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Table 1 Preliminary key mechanisms. This table outlines the nine key mechanisms that were originally identified by our team following data synthesis. These mechanisms were incorporated into the initial program theory and presented to stakeholders for confirmation, refinement, and refutation

From: Development of a program theory for shared decision-making: a realist synthesis

Health care provider recognition of need for decision
Health care provider and patient preference/willingness for engagement
Health care provider perception of patient competency/capacity
Health care provider perception of time available and required for SDM
Patient anxiety
Patient capacity to access external support and information
Patient belief in their ability (self-efficacy) to participate in SDM
Health Care System Support (including decision aids)
Patient trust in individual health care provider as a person and as a professional