisher Full Text | Free Full Text 69. van der Braak K, Ghannad M, Orelio C, et al. : The score after 10 years of registration of systematic review protocols. Syst Rev. 2022; 11 (1): 191. PubMed Abstract | Publisher Full Text | Free Full Text 70. Gallant A: Scope for Health PRISMA ScR Checklist. 2025. https://osf.io/hwnua/ Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 07 Feb 2025 ADD YOUR COMMENT Comment Author details Author details 1 Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Leinster, Ireland 2 Department of Psychiatry, Royal College of Surgeons in Ireland 26 York Street Campus, Dublin, Leinster, Ireland 3 University College Cork, Cork, County Cork, Ireland 4 School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Leinster, Ireland 5 Mental Health Ireland, Dublin, Ireland 6 ARCHES Recovery College, Dublin, Ireland 7 School of Psychology, University of Galway, Galway, County Galway, Ireland 8 School of Medicine, University of Galway, Galway, County Galway, Ireland 9 Dublin City University School of Nursing Psychotherapy and Community Health, Dublin, Leinster, Ireland Allyson J Gallant Roles: Data Curation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing John Paul Lyne Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Karen O'Connor Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Greg Sheaf Roles: Data Curation, Investigation, Methodology, Resources, Software, Writing – Review & Editing Shaakya Anand-Vembar Roles: Methodology, Writing – Review & Editing Donal O'Keeffe Roles: Conceptualization, Funding Acquisition, Methodology, Writing – Review & Editing Caroline Wilson Roles: Project Administration, Writing – Review & Editing Yulia Kartalova- O'Doherty Roles: Methodology, Writing – Review & Editing Louise Doyle Roles: Conceptualization, Funding Acquisition, Methodology Mary Cannon Roles: Conceptualization, Funding Acquisition, Methodology Leona Ryan Roles: Methodology, Writing – Review & Editing Gary Donohoe Roles: Conceptualization, Funding Acquisition, Methodology David McEvoy Roles: Methodology, Writing – Review & Editing David Cotter Roles: Conceptualization, Funding Acquisition, Methodology, Project Administration Olivia Longe Roles: Methodology, Writing – Review & Editing Colm McDonald Roles: Conceptualization, Funding Acquisition, Methodology Agnes Higgins Roles: Conceptualization, Funding Acquisition, Methodology Rebecca Murphy Roles: Conceptualization, Funding Acquisition, Methodology Sara Burke Roles: Conceptualization, Funding Acquisition, Methodology Catherine D Darker Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This study is funded by the Health Research Board Ireland- Applied Programme Grant 2023 (reference: 9610). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 12 May 2025, 8:28 https://doi.org/10.12688/hrbopenres.14032.2 version 1 Published: 07 Feb 2025, 8:28 https://doi.org/10.12688/hrbopenres.14032.1 Copyright © 2025 Gallant AJ et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Gallant AJ, Lyne JP, O'Connor K et al. Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.12688/hrbopenres.14032.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 12 May 2025 Revised Views 0 Cite How to cite this report: Kang M. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47635 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47635 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 21 Jul 2025 Melissa Kang , The University of Sydney, Sydney, Australia Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15560.r47635 Thank you for inviting me to review this manuscript, a protocol for a scoping review. The topic and objectives are important to advance the field of health services research in adolescent and youth health. I note that the context of ... Continue reading READ ALL Thank you for inviting me to review this manuscript, a protocol for a scoping review. The topic and objectives are important to advance the field of health services research in adolescent and youth health. I note that the context of this review relates to/ intends to align with, national mental health policy in Ireland. I note that this is a revised manuscript that has been reviewed by (I assume) the two original reviewers. Therefore I provide this brief review to offer any additional questions or comments as the review process and revisions are thorough, detailed and thoughtful. Terminology and Definitions - There is clarity about the definition of young people and justification for the age range in the eligibility criteria, which is important. - Can I suggest changing ‘Sexual Health’ to ‘Sexual and Reproductive Health’ ? There is (finally!) increasing use of this expression which is more comprehensive. - ‘Mental health difficulty’ – I note the clarity/ definition in using this term in the Eligibility criteria. Conceptualising holistic care While this scoping review aims to consider the physical and sexual (and reproductive) health needs for young people with a mental health difficulty, the ‘starting place’ / ‘index health issue’ is 'mental health difficulty'. This makes sense given that the purpose of the review springs from mental health policy. I argue that a biopsychosocial approach, and integrated care, doesn’t have a starting place that is an ICD-11 or any other diagnostic category but starts with the young person. A chronic or life-threatening physical health condition could lead to mental health difficulties, as could unplanned pregnancy or sexual violence or being in a sexual or gender minority. For the purposes of defining parameters for the scoping review, it is reasonable to start with the population as described in Table 1, but I would like to see this issue of health issue-centred care rather than person-centred care mentioned in the Discussion/ Limitations. Exclusion of neurodevelopmental conditions and substance use or abuse should also be considered among Limitations since they are generally intertwined with mental health difficulties. Scope of sexual (and reproductive) health issues May I suggest that sexual function be included/ considered – the authors list fertility management, STIs and sexual violence as potential issues; and report on the association between ‘high-risk sexual behaviours’ and mental health difficulties among young people. However there are potential sexual function side effects from commonly prescribed medications (such as SSRIs) and of course strong associations between mental health difficulties (including suicide) among young people from sexuality and/or gender diverse populations. Mental Health Policy - Sharing the Vision It would be interesting to include a brief paragraph which summarises the policy objectives pertaining to young people. Please note these are minor comments and I think the manuscript can be published in its current form (with the exception to add ‘reproductive’ in ‘sexual health’. