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Table 3 Suggested strategies for affecting motivation in a health service

From: Who is responsible for assessing children’s weight status? – a qualitative study of health professionals in regional Australia

Suggested strategy Connection with BCW intervention function Rationale
Clear division of roles regarding who and when is responsible for undertaking of the assessment and providing feedback to parents Education
Enablement
Currently Obesity Guidelines [1] do not provide sufficient nor specific details about assessing primary school children’s weight status and so it cannot be defined in behavioural terms. This makes it difficult to design interventions aiming to bring on a desired change. The National Institute for Health and Care Excellence (NICE) changed how the recommendations in guidelines on schizophrenia were written to provide behaviourally specific terms [24].
Promotion of this assessment to parents and staff in various formats (for example, via video, brochures, posters, on screens in waiting rooms, flip charts on desks, in conversation with staff) and restructure of the physical environment in the practice (for example moving scales and stadiometer to another area) Enablement
Persuasion
Environmental restructuringa
Similar strategies were use in an intervention which used COM-B, TDF and BCW and aimed to improve implementation of the “Sepsis Six” clinical care bundle [39].
Education and training on the benefits of the undertaking of this check, how to conduct it and incorporate it into unrelated to weight consultationsb Education
Incentivisation (Continuing Professional Development points could be awarded)
Training
Persuasion
Intervention for smoking cessation care for Australian Indigenous pregnant women, which was designed with the BCW, used videos (training and motivational), webinars and resources to enhance motivation of health providers [40].
Nominating a “leader” in each practice who would encourage routine undertaking of this assessment, act as a resource and a role model for others Modelling Demonstration of behaviour by a health professional who staff aspire to is a recommended BCT under Modelling [24]. This strategy was also previously used to promote habit formation [39].
Audits of performance with provision of feedback (praise given for improved rates of weight status assessment), discussion about practice performance goals and challenges to assessment undertaking during staff meetings to generate solutions Coercion
Incentivisation (praise-social reward)
Enablement (problem solvingc)
Persuasion (feedback)
Similar strategies were use in an intervention which used COM-B, TDF and BCW and aimed to improve implementation of the “Sepsis Six” clinical care bundle [39].
  1. aalso addresses Physical Opportunity and Physical Capability; balso addresses Psychological Capability; calso addresses Psychological Capability and Social Opportunity