Table 2.
BEAR (BEhavior and Acceptance fRamework) constructs and domains.
| Domaina | Domain definition | Constructsb |
| Knowledge | Awareness, understanding, or information about a subject that has been obtained by experience or study: based on [46] | Knowledge Knowledge of task environment Procedural knowledge Knowledge of the decision algorithm Knowledge of the patient’s condition Previous experience with decision support technology |
| Skills, ability, and competence | An ability or proficiency acquired through training and practice [28]: based on [47] | Skills, ability, and competence Computer and mobile device skill Interpersonal skills Skills development |
| Role and identity | A coherent set of behaviors and displayed personal qualities of an individual in a social or work setting [28]: based on [47] | Individual identity Professional identity Organizational commitment Professional boundaries Professional role Professional autonomy |
| Beliefs about capabilities | Acceptance of the truth, reality, or validity about an ability, talent, or facility that a person can put to constructive use [28]: based on [47] | Beliefs about capabilities Empowerment Perceived behavioral control Professional confidence Self-confidence Self-efficacy Self-esteem |
| Beliefs about consequences | Acceptance of the truth, reality, or validity about outcomes of a behavior in a given situation [28]: based on [47] | Beliefs about consequences Anticipated regret Outcome expectancies Beliefs that technology would disrupt the delivery of care Characteristics of outcome expectancies Concerns about liability and responsibility Concerns over patient privacy |
| Attitudes | Relatively enduring and general evaluations of an object, person, group, issue, or concept on a dimension ranging from negative to positive. Attitudes provide summary evaluations of target objects and are often assumed to be derived from specific beliefs, emotions, and past behaviors associated with those objects [48]. | Attitudes Interest in technology Perceived uselessness Optimism Pessimism Unrealistic optimism Attitude toward practice guidelines |
| Contingencies | A conditional probabilistic relationship between two events. Contingencies may be arranged via dependencies or they may emerge by accident [28]: citing [47]. | Contingencies Consequences Reinforcement Incentives Punishment Rewards Sanctions |
| Intentions | A conscious decision to perform a behavior; a resolve to act in a certain way or an impulse for purposeful action. In experiments, intention is often equated with goals defined by the task instruction [28]: citing [47]. | Intentions Stability of intentions Stages of change—precontemplation Stages of change—contemplation Stages of change—preparation Stages of change—action Stages of change—maintenance |
| Goals | Mental representations of outcomes or end states that an individual wants to achieve [28]: based on [47] | Goals Goals—level of control (autonomous vs controlled) Goals—temporality (distal vs proximal) Target setting Goal priority Action planning Change plan |
| Memory, attention, and decision processes | The ability to retain information, focus selectively on aspects of the environment, and choose between two or more alternatives [28]: based on [47] | Memory Attention Attention control Decision process Cognitive overload and tiredness |
| Environmental context and resources | Any circumstance of a person’s situation or environment that discourages or encourages the development of skills and abilities, independence, social competence, and adaptive behavior [28]: based on [47] | Environmental context Resources Environmental stressors Organizational structure Organizational culture and climate Assessment—skills Assessment—knowledge Assessment—performance Person × environment interaction Salient events and critical incidents Time availability—patient care Time availability—learning Technical support Technical infrastructure Facilities Implementation climate Tension for change Access to information and knowledge about the intervention |
| Social influences | Those interpersonal processes that can cause individuals to change their thoughts, feelings, or behaviors [28]: based on [47] The degree to which an individual perceives that others important to him or her believe he or she should use the new system [34] |
Social influences Alienation Group conformity Group identity Group norms Leadership Intergroup conflict Modelling Power Social comparisons Social norms Social pressure Social support |
| Emotions | A complex reaction pattern, involving experiential, behavioral, and physiological elements, by which the individual attempts to deal with a personally significant matter or event [28]: based on [47] | Emotions Affect Positive affect Negative affect Anxiety Burnout Depression Apprehension Fear Stress Frustration Uncertainty Dissatisfaction |
| Behavioral regulation | Anything aimed at managing or changing objectively observed or measured actions [28]: based on [47] | Behavioral regulation Breaking habit Self-monitoring |
| Intervention characteristics | Intervention attributes that facilitate or hinder its implementation. The intervention includes not only the system but also all processes and resources needed to deploy it. | Intervention characteristics Intervention source Adaptability Trialability Interoperability Implementation complexity Costs—initial Costs—recurrent Voluntariness of use |
| Performance expectancy | The degree to which an individual believes that using the system will help him or her to attain gains in job performance [34] | Performance expectancy Benefits for the patient Improved communication with other health professionals Improved access to knowledge Consistency of care Error prevention Time-saving Habituation |
| Effort expectancy | The effort an individual believes is required to implement or use the system | Effort expectancy Quality of the user interface Compatibility with the clinical workflow Access at the point of care Familiarization |
| Demographic characteristics | The characteristics of people who form a particular group, with reference to distribution, composition, or structure: based on [46,49] | Demographic characteristics Age Gender Professional experience Training level and educational level Nationality |
| System quality | The degree to which the information and functions provided by the system meet the user’s needs or expectations and give user satisfaction; the degree to which the system is free from deficiencies or defects: based on [50] | System quality System performance Output quality Output quality—accuracy Output quality—completeness Output quality—specificity Output quality—timeliness System reliability |
| Agreement with the decision algorithm | The degree to which the user agrees that the decision algorithm is a correct way to make the intended decision | Agreement with the decision algorithm Applicability to complex cases Evidence strength and quality |
| Patient–health professional relationship | The way the system affects the relationship between the health professional and the patient | Patient–health professional relationship Obtrusiveness Diminished eye contact Disruption of flow in conversation with the patient Knowledgeable image |
| Patient’s preferences | The way the patient’s preferences affect the health professional’s decision about using the system | Patient’s preferences Patient’s decision not to follow the recommendation |
aThe way we include references in this column seeks to help the reader trace back the origin of each definition. In cases where we use the same text from the source (ie, a textual citation), we only include the reference number. In cases where the source text was adapted, we precede the reference number with the phrase “based on.” In cases where the source is citing another source, we include a reference for the latter, preceded by the word “citing.” Finally, definitions without a reference were developed by the authors.
bConstruct definitions are included in Multimedia Appendix 1.