Abstract
OBJECTIVE: This study reports on the barriers and facilitators experienced by primary care providers, clinic staff and clinic leadership when implementing the SPARK Tool to collect demographic and social needs data in primary care clinics across Canada. DESIGN: A qualitative process evaluation was conducted using semistructured interviews and focus groups to identify facilitators and barriers to implementing the SPARK Tool, comprising 20 demographic and social needs questions, in primary care. A SPARK Tool Implementation Logic Model was developed to guide the implementation process. SETTING: The SPARK Tool was implemented over 6 months, from September 2022 to October 2023, at five primary care clinics across five Canadian provinces. PARTICIPANTS: 49 participants, including primary care providers, clinic staff and leadership, participated in an interview or focus group as part of this 6-month implementation study. RESULTS: Key facilitators included leadership support, the clinic's context (eg, staff availability and engagement, multidisciplinary teams), staff training and the provision of accessible materials. Barriers involved technological challenges, time constraints, privacy concerns and language limitations. Overall, the SPARK Tool facilitated the systematic and routine collection of demographic and social needs data, supporting individualised care plans informed by a more comprehensive capture of patient needs. The SPARK Tool Implementation Logic Model was adapted based on the findings of this study, which represent the adapted model's core components, including prerequisites, inputs, activities, outputs and outcomes. CONCLUSIONS: The study highlighted the potential of the SPARK Tool to integrate demographic and social needs data into primary care workflows, thereby improving individualised care and facilitating clinic-level service planning. It emphasised the importance of addressing barriers to ensure equitable implementation and long-term success.