Decision XXXX Use in Primary Care: An Overview and Theory-Based Framework.

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BACKGROUND AND OBJECTIVES: Increasing @entity1 ' participation in health care is a commonly cited goal. While @entity1 decision aids can promote participation, they remain underutilized. Theory-based models that assess barriers and facilitators to sustained decision @entity3224 use are needed. The ready, willing, and able model specifies three preconditions for behavioral change. We present a descriptive analysis of the uptake of @entity1 decision aids in the primary care setting and show how the ready, willing, and able model can be used to identify potential barriers and facilitators. METHODS: An Ovid Medline literature search from January 2004 to November 2014 was used; additional sources were identified from reference lists and through peer consultations. Barriers and facilitators to decision @entity3224 use were identified and grouped into salient themes. RESULTS: The ready, willing, and able model provided a simple yet practical framework for identifying the mechanisms that facilitate (or work against) the adoption of @entity1 decision aids within primary care. While time was a prominent barrier, additional barriers such as perceived legitimacy, clinic capacity, processes of care, and the overarching health care environment were also noted. CONCLUSIONS: The ready, willing, and able model posits that several preconditions must first be satisfied before sustained use of @entity1 decision aids can take hold. By pinpointing bottlenecks, the model can inform policies and tailored interventions to target identified problems. Using the model to troubleshoot for bottlenecks prior to the implementation of a decision @entity3224 could help to improve uptake and sustained use within the primary care setting.
