Table 1 Needs analysis by COM-B and TDF with decisions for inclusion/exclusion in the intervention
COM-B component | TDF domain | Needs analysis | Inclusion/exclusion |
|---|---|---|---|
Physical capability | Physical skills | Need skills to use nebuliser, prepare treatment, and clean nebuliser | Included |
Psychological capability | Knowledge | Need to know about the correct treatment-taking procedures, to understand treatment action and the importance of nebuliser treatment Need to address treatment concerns | Included |
Memory, attention, and decision processes | Need to remember to take treatment | Included | |
Behavioural regulation | Need to develop routines, plans, and habits for treatment Need to monitor adherence behaviour | Included | |
Physical opportunity | Environmental context and resources | Need to have a time, place, and the equipment do take treatment Need to develop strategies to take treatment around specific barriers or times when treatment taking is more difficult | Included |
Social opportunity | Social influences | Need positive support from family, healthcare professionals, and/or others to do treatment Need to have social norms for adherence | Included |
Reflective motivation | Professional/social role and identity | Need to develop a social identify that is consistent with treatment adherence | Excluded—social identity change in the context of adherence is not well understood |
Beliefs about capabilities | Need to develop confidence in the ability to take and adhere to treatment Need to develop strategies to take treatment at times or in situations when it is more difficult | Included | |
Optimism | Need to be optimistic that full treatment adherence is possible | Excluded—focus on achieving higher but realistic adherence | |
Beliefs about consequences | Need to believe that treatment is effective and necessary for long-term health, symptom reduction, avoiding IVs/hospital stays Need to believe that treatment is important irrelevant of perceptions of current wellness Need to address treatment concerns | Included | |
Intentions | Need to encourage intentions to adhere to treatment and avoid periods of intentional non-adherence | Included | |
Goals | Need goals for treatment adherence Need to develop strategies to address conflicting goals | Included | |
Automatic motivation | Reinforcement | Need to provide some reinforcement for treatment-taking Need to address treatment concerns | Included |
Emotion | Need to focus on emotional drivers for adherence (fear, anticipated regret) Need to address low mood and avoidance | Excluded—not acceptable to focus on fear and may increase avoidance. Addressing low mood/depression outside the scope of this intervention (signposting to other support services) |