Table 4 Section of intervention mapping matrix for the performance objective “engage in exercise training” (NB: this is only a selection from the full intervention map for the wider change target “engaging in exercise training and physical activity to build (and maintain) cardiovascular fitness)”

1. Engage in exercise training sessions two to three times per week:

NB: Exercises designed to improve cardiovascular fitness, improve efficiency of movement and enhance the ability to perform functional activities associated with daily living (by building and maintaining muscle strength and prevention of muscle shortening).

Perceived importance/treatment efficacy

Illness perceptions

Provide information on consequences^a

Provide information on illness identity, timeline, causes, consequences and control to build a functional understanding/illness model (how HF works and how exercise affects HF)^b

Simultaneous self-monitoring of behaviour and symptoms^b

Prompt intention formation^a

Motivational interviewing^a

Manual text on benefits of PA/fitness in relation to HF symptoms (M).

Self-monitoring of symptoms (inc. mood, sleep quality) alongside progress with exercise to help build associations between exercise and health/learning from experience (M). Reflections by facilitator on these associations (F).

Discussion of existing knowledge about how heart failure works and how self-care actions affect symptoms, mood/stress and quality of life (F).

Assessment of barriers to activity and tailored support/encouragement using MI techniques (F).

Time

Time management^a

Assessment of barriers to activity and tailored support (F), including a time management activity in the manual (M).

Support from others

Plan social support (informational, emotional, practical)^a

Assessment of barriers to activity and tailored support (F), including exploration of social support.

Engage caregiver in a supporting role, with encouragement, planning and practical help (F).

Provide caregiver with Family and Friends manual (CGM).

Physical capacity

Individual tailoring of exercise level to current fitness^b

Set starting level to match existing capacity (based on incremental shuttle walk test (F).

Confidence (self-efficacy)

Set graded tasks (graded efficacy and capacity building)^a

Prompt-specific goal setting^a

Prompt barrier identification (and problem solving)^a

Prompt review of behavioural goals^a

Motivational interviewing^a

Multi-level DVD of graded exercises to demonstrate suitable exercises (M).

Walking programme

As an alternative to the DVD.

Facilitation of use of action-planning and problem-solving tools in the manual and Progress Tracker (F, M).

Regular review of progress and increasing goals for level/duration of exercise, when existing level becomes easy (F).

Exploring and addressing barriers through use of MI techniques (F).

Enjoyment

Offer choice of options for exercise (to address enjoyment)^b

Simultaneous self-monitoring of behaviour and mood^b

Patient to choose between DVD programme or walking programme (or a mixture).

Self-monitoring of mood (and sleep quality) alongside progress with exercise to help build associations between exercise and positive mood/learning from experience (M).

Reflections by facilitator on these associations (F).