Describing Without Deciding: The Limits of Barriers-and-Facilitators Framing in Implementation Research

This manuscript analyzes approximately 1.5 million PubMed abstracts to examine whether barriers-and-facilitators research provides decision-useful evidence for policymakers and implementation leaders. It introduces a framework for evaluating implementation evidence based on prioritization, mechanism, institutional leverage, and actionable recommendations. The manuscript is accompanied by an open-source analysis pipeline and a public essay series exploring these ideas in greater depth.