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Table 8 Mapping BCTs to COM-B component, intervention functions and implementation strategy

From: Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare

Behavior change technique (BCTv1)

Motivation - Automatic

Motivation - Reflective

Capability - Psychological

Capability - Physical

Opportunity - Physical

Opportunity - Social

Implementation strategy

1.1 [45, 55,56,57]

Goal setting (behavior)

Enablement

     

Goal setting plans and workbooks to facilitate goal setting in practice

1.255–57,59

Problem-solving

Enablement

 

Enablement

   

Evidence-based practical solutions to problems that come up in consultation, such as how to introduce the topic and address common concerns

1.3 [45, 57]

Goal setting (outcome)

   

Enablement

  

Provide resources to support collaborative goal setting

1.4 [55, 56, 58]

Action planning

   

Enablement

  

Provide resources to support collaborative action planning

1.6 [55]

Discrepancy between current behavior and goal

Enablement

  

Enablement

  

Provide examples outlining the difference between successful and unsuccessful behavioral change conversations on physical activity and offer supporting education opportunities to address common problems recognized by clinicians

Provide a mechanism to assess physical activity levels for comparison to national recommendations

Identify disease-specific requirements of best practice

2.355–57,59

Self-monitoring of behavior

 

Education

Enablement

 

Enablement

 

Encourage reflective practice on the frequency of physical activity conversations

Provide self-monitoring tools and materials for healthcare professionals to use

4.1 [45, 55, 56, 58]

Instruction on how to perform a behavior

  

Training

Training

  

Demonstration on how to use physical activity resources. Include direction and supporting training capability on how to improve conversations on physical activity

5.1 [45, 55, 58]

Information about health consequences

 

Education and persuasion

Education

   

Provide education on the benefits of physical activity on the prevention and treatment of disease

Present comparably to other medical resources and report their evidence base

Customize resources by disease area and focus on symptomatic benefits

5.3 [55, 56]

Information about social and environmental consequences

 

Education and persuasion

Education

   

Give information on the global burden of physical inactivity and the role of healthcare in addressing this

Demonstrate the impact of physical activity counselling on general wellbeing and crossover benefits for conversations with patients and colleagues regarding other healthcare issues

Include quotes from patients and other professionals

6.2 [45, 58]

Social comparison

 

Persuasion

    

Develop assets relaying positive messages around the importance of physical activity conversations from patients, influential clinicians and professional bodies

6.1 [45, 56, 58]

Demonstration of the behavior

Modelling

 

Training

Training

  

Provide supporting training materials demonstrating real-life conversational skills between healthcare professionals and members of the public in routine clinical practice

Identify things to include and things to avoid when talking about physical activity to promote positive interactions

6.3

Information about others’ approval

Persuasion

Education, Persuasion

Education

   

Develop and disseminate in collaboration with affiliated professional bodies to provide credibility and alternate avenues for education

Facilitate the development of an ambassador network of engaged and like-minded individuals to take on local leadership roles

Include quotes from patients and other professionals

7.1 [45, 58]

Prompts/cues

Environmental restructuring

   

Environmental restructuring

Environmental restructuring

Provide resources such as leaflets, posters and digital assets, for instance, screensavers and email for display to improve visibility, awareness and prompt both healthcare professionals and members of the public to initiate physical activity conversations

Align with mandatory components of incentivized practise such as brief advice in established guidelines and care pathways

8.1 [45, 56, 58]

Behavioral practice/ rehearsal

  

Training

   

Advocate reflective practice and provide access to training resources

9.1 [58]

Credible source

Persuasion

Persuasion

    

Develop a trusted and recognizable source of information on physical activity in clinical practice

Peer approval and communication through collaboration and development with professional bodies

9.2 [58]

Pros and cons

  

Enablement

   

Explain the pros and cons of person-centered approaches to conversations on physical activity, citing relevant literature and fundamental concepts of behavioral change

12.1

Restructuring the physical environment

    

Enablement

 

Form a recognizable an open access, internet-based single point of access to disease-specific information on physical activity in the management of long-term conditions for healthcare professionals to access wherever they work

12.2 [56]

Restructuring the social environment

Environmental restructuring and enablement

   

Environmental restructuring

Environmental restructuring

Help define social norms around physical activity behaviors

Offer time-saving options for busy clinicians

Encourage patient-led initiation of physical activity conversations and give access to educational resources that colleagues can share

Provide an online community to support learning and facilitate sharing of good practice across workplaces

12.5 [55,56,57]

Adding objects to the environment

Environmental restructuring

 

Enablement

Enablement

Environmental restructuring and enablement

 

Provide resources to be displayed, for instance, in waiting areas, to prompt discussion and awareness amongst members of the public

Provide an online forum for interprofessional communication

Make all resources freely available online

13.1

Identification of self as a role model

Persuasion

Persuasion

Enablement

   

Share information on the importance of clinician behavior on influencing good practice amongst their patients and colleagues

15.3

Focus on past success

 

Persuasion

    

Provide resources and educational strategies to help clinicians reflect on positive conversations they may have had with patients about physical activity in the past and suggest theoretical reasons why they may have worked to help build self-efficacy

15.4 [45, 55]

Self-talk

   

Training

  

Encourage users to rehearse their conversational approach with patients