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Table 5 Mapping data to the Theoretical Domains Framework, intervention functions and policy categories

From: ‘Making the most of together time’: development of a Health Visitor–led intervention to support children’s early language and communication development at the 2–2½-year-old review

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TDF

Specifics of barriers and enablers of relevance to the domain

Intervention function

Policy categories

Physical capability

Physical skills

• Skill development—learn the skills of how to share a book; follow a child’s lead, etc.

• Skill development—adult literacy to be able to share a book

• Skill development—how to share SPECIFIC books, what questions to ask, etc.

Training

Service delivery

Psychological capability

Knowledge

• Procedural—know how to share a book; follow a child’s lead, etc., play and read

• Knowledge—know which behaviours are important and why

• Knowledge—what is an age-appropriate book

• Knowledge—what kinds of questions could they ask in shared book reading?/How would they support child’s enjoyment in reading?

Education

Communication/ marketing service provision

Cognitive and interpersonal skills

   

Memory, attention and decision processes

• Learn how to reason about what to change to do target behavior (e.g. through watching other people on video)

Training

Environmental restructuring

Enablement

Service provision

Service provision

Behavioural regulation

• Self-monitoring; action planning

Education

Training

Modelling

Enablement

Communication/marketing

Service provision

Physical opportunity

Environmental context and resources

• Material resources provided—books & toys

• Cues and reminders to carry out the behaviours (e.g. fridge magnets, phone calls). Bookstart was a reminder as well as a resource

• Material resources opportunities for play through attending playgroups/drop-ins.

• Time available for busy family, mobilising wider family, piggyback on routines

• Availability of age-appropriate books in Home Languages

• Access to transport to access wider support

• Accessing their rights for paid childcare—need support?

• Special, concrete materials can help mobilise wider family resource

• Need to work for full-time working parents as well as non-working

Training

Restriction

Environmental Restructuring

Enablement

Service provision

Fiscal measures

Environment/social planning

Social opportunity

Social influences

• Modelling—seeing others doing it

• Social norms; group conformity, group norms, social support, group identity, modelling (e.g. in parent groups) seeing others do it

• Social support—getting wider family involved

• Group norms—may be cultural differences in adult–child interaction patterns

• Social support—importance of faith communities

• Social support—cannot be stigmatising and needs to be intrinsically motivating/fun

Restriction

Environmental restructuring

Modelling

Enablement

Communication/marketing

Service provision

Fiscal measures

Environment/social planning

Reflective motivation

Professional/social role and identity

• Social role—parents want to do the best for their child

Education

Persuasion

Modelling

Communication/marketing

Service provision

Beliefs about capabilities

• Self-esteem, belief about own capabilities, perceived competence (e.g. training others)

• Some parents may believe they are “doing it all” (need to be challenged?)

Education

Persuasion

Modelling

Enablement

Communication/marketing

Service provision

Optimism

• Optimism—self efficacy through video of progress

Education

Persuasion

Modelling

Enablement

Communication/marketing

Service provision

Beliefs about consequences

• Believe advantaging children if give them technology whilst underestimating value of own interactions

• Want to do the best for their child—but need simple messages explaining benefits of specific behaviours to their child

• Parent believes child cannot do it—sees HV do it and changes their views

• Parent may believe that what they do will not make a difference.

• Parent may believe watching a story on the television is the same as sharing a book

Education

Persuasion

Modelling

Communication/marketing

Service provision

Intentions

• Develop intentions to do the behavior—agree to try

• Maintain stable intentions

Education

Persuasion

Incentivisation

Coercion

Modelling

Communication/marketing

Service provision

Goals

• Set goals—describe and identify concrete time and contexts to do behaviours

• Action planning

• Choose goal and time of day and make a very specific time and context to try something new

• Know that you will be reviewed—have check in a good motivator

Education

Persuasion

Incentivisation

Coercion

Modelling

Enablement

Communication/marketing

Service provision

Automatic motivation

Reinforcement

• e.g. Through video of child’s progress

• Having a go and seeing it work is best reinforcement

• Video could reinforce feelings of hopelessness—inability

• Pleasure gained from sharing ‘special toys’

• Books/gifts much more rewarding than info giving leaflet—more likely to engage

Training

Incentivisation

Coercion

Environmental restructuring

Communication/marketing

Service provision

Emotion

• Embarrassment/discomfort to try new behavior

• Overwhelm

• Fear of exposure as not having skills themselves

Persuasion

Incentivisation

Coercion

Modelling

Enablement

Communication/marketing

Service provision

  1. Analysis is based on guidance and resources in Michie, S., L. Atkins, and R. West’s, The behaviour change wheel: a guide to designing interventions. 2014, Surrey: England: Silverback Publishing. Strike through (i.e. Incentivisation) indicates an intervention function identified as relevant to the TDF and barrier/enabler but judged not to be appropriate to the intervention context