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Health services research and models of care for young people; knowledge translation/ implementation of policy and programs I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Kang M. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47635 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47635 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Kågesten AE. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47235 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47235 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 05 Jun 2025 Anna E Kågesten , Karolinska Institutet, Stockholm, Sweden Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15560.r47235 Thank you to the authors for sharing their revised version. All my ... Continue reading READ ALL Thank you to the authors for sharing their revised version. All my comments have been addressed and I have no futther comments to make. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Sexual and reproductive health and rights; Sexual wellbeing; Adolescent Health; Systematic and scoping reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Kågesten AE. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47235 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47235 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Brown E. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47234 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47234 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 May 2025 Ellie Brown , The University of Melbourne, Melbourne, Victoria, Australia Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15560.r47234 Thanks to the reviewers ... Continue reading READ ALL Thanks to the reviewers for making the suggested amendments. Competing Interests: No competing interests were disclosed. Reviewer Expertise: I am an academic with expertise in youth mental health, models of care, physical health and sexual wellbeing in youth mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Brown E. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47234 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47234 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 07 Feb 2025 Views 0 Cite How to cite this report: Brown E. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r46252 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-46252 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Mar 2025 Ellie Brown , The University of Melbourne, Melbourne, Victoria, Australia Approved with Reservations VIEWS 0 https://doi.org/10.21956/hrbopenres.15403.r46252 Thank you for inviting me to review this manuscript. Some specific comments that I feel would help strengthen it further follow: Background - you suggest that severe mental health difficulties are vulnerable to several physical conditions due ... Continue reading READ ALL Thank you for inviting me to review this manuscript. Some specific comments that I feel would help strengthen it further follow: Background - you suggest that severe mental health difficulties are vulnerable to several physical conditions due to antipsychotic medication, but just attributing it to this misses the impact of lifestyle factors as well such as sedatory behaviors and increased smoking and poor diet. I suggest expanding these examples. In your eligibility criteria you state 'Studies should include young people, defined as those aged ten and up to, and including, 25 years' but I wonder how you might consider samples that cover up to 30 years old but with a mean age of under 25? Discussion: "Findings from this review will improve our understanding of shared model of care" type in model(s) Overall this is an important topic, a well written protocol, and I look forward to reading the findings of your scoping review! Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: I am an academic with expertise in youth mental health, models of care, physical health and sexual wellbeing in youth mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Brown E. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r46252 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-46252 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 03 Jun 2025 Allyson Gallant , Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland 03 Jun 2025 Author Response 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference ... Continue reading 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference 2.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 3.) Thank you for these thoughtful comments and catching the typo! We have now addressed this on page 13. 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference 2.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 3.) Thank you for these thoughtful comments and catching the typo! We have now addressed this on page 13. Competing Interests: NA Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 03 Jun 2025 Allyson Gallant , Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland 03 Jun 2025 Author Response 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference ... Continue reading 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference 2.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 3.) Thank you for these thoughtful comments and catching the typo! We have now addressed this on page 13. 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference 2.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 3.) Thank you for these thoughtful comments and catching the typo! We have now addressed this on page 13. Competing Interests: NA Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Kågesten AE. