Table 4.

Key enablers mapped to socioecological levels of influence and frequency reported

Level identified	Enabler	No of studies	References
Individual level	Demographic likelihood (increased age)	3	41 66 67
	Education and public awareness	7	31 43 56 67–70
	Stage of change—readiness	6	15 34 39 43 47 71
	Timing	6	13 31 61 65 67 69
Interpersonal level	Doctor–patient relationship (strength, length of, trust, familiarity)	10	14 15 42 48 49 61–64 67
	Nurse–patient relationship	5	14 64 72–74
	Conversation and deliberation	5	14 43 57 64 65
	Group interaction	2	66 73
	Previous experience with ACP	4	15 31 47 58
Provider level	GP and practice nurse education and communication training	8	14 60 65 69 74–77
	GP or practice nurse initiating the ACP discussion	6	14 46 50 52 63 74
	GP with philosophical agreement to ACP	8	40 42 43 49 55 57 58 63
	GP engagement in team approach	3	60 64 66
System level	IT systems—portals, prompts, decision aids	8	44 46 54 59 63 64 71 80
	Templates	6	57 63 67 70 75 78
	Business as usual processes and protocols	11	13 39 46 50 51 54 56 65 67 69 76
	Models of care—group appointments, nurse led clinics, ACP facilitators	10	14 49 60 64 66 72–74 76 79

ACP, advance care planning.