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Table 4 COM-B and Theoretical Domains Framework applied to women’s use of liquefied petroleum gas (LPG) stoves

From: Designing a behavioral intervention using the COM-B model and the theoretical domains framework to promote gas stove use in rural Guatemala: a formative research study

Theoretical Domains Framework  
Domains Constructs General assessment questions for women in target households
Capability-Physical (COM-B)
  Skills Skills
Skills development
- Can women light the flame using a match and can they regulate the flame?
- Can women connect the tank to the stove?
- Can women turn gas on and off at the tank valve?
- Can women detect and respond to a gas leak?
- Can women lift and transport the tanks?
- Can women keep children out of the way of the tanks when cooking or when not cooking?
Capability-Psychological (COM-B)
  Knowledge Procedural knowledge - Do women know the sequence of steps for use of the stove on a daily basis?
- Do women know how to determine the tank is empty and how to turn stove off and attach a new tank?
- Do women know how to get the tank refilled and delivered to their home?
Knowledge (related to gas stove benefits) Household Benefits
- Do women know that using the gas stove makes a cleaner kitchen?
- Do women understand the economic and time-saving aspects of the stoves?
Health Benefits
- Do women understand the health benefits of avoiding wood smoke for them and their children?
Community or Ecological Benefits
- Do women know that using a gas stove reduces deforestation/saves ecologic resources?
Concerns
- Do women have concerns about the stove, (e.g. based on collective myth about explosion risk or other concerns)?
Knowledge of task environment - Do women have the interpersonal skills to promote gas stove use within their families?
  Memory, attention, and decision processes Attention - Can women remember how to use stove and tank, and can they demonstrate the steps involved?
Decision making - Can women recall a time when they were trying to cook and something happened to trigger them to stop using the gas stove and switch to the wood stove?
Cognitive overload - Can women concentrate on using the gas stove in different types of situations (e.g. when children are under foot, when mother in law is directing in the kitchen, when guests are present)?
  Behavioral regulation Self-monitoring - Do women have any symptoms that prompt them to avoid smoke exposures (headache, eye irritation, cough)?
Action planning - Are there some unavoidable situations where women must use wood? What are they?
- Can women plan ahead to use gas for parties with large amounts of food?
- Can women plan ahead to cook the animal food early on when the tank is full?
Motivation-Reflective (COM-B)
  Social/Professional Identity Identity (within household) - How do women feel being the owner of the gas stove? How has the stove changed how they spend their day?
- Does using the gas stove resonate with view of self as good cook and wife?
- What have other family members said about the stove?
Social identity - Do women know others who use a gas stove?
- Have women seen anyone else cooking with a gas stove outside their family?
- How is the women perceived by friends and family perceive her using the gas stove?
Group identity - Is there a community group that women could work together with to promote gas stove use?
- Would being part of a group of women who were using gas stoves enhance women’s roles in the community?
- Would this strengthen women’s view of themselves?
  Beliefs about capability Self-confidence - Do women feel confident they can use the gas stove for cooking most meals? Can women avoid using wood for cooking meals? Can women avoid using wood for other tasks?
Perceived behavioral control - Can women describe a time that they were not able to use the stove because others did not want them to? How confident were women about continuing to use the gas stove when this happens?
- What things do women do to influence the health of their family?
Self-esteem
Empowerment
- Do women believe that their actions are important for changing their family’s health?
- What things do women do to influence the health of their family?
- How do women think that using a gas stove can help their family’s health?
  Optimism Optimism
Pessimism
- Do women think that their actions can positively affect their children’s health?
- Do women think that no matter what they do, they cannot make a difference in children’s health? In their health?
Identity - Do women see themselves in charge of children and the cooking realm in the home?
  Beliefs about consequences Beliefs - Do women believe that changing to gas stoves will reduce the risk of illness to their children? To self? To others?
Outcome expectations - Do women believe that illnesses can be controlled/avoided by their own actions?
Consequences - What do women think will happen if they do not use the gas stove?
- What will happen if women start using the gas stove? If they don’t like the gas stove, will they be able to change back to the wood stove easily?
- What will happen if women stop using a wood stove?
- What do women gain or lose from switching stoves?
- What will happen if the woman tells their family that they are switching to a gas stove?
  Intentions Stability of intentions - What are women’s intentions for purchasing wood in the future?
- What are women’s intentions for purchasing refillable gas tanks in the future?
- What are women’s intentions for repairing the gas stove if it breaks in the future?
  Goals Goals - What are women’s goals for preventing respiratory illnesses in the family?
- What are women’s goals for using a gas stove? Using a wood stove?
- How much do they want to use a gas stove?
Motivation-Automatic (COM-B)
  Reinforcement Rewards - Are there any good reasons to use the gas stove over the wood stove? What are those reasons?
Consequences - Do women think that using the stove change has had other impacts in their home? Good or bad?
  Emotion Fear - How afraid are women when they use the gas stove?
- What makes women afraid of the stove? (probe on valve, gas leak, lighting, explosion, playing with knobs)
- How afraid are women about their children getting too close to the gas stove?
- What can women do to overcome these fears?
- What are women afraid may happen if they use it?
- Are others in the home afraid of the stove? What are they afraid of?
- Do women have fears about the wood stove? What are those fears?
Positive/negative affect - How happy or proud are women about using the stove?
- Have women’s interest in using this stove increased, or decreased or stayed the same over time?
Opportunity- Physical (COM-B)
  Environmental context and resources Environmental stressors - During certain seasons, is it harder to use a gas or a wood stove? What might make it easier to use the gas stove?
- Have price fluctuations in the cost of tank refills affected the household? How?
Resources/material resources - How does the family procure gas tank refills?
- Who does the stove repairs in the house? In the community?
- What if the stove broke? What would the woman do? Would she be able to afford to repair it?
- If she had to buy a new stove would she be able to do so? Would she have to borrow money? Can she buy a new stove on credit from a store?
Barriers and facilitators - Is it hard to get gas tank refills? Why? Discuss how she would go about refilling the tank when it is empty
- Is it hard to make repairs to the gas stove? Why? Discuss a time when she had to repair her stove and what she did
Opportunity- Social (COM-B)
  Social influences Social pressure - Do family/friends pressure women to use either the wood or the gas stove? Why does she think that happens?
What if women don’t agree to use the wood stove? Can she describe an instance where this happened?
Social supports - Do husbands provide support for tank refills and stove repairs? How? What kind of support?
- Do other friends and family provide support? How? What kind of support?
Group norms - Do women think that other women similar to them are starting to use gas stoves?
- Do women see themselves as setting an example for other women by using a gas stove? How does that make women feel?