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r45551 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-45551 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 24 Mar 2025 Anna E Kågesten , Karolinska Institutet, Stockholm, Sweden Approved with Reservations VIEWS 0 https://doi.org/10.21956/hrbopenres.15403.r45551 Thank you for the opportunity to review this paper, which I have read with great interest. This is an overall well-written protocol for a scoping review mapping barriers, enablers and implementation enablers for shared models of care in relation to ... Continue reading READ ALL Thank you for the opportunity to review this paper, which I have read with great interest. This is an overall well-written protocol for a scoping review mapping barriers, enablers and implementation enablers for shared models of care in relation to physical and sexual wellbeing among young people with mental health difficulties. The focus of the review on a specific topic, which has not been extensively mapped before, is a key strength. In addition, the CFIR is suitable given the implementation focus. However, there are a number of places where the protocol would benefit from additional details or clarification. Below I have included some major points for the author's consideration. First, Please clarify the rationale behind choosing a scoping review design for this paper, as it seems more aligned with a systematic review approach. Typically, a scoping review does not involve quality assessments or critical appraisal of included studies, as planned in this case. Instead, it usually aims to map existing evidence on a topic rather than to determine causality or what influences what. Considering your second aim, which focuses on determinants of shared care models, it is unclear why a systematic review is not being conducted. Additionally, I am curious about the overall strength of the evidence generated from the review, particularly in relation to understanding “determinants.” If you are using a thematic approach to synthesizing findings, will you be applying tools such as GRADE-CERQual to assess the quality and confidence of the evidence? Clarifying this aspect would strengthen the methodological rigor. Second, I am not familiar with the use of reflexive thematic analysis in the context of a scoping review (or even a systematic review), as this method is traditionally applied to qualitative data. In your paper, it seems that you are combining different study designs. It would be helpful to clarify how you plan to differentiate and code quantitative versus qualitative findings. Furthermore, the use of thematic synthesis (distinct from thematic analysis) is typically suited for qualitative studies, whereas thematic summary can be applied to quantitative studies. You also mention that the data will be aggregated and summarized narratively, with figures used to support narratives. Could you specify whether this approach is consistent with reflective thematic analysis, and clearly define what you mean by “narratives” in this context? Are these the main themes identified, or are they related to another analytical approach? Third, the definition of “sexual health and wellbeing” cited in the introduction is not commonly used or widely recognized within the field of Sexual and Reproductive Health and Rights (SRHR). These two concepts, while interrelated, are distinct and often conceptualized differently. To enhance clarity and alignment with existing literature, consider referencing more established definitions or frameworks, such as: Mitchell et al.’s framework for sexual wellbeing, which highlights the relationship between health, wellbeing, rights, and justice. [Ref 1] The Guttmacher-Lancet integrated definition of SRHR, which comprehensively covers related concepts. [Ref 2] Additionally, the term “common sexual health concerns” among youth does not accurately reflect the most prevalent issues from a global perspective. I recommend adding unintended pregnancy, HIV/STIs, and sexual violence, rather than issues such as cervical cancer screening, as it is typically not a routine clinical service offered to youth (particularly those under the age of 25). If the issues listed are specific to the local study context, then please clarify this in the text. Please also clarify the definition of "youth" used in the review. Currently, it seems to include individuals aged 25, which is higher than the international standard definitions (e.g., WHO defines “youth” as 15-24 years and “young people” as 10-24 years). Would it be more appropriate to refer to those aged 25-30 as “young adults” instead? Finally, the only limitation mentioned in the paper is that not all relevant studies may be identified. While this is a common and expected limitation of any review, it would be helpful to acknowledge other potential limitations specific to your approach. For example: biases introduced by combining qualitative and quantitative data without clear differentiation; and the challenge of assessing evidence quality when using diverse study designs. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Partly Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable References 1. Mitchell KR, Lewis R, O'Sullivan LF, Fortenberry JD: What is sexual wellbeing and why does it matter for public health?. Lancet Public Health . 2021; 6 (8): e608-e613 PubMed Abstract | Publisher Full Text 2. Starrs AM, Ezeh AC, Barker G, Basu A, et al.: Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission. Lancet . 2018; 391 (10140): 2642-2692 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Sexual and reproductive health and rights; Sexual wellbeing; Adolescent Health; Systematic and scoping reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Kågesten AE. Reviewer Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r45551 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-45551 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 22 May 2025 Allyson Gallant , Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland 22 May 2025 Author Response Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic ... Continue reading Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic review as we are seeking to identify the breadth of evidence on shared models of care to summarise what has previously been done, rather than to answer a specific, in-depth question or identify effective components of shared models of care as with a systematic review. Additionally, we would likely be unable to do an adequate synthesis of the evidence to complete a systematic review as we anticipate a high level of heterogeneity in both the literature sources and their quality. Summarising the breadth of evidence will likely be a more sensible approach to address our aims compared to a systematic review. We have added a few more details on Page 8 and Page 12, and a new citation (highlighted below) to the manuscript to help address this. Finally, the critical appraisals of included sources is an optional step on a scoping review as outlined by JBI and the PRISMA-ScR reporting guidelines. We will also be including all evidence sources regardless of the critical appraisal/MMAT scores, which can differ from typical systematic reviews. Our critical appraisal will therefore inform our understanding of the quality of the existing research, affording us the opportunity to include a commentary on quality rather than utilising quality appraisal as a mechanism for exclusion of studies. Reference: Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18, 1-7. 