The U. S. Preventive Services Task Force recommends that clinicians engage in shared decision making with women at high-risk for breast cancer about medications to reduce their risk, also known as chemoprevention. However, uptake has been low (<5%) in the primary care setting. The goal of this project was to implement a comprehensive informatics framework to increase breast cancer risk assessment and chemoprevention in the primary care setting. We built a novel breast cancer risk navigation (BNAV) tool, which incorporates the Gail breast cancer risk model into the electronic health record. To address patient-related barriers to chemoprevention, an interactive decision aid, RealRisks, was developed that allows participants to experience risk through an activity. An automated system of theory-based tailored messaging was built to alert providers to engage in guideline-concordant chemoprevention practices. This innovative technology has high potential to facilitate evidence-based decision support for women's health in primary care setting.