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Table 2 List of Key Mechanism of Actions (MoAs), the associating themes and intervention functions

From: Enabling women to access preferred methods of contraception: a rapid review and behavioural analysis

MoA (COM-B) Themes associated with the MoA Intervention Functions linked to COM-Ba
Environmental Context and Resources (Physical opportunity) (i) Advice from health care professionals
(ii) Advice from informal sources
(iii)Age limiting method of choice [sterilisation]
(iv)Contraception not a priority [for homeless] due to competing priorities/Lack of stability and transient lifestyle due to homelessness
(v) Cost
(vi)Underlying medical condition (diabetes) limiting choice
(vii) Health care professional’s lack of knowledge
(viii) Women’s lack of understanding of the UK context
(ix)Language barrier and cultural misunderstanding
(x)Women with learning disability not being involved in decision making or lack accessible information resources
(xi)Not being registered with GP
(xii)Perceived resistance by health care professionals to remove implant
(xiii)Unwelcoming healthcare setting
(xiv)Accessibility of location and time (including organisation of health service)
(xv)Easy availability of method
(xvi)Support by someone (such as key workers) for contraception appointment (for women with intellectual disability)
T, R, ER, En
Social Influences (Social opportunity) (i)Advice from informal sources
(ii)Embarrassment
(iii)Personal experience and other people’s experience
(iv)Pressure or Influence of young men and violence
(v)Religious background
(vi)Unwelcoming healthcare setting
(vii)Expectations of use and the influence of others
(viii)Partners perceived willingness [to use condom]
(ix)Relationship with health professionals
(x)Support by someone (such as key workers) for contraception appointment (for women with learning disability)
R, ER, M, En
Beliefs about Consequences (Reflective motivation) (i) Anticipated emotional cost of accessing services for women with drug problems
(ii)Concern about adding extra chemicals or hormones to the body/Perception that hormonal contraceptives are unnatural
(iii)Concern about side effects
(iv) Effect on menstruation
(v)Mechanism of the contraceptive methods or procedure of fitting them
(vi)Protects against sexually transmitted diseases
(vii)Comfort or convenience of method
(viii)Effectiveness of method at preventing pregnancy
(ix)Perceived positive benefit [predicts intention to use long-acting reversible contraception]
Ed, P, M
Knowledge (Psychological capability) (i) Women’s lack of understanding of the UK context
(ii)Language barrier and cultural misunderstanding
(iii)Poor information or knowledge about various birth control methods
(iv Health care professionals not providing sufficient information about contraception to women
(v)Not knowing where to get help or advice
(vi)Misconceptions about IUD
(vii)Real life experience of seeing an IUD
(viii)Knowledge of where to access services
(ix)Low perceived value of undergoing intervention as barrier for women with drug problems
Ed
Attitude towards the behaviour (Automatic motivation and reflective motivation) (i)Concern about adding extra chemicals or hormones to the body/Perception that hormonal contraceptives are unnatural
(ii)Personal experience and other peoples experience
Ed, P, I, C, T, ER, M, En
General Attitudes / Beliefs (reflective and automatic motivation and capability) (i)Trustworthiness of information source
(ii)Lackadaisical attitude, acceptance of pregnancy or feel pregnancy is not a problem
(iii) Being ‘in the moment’
(iv)Concern about adding extra chemicals or hormones to the body/Perception that hormonal contraceptives are unnatural
(v)Preference for female GP
(vi)Religious background or grounds
Ed, P, I, C, T, ER, M, En,
Perceived susceptibility / vulnerability (Automatic motivation and reflective motivation) (i) Anticipated emotional cost of accessing services for women with drug problems
(ii)Issues relating to mechanism of the contraceptive methods or procedure of fitting them
(iii)Misconceptions about IUD
Ed, P, I, C, T, ER, M, En
Values (Automatic motivation, reflective motivation and social opportunity) (i) Lackadaisical attitude, acceptance of pregnancy or feel pregnancy is not a problem
(ii)Protects against sexually transmitted diseases
(iii)Low perceived value of undergoing intervention as barrier for women with drug problems
E, P, I, C, T, R, ER, M, En
  1. aKey: Ed Education, P Persuasion, I Incentivisation, C Coercion, T Training, ER Environmental restructuring, M Modelling, En Enablement, R Restriction