2.) The use of reflexive thematic analysis has been previously used in other reviews by research team members and in mental health/implementation science systematic reviews (see citations below). When we refer to “narratives” in our proposed approach, we mean the analytically constructed accounts that represent patterns of shared meaning—namely, the main themes generated through iterative analysis. These narratives are not participant case studies or chronological storylines but rather represent the interpretative presentation of the central themes identified through coding and theme development. Any figures included will be intended to illustrate and support these themes, providing visual clarity to aspects of the analysis (e.g., thematic maps, frequency counts of theme prevalence if appropriate, or illustrative quotes), rather than to quantify findings in a positivist sense. References: O’connell, N., O’connor, K., McGrath, D., Vagge, L., Mockler, D., Jennings, R., & Darker, C. D. (2022). Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry, 65(1), e2. Geerligs, L., Rankin, N. M., Shepherd, H. L., & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13, 1-17. 3.) Thank you for these insights and additional references to consider. We have revised the definition we used for sexual health & wellbeing to a more suitable international context, using the Mitchell et al (2021) framework suggested. Please see page 5 for the revised terminology. 4.)We have revised this section in the manuscript to better reflect the current health needs and concerns of youth, based on a new WHO report. Please see revisions on Page 5. 5.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 6.) We have now revised this paragraph to be more comprehensive. Please see page 12. Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic review as we are seeking to identify the breadth of evidence on shared models of care to summarise what has previously been done, rather than to answer a specific, in-depth question or identify effective components of shared models of care as with a systematic review. Additionally, we would likely be unable to do an adequate synthesis of the evidence to complete a systematic review as we anticipate a high level of heterogeneity in both the literature sources and their quality. Summarising the breadth of evidence will likely be a more sensible approach to address our aims compared to a systematic review. We have added a few more details on Page 8 and Page 12, and a new citation (highlighted below) to the manuscript to help address this. Finally, the critical appraisals of included sources is an optional step on a scoping review as outlined by JBI and the PRISMA-ScR reporting guidelines. We will also be including all evidence sources regardless of the critical appraisal/MMAT scores, which can differ from typical systematic reviews. Our critical appraisal will therefore inform our understanding of the quality of the existing research, affording us the opportunity to include a commentary on quality rather than utilising quality appraisal as a mechanism for exclusion of studies. Reference: Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18, 1-7. 2.) The use of reflexive thematic analysis has been previously used in other reviews by research team members and in mental health/implementation science systematic reviews (see citations below). When we refer to “narratives” in our proposed approach, we mean the analytically constructed accounts that represent patterns of shared meaning—namely, the main themes generated through iterative analysis. These narratives are not participant case studies or chronological storylines but rather represent the interpretative presentation of the central themes identified through coding and theme development. Any figures included will be intended to illustrate and support these themes, providing visual clarity to aspects of the analysis (e.g., thematic maps, frequency counts of theme prevalence if appropriate, or illustrative quotes), rather than to quantify findings in a positivist sense. References: O’connell, N., O’connor, K., McGrath, D., Vagge, L., Mockler, D., Jennings, R., & Darker, C. D. (2022). Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry, 65(1), e2. Geerligs, L., Rankin, N. M., Shepherd, H. L., & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13, 1-17. 3.) Thank you for these insights and additional references to consider. We have revised the definition we used for sexual health & wellbeing to a more suitable international context, using the Mitchell et al (2021) framework suggested. Please see page 5 for the revised terminology. 4.)We have revised this section in the manuscript to better reflect the current health needs and concerns of youth, based on a new WHO report. Please see revisions on Page 5. 5.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 6.) We have now revised this paragraph to be more comprehensive. Please see page 12. Competing Interests: NA Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 22 May 2025 Allyson Gallant , Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland 22 May 2025 Author Response Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic ... Continue reading Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic review as we are seeking to identify the breadth of evidence on shared models of care to summarise what has previously been done, rather than to answer a specific, in-depth question or identify effective components of shared models of care as with a systematic review. Additionally, we would likely be unable to do an adequate synthesis of the evidence to complete a systematic review as we anticipate a high level of heterogeneity in both the literature sources and their quality. Summarising the breadth of evidence will likely be a more sensible approach to address our aims compared to a systematic review. We have added a few more details on Page 8 and Page 12, and a new citation (highlighted below) to the manuscript to help address this. Finally, the critical appraisals of included sources is an optional step on a scoping review as outlined by JBI and the PRISMA-ScR reporting guidelines. We will also be including all evidence sources regardless of the critical appraisal/MMAT scores, which can differ from typical systematic reviews. Our critical appraisal will therefore inform our understanding of the quality of the existing research, affording us the opportunity to include a commentary on quality rather than utilising quality appraisal as a mechanism for exclusion of studies. Reference: Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18, 1-7. 