Table 4 Theoretical Domains Framework target determinants, behaviour change techniques (BCT) and BCT operationalisation within the workplace intervention
Determinant targeted by Behaviour change technique | Behaviour change technique | An example of what the behaviour change technique would look like within the workplace intervention | Mode of delivery |
|---|---|---|---|
Environmental context and resources | Restructuring the physical environment | Vinyl footsteps placed on hospital floors to promote stair walking Smaller portion sizes provided as substitutes in the workplace canteen | Printed material |
Avoidance/changing exposure to cues for the behaviour | Online-based self-completed session (Module Session 1); • Recommendations to i) Determine appropriate servings in advance when eating foods (either in workplace/out of workplace); ii) Focus on activities other than watching television and going to pubs and bars which might have previously been associated with sedentary behaviour | Digital—individual | |
Prompts/cues | Vinyl footsteps placed on hospital floors to promote stair walking Food within workplace calorie labelled at the point of purchase | Printed material | |
Restructuring the social environment | Social marketing campaign with branding. For branding, a professionally created logo placed across all intervention components | Digital—individual | |
Discriminative (learned) cue | Online-based self-completed session (Module Session 1); • Advises nurses’ about taking the stairs during the working day but not the lift and provide information about entry to a draw for a non-monetary incentive | Digital—individual | |
Behavioural regulation | Self-monitoring of behaviour | Online-based self-completed session (Module Session 1); • Pedometer for tracking daily footsteps on personal page of online-based programme • Nurses requested to keep a record of unhealthy snacking/physical inactivity on personal page of online-based programme | Digital—individual |
Knowledge | Biofeedback | Online-based self-completed session (Module Session 2); • Invite nurses to undertake a fitness and strength test | Digital—individual |
Information about health consequences | A brief message about the increased risk of chronic disease following unhealthy dietary/physical activity patterns placed on pedometer in conjunction with advice on how to mitigate this risk | Printed material | |
Antecedents | Online-based self-completed session (Module Session 2); • Nurses requested to keep a record of unhealthy snacking/physical inactivity on personal page of online-based programme. This is to identify situations or events occurring prior to unhealthy snacking/physical inactivity | Digital—individual | |
Feedback on behaviour | Online group-based motivational interviewing session (Module Session 3); • A registered dietitian/nutritionist/physiotherapist provides feedback within motivational interviewing session on healthy eating/physical activity progress | Digital—grouped | |
Optimism | Verbal persuasion to boost self-efficacy | Online group-based motivational interviewing session (Module Session 3); • Nurses verbally persuaded to enhance self-efficacy as part of online group-based motivational interviewing session | Digital—grouped |
Beliefs about consequences | Information about emotional consequences | Online-based self-completed session (Module Session 2) Nurses advised to track their mood alongside their eating and physical activity behaviours on personal page of online-based programme. This is to support nurses identify the emotional consequences of healthy and unhealthy behaviours for themselves. | Digital—individual |
Salience of consequences | Online-based self-completed session (Module Session 2) Nurses requested to keep a record of the dangers of eating unhealthy/being sedentary on personal page of online-based programme. Concrete information on what will happen if a nurse does this every day (e.g. if you eat like this every day for the next 4 weeks you will lose/gain X kg) provided to increase the personal salience of the consequences of unhealthy behaviours | Digital—individual | |
Anticipated regret | Online group-based motivational interviewing session (Module Session 3) Nurses requested to answer the following two questions (“If I did not eat healthily and participate in physical activity I would later feel regret.”) and (“If I did not eat healthily and participate in physical activity, I would later wish I had.”) | Digital—grouped | |
Information about social and environmental consequences | A web-based staff newsletter and social media used for communicating information about social and environmental consequences of healthy eating and physical activity | Digital—individual | |
Comparative imaging of future outcomes | Online-based self-completed session (Module Session 2) Prompt nurses to imagine and compare likely or possible outcomes following eating healthily/participating in physical activity versus not performing these behaviours | Digital—individual | |
Beliefs about consequences | Vicarious reinforcement | Online group-based motivational interviewing session (Module Session 3) A registered dietitian/nutritionist/physiotherapist would provide feedback on healthy eating/physical activity progress | Digital—grouped |
Threat (future punishment) | A fear appeal message in combination with a self-affirmation message incorporated into social marketing campaign | Digital—grouped | |
Pros and cons | Online-based self-completed session (Module Session 4) Nurses requested to list and compare the advantages and disadvantages of eating healthy/physical activity participation | Digital—individual | |
Emotion | Reduce negative emotions | Online-based self-completed session (Module Session 4) Expert video discussing the use of stress management techniques such as progressive muscular relaxation and diaphragmatic breathing to help nurses manage their stress | Digital—individual |
Self-assessment of affective consequences | Online-based self-completed session (Module Session 4) Advises nurses to record how they feel after eating healthily/participating in physical activity on personal page of online-based programme | Digital—individual | |
Social support (emotional) | Online-based group-based forum and discussion (Module Session 5) Participants could share experiences and give each other tips or search for training partners | Digital—grouped |