Abstract / Summary
Abstract Introduction Kidney genetics services are expanding globally, but implementation remains fragmented, variably resourced, and inequitable. We aimed to identify multilevel determinants of kidney genetics service implementation and align them with evidence-based strategies to inform a global implementation roadmap. Methods We conducted a scoping review following JBI methodology and PRISMA-ScR reporting guidelines, searching MEDLINE, Scopus, and Embase for English-language publications from 2000–2025. Determinants were coded using the Consolidated Framework for Implementation Research (CFIR) across innovation, individuals, inner setting, outer setting, and process domains. Priority barriers were matched to Expert Recommendations for Implementing Change (ERIC) strategies. Findings were triangulated with an international survey of kidney genetics clinic leads. Results Among 60 included studies, 28 reported implementation determinants. Barriers varied by region but most commonly included limited implementation team capability (n = 22), financing constraints (n = 16), service complexity (n = 14), policy and legal barriers (n = 10), resources limitations (n = 9), and low individual motivation (n = 8). Facilitators converged around innovation and inner setting domains, including perceived relative advantage (n = 12), design quality (n = 12), adaptability (n = 7), strong relational connections (n = 14), available resources (n = 8), and access to knowledge (n = 3). Survey responses from 48 international clinic leads corroborated these patterns. ERIC-matched priorities included utilizing financial strategies, developing stakeholder relationships, training stakeholders, and using evaluative and interactive strategies. Conclusion This CFIR–ERIC synthesis provides a theory-informed, strategy-linked roadmap for strengthening kidney genetics services and advancing equitable implementation globally.