2.) The use of reflexive thematic analysis has been previously used in other reviews by research team members and in mental health/implementation science systematic reviews (see citations below). When we refer to “narratives” in our proposed approach, we mean the analytically constructed accounts that represent patterns of shared meaning—namely, the main themes generated through iterative analysis. These narratives are not participant case studies or chronological storylines but rather represent the interpretative presentation of the central themes identified through coding and theme development. Any figures included will be intended to illustrate and support these themes, providing visual clarity to aspects of the analysis (e.g., thematic maps, frequency counts of theme prevalence if appropriate, or illustrative quotes), rather than to quantify findings in a positivist sense. References: O’connell, N., O’connor, K., McGrath, D., Vagge, L., Mockler, D., Jennings, R., & Darker, C. D. (2022). Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry, 65(1), e2. Geerligs, L., Rankin, N. M., Shepherd, H. L., & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13, 1-17. 3.) Thank you for these insights and additional references to consider. We have revised the definition we used for sexual health & wellbeing to a more suitable international context, using the Mitchell et al (2021) framework suggested. Please see page 5 for the revised terminology. 4.)We have revised this section in the manuscript to better reflect the current health needs and concerns of youth, based on a new WHO report. Please see revisions on Page 5. 5.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 6.) We have now revised this paragraph to be more comprehensive. Please see page 12. Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic review as we are seeking to identify the breadth of evidence on shared models of care to summarise what has previously been done, rather than to answer a specific, in-depth question or identify effective components of shared models of care as with a systematic review. Additionally, we would likely be unable to do an adequate synthesis of the evidence to complete a systematic review as we anticipate a high level of heterogeneity in both the literature sources and their quality. Summarising the breadth of evidence will likely be a more sensible approach to address our aims compared to a systematic review. We have added a few more details on Page 8 and Page 12, and a new citation (highlighted below) to the manuscript to help address this. Finally, the critical appraisals of included sources is an optional step on a scoping review as outlined by JBI and the PRISMA-ScR reporting guidelines. We will also be including all evidence sources regardless of the critical appraisal/MMAT scores, which can differ from typical systematic reviews. Our critical appraisal will therefore inform our understanding of the quality of the existing research, affording us the opportunity to include a commentary on quality rather than utilising quality appraisal as a mechanism for exclusion of studies. Reference: Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18, 1-7. 2.) The use of reflexive thematic analysis has been previously used in other reviews by research team members and in mental health/implementation science systematic reviews (see citations below). When we refer to “narratives” in our proposed approach, we mean the analytically constructed accounts that represent patterns of shared meaning—namely, the main themes generated through iterative analysis. These narratives are not participant case studies or chronological storylines but rather represent the interpretative presentation of the central themes identified through coding and theme development. Any figures included will be intended to illustrate and support these themes, providing visual clarity to aspects of the analysis (e.g., thematic maps, frequency counts of theme prevalence if appropriate, or illustrative quotes), rather than to quantify findings in a positivist sense. References: O’connell, N., O’connor, K., McGrath, D., Vagge, L., Mockler, D., Jennings, R., & Darker, C. D. (2022). Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry, 65(1), e2. Geerligs, L., Rankin, N. M., Shepherd, H. L., & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13, 1-17. 3.) Thank you for these insights and additional references to consider. We have revised the definition we used for sexual health & wellbeing to a more suitable international context, using the Mitchell et al (2021) framework suggested. Please see page 5 for the revised terminology. 4.)We have revised this section in the manuscript to better reflect the current health needs and concerns of youth, based on a new WHO report. Please see revisions on Page 5. 5.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 6.) We have now revised this paragraph to be more comprehensive. Please see page 12. Competing Interests: NA Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 07 Feb 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 2 (revision) 12 May 25 read read read Version 1 07 Feb 25 read read Anna E Kågesten , Karolinska Institutet, Stockholm, Sweden Ellie Brown , The University of Melbourne, Melbourne, Australia Melissa Kang , The University of Sydney, Sydney, Australia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Kang M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 21 Jul 2025 | for Version 2 Melissa Kang , The University of Sydney, Sydney, Australia 0 Views copyright © 2025 Kang M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for inviting me to review this manuscript, a protocol for a scoping review. The topic and objectives are important to advance the field of health services research in adolescent and youth health. I note that the context of this review relates to/ intends to align with, national mental health policy in Ireland. I note that this is a revised manuscript that has been reviewed by (I assume) the two original reviewers. Therefore I provide this brief review to offer any additional questions or comments as the review process and revisions are thorough, detailed and thoughtful. Terminology and Definitions - There is clarity about the definition of young people