Barriers and facilitators to implementing childcare in long-term care homes: A scoping review protocol and consultative exercise

BACKGROUND: Long-term care (LTC) homes face persistent workforce recruitment and retention challenges, particularly among staff balancing professional responsibilities with childcare needs. Integrating childcare services within LTC homes has the potential to improve staff well-being, workforce stability, and resident experiences through intergenerational engagement. Despite this potential, the implementation literature remains fragmented, and no systematic synthesis of barriers, facilitators, or contextual determinants exists. OBJECTIVE: To systematically map the literature on barriers and facilitators to implementing childcare services within LTC homes and identify gaps to inform research, policy, and practice. METHODS: We will conduct a scoping review following the Arksey and O'Malley framework, enhanced by Levac et al., and report findings according to PRISMA-P and PRISMA-ScR guidelines. Literature searches will be conducted in MEDLINE, CINAHL, Embase, Scopus, and PsycINFO, supplemented by grey literature searches. Eligible studies include qualitative, quantitative, or mixed-methods research, program evaluations, and policy reports examining implementation of childcare services within or linked to LTC homes. Two reviewers will independently screen studies, extract data using a standardized form, and resolve discrepancies through discussion or a third reviewer. Extraction will capture study characteristics, childcare model details, reported barriers and facilitators, and outcomes. Findings will be synthesized narratively and organized thematically using the Consolidated Framework for Implementation Research (CFIR 2.0). Stakeholder engagement with LTC and early childhood centre staff will guide interpretation and knowledge translation. EXPECTED OUTCOMES: The review will identify key determinants of successful implementation, highlight gaps in the evidence, and provide actionable insights for LTC administrators, early childhood partners, and policymakers seeking to develop sustainable, equitable co-located childcare programs that benefit residents, children, and staff.