and justification for the age range in the eligibility criteria, which is important. - Can I suggest changing ‘Sexual Health’ to ‘Sexual and Reproductive Health’ ? There is (finally!) increasing use of this expression which is more comprehensive. - ‘Mental health difficulty’ – I note the clarity/ definition in using this term in the Eligibility criteria. Conceptualising holistic care While this scoping review aims to consider the physical and sexual (and reproductive) health needs for young people with a mental health difficulty, the ‘starting place’ / ‘index health issue’ is 'mental health difficulty'. This makes sense given that the purpose of the review springs from mental health policy. I argue that a biopsychosocial approach, and integrated care, doesn’t have a starting place that is an ICD-11 or any other diagnostic category but starts with the young person. A chronic or life-threatening physical health condition could lead to mental health difficulties, as could unplanned pregnancy or sexual violence or being in a sexual or gender minority. For the purposes of defining parameters for the scoping review, it is reasonable to start with the population as described in Table 1, but I would like to see this issue of health issue-centred care rather than person-centred care mentioned in the Discussion/ Limitations. Exclusion of neurodevelopmental conditions and substance use or abuse should also be considered among Limitations since they are generally intertwined with mental health difficulties. Scope of sexual (and reproductive) health issues May I suggest that sexual function be included/ considered – the authors list fertility management, STIs and sexual violence as potential issues; and report on the association between ‘high-risk sexual behaviours’ and mental health difficulties among young people. However there are potential sexual function side effects from commonly prescribed medications (such as SSRIs) and of course strong associations between mental health difficulties (including suicide) among young people from sexuality and/or gender diverse populations. Mental Health Policy - Sharing the Vision It would be interesting to include a brief paragraph which summarises the policy objectives pertaining to young people. Please note these are minor comments and I think the manuscript can be published in its current form (with the exception to add ‘reproductive’ in ‘sexual health’. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Health services research and models of care for young people; knowledge translation/ implementation of policy and programs I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Kang M. Peer Review Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47635) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47635 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Kågesten A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 05 Jun 2025 | for Version 2 Anna E Kågesten , Karolinska Institutet, Stockholm, Sweden 0 Views copyright © 2025 Kågesten A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you to the authors for sharing their revised version. All my comments have been addressed and I have no futther comments to make. Competing Interests No competing interests were disclosed. Reviewer Expertise Sexual and reproductive health and rights; Sexual wellbeing; Adolescent Health; Systematic and scoping reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Kågesten AE. Peer Review Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47235) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47235 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Brown E. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 May 2025 | for Version 2 Ellie Brown , The University of Melbourne, Melbourne, Victoria, Australia 0 Views copyright © 2025 Brown E. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thanks to the reviewers for making the suggested amendments. Competing Interests No competing interests were disclosed. Reviewer Expertise I am an academic with expertise in youth mental health, models of care, physical health and sexual wellbeing in youth mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Brown E. Peer Review Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15560.r47234) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v2#referee-response-47234 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Brown E. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Mar 2025 | for Version 1 Ellie Brown , The University of Melbourne, Melbourne, Victoria, Australia 0 Views copyright © 2025 Brown E. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for inviting me to review this manuscript. Some specific comments that I feel would help strengthen it further follow: Background - you suggest that severe mental health difficulties are vulnerable to several physical conditions due to antipsychotic medication, but just attributing it to this misses the impact of lifestyle factors as well such as sedatory behaviors and increased smoking and poor diet. I suggest expanding these examples. In your eligibility criteria you state 'Studies should include young people, defined as those aged ten and up to, and including, 25 years' but I wonder how you might consider samples that cover up to 30 years old but with a mean age of under 25? Discussion: "Findings from this review will improve our understanding of shared model of care" type in model(s) Overall this is an important topic, a well written protocol, and I look forward to reading the findings of your scoping review! Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise I am an academic with expertise in youth mental health, models of care, physical health and sexual wellbeing in youth mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 03 Jun 2025 Allyson Gallant, Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland 1.) We have now added that physical health can be affected by both modifiable individual behaviours and mental health treatment plans. Please see page 4 for this update and additional reference 2.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 3.) Thank you for these thoughtful comments and catching the typo! We have now addressed this on page 13. View more View less Competing Interests NA reply Respond Report a concern Brown E. Peer Review Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r46252) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-46252 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Kågesten A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 24 Mar 2025 | for Version 1 Anna E Kågesten , Karolinska Institutet, Stockholm, Sweden 0 Views copyright © 2025 Kågesten A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the opportunity to review this paper, which I have read with great interest. This is an overall well-written protocol for a scoping review mapping barriers, enablers and implementation enablers for shared models of care in relation to physical and sexual wellbeing among young people with mental health difficulties. The focus of the review on a specific topic, which has not been extensively mapped before, is a key strength. In addition, the CFIR is suitable given the implementation focus. However, there are a number of places where the protocol would benefit from additional details or clarification. Below I have included some major points for the author's consideration. First, Please clarify the rationale behind choosing a scoping review design for this paper, as it seems more aligned with a systematic review approach. Typically, a scoping review does not involve quality assessments or critical appraisal of included studies, as planned in this case. Instead, it usually aims to map existing evidence on a topic rather than to determine causality or what influences what. Considering your second aim, which focuses on determinants of shared care models, it is unclear why a systematic review is not being conducted. Additionally, I am curious about the overall strength of the evidence generated from the review, particularly in relation to understanding “determinants.” If you are using a thematic approach to synthesizing findings, will you be applying tools such as GRADE-CERQual to assess the quality and confidence of the evidence? Clarifying this aspect would strengthen the methodological rigor. Second, I am not familiar with the use of reflexive thematic analysis in the context of a scoping review (or even a systematic review), as this method is traditionally applied to qualitative data. In your paper, it seems that you are combining different study designs. It would be helpful to clarify how you plan to differentiate and code quantitative versus qualitative findings. Furthermore, the use of thematic synthesis (distinct from thematic analysis) is typically suited for qualitative studies, whereas thematic summary can be applied to quantitative studies. You also mention that the data will be aggregated and summarized narratively, with figures used to support narratives. Could you specify whether this approach is consistent with reflective thematic analysis, and clearly define what you mean by “narratives” in this context? Are these the main themes identified, or are they related to another analytical approach? Third, the definition of “sexual health and wellbeing” cited in the introduction is not commonly used or widely recognized within the field of Sexual and Reproductive Health and Rights (SRHR). These two concepts, while interrelated, are distinct and often conceptualized differently. To enhance clarity and alignment with existing literature, consider referencing more established definitions or frameworks, such as: Mitchell et al.’s framework for sexual wellbeing, which highlights the relationship between health, wellbeing, rights, and justice. [Ref 1] The Guttmacher-Lancet integrated definition of SRHR, which comprehensively covers related concepts. [Ref 2] Additionally, the term “common sexual health concerns” among youth does not accurately reflect the most prevalent issues from a global perspective. I recommend adding unintended pregnancy, HIV/STIs, and sexual violence, rather than issues such as cervical cancer screening, as it is typically not a routine clinical service offered to youth (particularly those under the age of 25). If the issues listed are specific to the local study context, then please clarify this in the text. Please also clarify the definition of "youth" used in the review. Currently, it seems to include individuals aged 25, which is higher than the international standard definitions (e.g., WHO defines “youth” as 15-24 years and “young people” as 10-24 years). Would it be more appropriate to refer to those aged 25-30 as “young adults” instead? Finally, the only limitation mentioned in the paper is that not all relevant studies may be identified. While this is a common and expected limitation of any review, it would be helpful to acknowledge other potential limitations specific to your approach. For example: biases introduced by combining qualitative and quantitative data without clear differentiation; and the challenge of assessing evidence quality when using diverse study designs. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Partly Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable References 1. Mitchell KR, Lewis R, O'Sullivan LF, Fortenberry JD: What is sexual wellbeing and why does it matter for public health?. Lancet Public Health . 2021; 6 (8): e608-e613 PubMed Abstract | Publisher Full Text 2. Starrs AM, Ezeh AC, Barker G, Basu A, et al.: Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission. Lancet . 2018; 391 (10140): 2642-2692 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Sexual and reproductive health and rights; Sexual wellbeing; Adolescent Health; Systematic and scoping reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 22 May 2025 Allyson Gallant, Public Health & Primary Care, The University of Dublin Trinity College, Dublin, Ireland Thank you for these comments on our protocol and the opportunity to enhance our review. 1.) First, we are aiming to conduct a scoping review rather than a systematic review as we are seeking to identify the breadth of evidence on shared models of care to summarise what has previously been done, rather than to answer a specific, in-depth question or identify effective components of shared models of care as with a systematic review. Additionally, we would likely be unable to do an adequate synthesis of the evidence to complete a systematic review as we anticipate a high level of heterogeneity in both the literature sources and their quality. Summarising the breadth of evidence will likely be a more sensible approach to address our aims compared to a systematic review. We have added a few more details on Page 8 and Page 12, and a new citation (highlighted below) to the manuscript to help address this. Finally, the critical appraisals of included sources is an optional step on a scoping review as outlined by JBI and the PRISMA-ScR reporting guidelines. We will also be including all evidence sources regardless of the critical appraisal/MMAT scores, which can differ from typical systematic reviews. Our critical appraisal will therefore inform our understanding of the quality of the existing research, affording us the opportunity to include a commentary on quality rather than utilising quality appraisal as a mechanism for exclusion of studies. Reference: Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18, 1-7. 2.) The use of reflexive thematic analysis has been previously used in other reviews by research team members and in mental health/implementation science systematic reviews (see citations below). When we refer to “narratives” in our proposed approach, we mean the analytically constructed accounts that represent patterns of shared meaning—namely, the main themes generated through iterative analysis. These narratives are not participant case studies or chronological storylines but rather represent the interpretative presentation of the central themes identified through coding and theme development. Any figures included will be intended to illustrate and support these themes, providing visual clarity to aspects of the analysis (e.g., thematic maps, frequency counts of theme prevalence if appropriate, or illustrative quotes), rather than to quantify findings in a positivist sense. References: O’connell, N., O’connor, K., McGrath, D., Vagge, L., Mockler, D., Jennings, R., & Darker, C. D. (2022). Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry, 65(1), e2. Geerligs, L., Rankin, N. M., Shepherd, H. L., & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13, 1-17. 3.) Thank you for these insights and additional references to consider. We have revised the definition we used for sexual health & wellbeing to a more suitable international context, using the Mitchell et al (2021) framework suggested. Please see page 5 for the revised terminology. 4.)We have revised this section in the manuscript to better reflect the current health needs and concerns of youth, based on a new WHO report. Please see revisions on Page 5. 5.) We spent a long time within our group considering and discussing the age range of interest. Ultimately, we landed on utilising the age range within Ireland’s national mental health policy as our guide. The ‘bigger picture’ purpose of this review (alongside other activities) will be to inform the design of a new model of shared care for youth with mental health difficulties as regards to their physical and sexual wellbeing. We are therefore cognisant to keep our framework within the scope of the relevant national policies and the broader health services that will be tasked with implementation of any future model. We have added a few additional lines to the initial Methods paragraph to address this (please see Page 8). 6.) We have now revised this paragraph to be more comprehensive. Please see page 12. View more View less Competing Interests NA reply Respond Report a concern Kågesten AE. Peer Review Report For: Mapping barriers, enablers and implementation determinants to shared models of care for physical health and sexual wellbeing among young people with mental health difficulties using the Consolidated Framework for Implementation Research: A scoping review protocol [version 2; peer review: 3 approved] . HRB Open Res 2025, 8 :28 ( https://doi.org/10.21956/hrbopenres.15403.r45551) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-28/v1#referee-response-45551 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with HRB Open Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Mapping barriers, enablers and implementation...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://hrbopenresearch.org/articles/8-28/v2" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://hrbopenresearch.org/articles/8-28/v2&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://hrbopenresearch.org/articles/8-28/v2" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Gallant AJ et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://hrbopenresearch.org/articles/8-28/v2/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://hrbopenresearch.org/articles/8-28", templates : { twitter : "Mapping barriers, enablers and implementation determinants to.... Gallant AJ et al., published by " + "@HRBOpenRes" + ", https://hrbopenresearch.org/articles/8-28/v2" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/14032/15560") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "15560"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "47234": 9, "47235": 5, "45835": 0, "45836": 0, "45837": 0, "45838": 0, "45839": 0, "45840": 0, "45841": 0, "45842": 0, "47634": 0, "45843": 0, "46099": 0, "47635": 4, "45844": 0, "46100": 0, "47636": 0, "46101": 0, "47637": 0, "46102": 0, "47638": 0, "46103": 0, "47639": 0, "46104": 0, "47640": 0, "46105": 0, "47641": 0, "46106": 0, "47642": 0, "46107": 0, "47643": 0, "46108": 0, "47523": 0, "47524": 0, "47525": 0, "47526": 0, "47527": 0, "47528": 0, "46249": 0, "47529": 0, "46250": 0, "47530": 0, "46251": 0, "47531": 0, "46252": 9, "47532": 0, "46253": 0, "46254": 0, "46255": 0, "46256": 0, "46257": 0, "46258": 0, "47287": 0, "47415": 0, "47288": 0, "47416": 0, "47289": 0, "47417": 0, "47290": 0, "47418": 0, "47291": 0, "47419": 0, "47292": 0, "47420": 0, "47293": 0, "47421": 0, "47294": 0, "47422": 0, "45547": 0, "45548": 0, "45549": 0, "45550": 0, "45551": 22, "45552": 0, "45553": 0, "45554": 0, "45555": 0, "45556": 0, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "7ed8a973-02c7-4359-878d-ab7f3f303f51"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); Are you a HRB-funded researcher? Submission to HRB Open Research is open to all HRB grantholders or people working on a HRB-funded/co-funded grant on or since 1 January 2017. Sign up for information about developments, publishing and publications from HRB Open Research. First Name * You must provide your first name Last Name * You must provide your last name Email * You must provide a valid email address Institution You must provide an institution. Submit Thank you! We'll keep you updated on any major new updates to HRB Open Research HRB Open Research Browse How to Publish About Contact RSS Cookie Notice Privacy Notice Legal Submit Your Research © F1000 Research Limited and its licensors ISSN 2515-4826 | Legal background var F1000platform = new F1000.Platform({ name: "hrb", displayName: "HRB Open Research", hostName: "hrbopenresearch.org", id: "5", editorialEmail: "[email protected]", infoEmail: "[email protected]" }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); }); (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'a002a4681b858650',t:'MTc3OTUyNDQzNQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();