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Table 2 Analysis of target behaviours impacting positive behaviour using COM-B and TDF

From: Improving the health-related quality of life of adult Nigerians living with cancer and their family caregivers: intervention development

COM-B TDF Domain Relevance of domain Intervention function(s) Behaviour change
Description of the intervention's behaviour change technique
Physical capability Physical skills
Individuals do not have the skills essential to cope with a cancer diagnosis and to provide cancer care Training Instructions on how to perform specific behaviours such as breathing exercise Advise on how to adjust their existing behaviour in accordance with the guidelines
Demonstration of the behaviour Individuals will be introduced to resources, such as graphical instructions, and encouraged to demonstrate caregiving abilities
Behavioural practice/rehearsal Prompt participants to practise certain tasks throughout the intervention
Participants multitasking skills Modelling Graded tasks. Adults with cancer + family caregivers encouraged to achieve simple tasks before graduating to more complex duties. Highlight importance of self-care
Self-monitoring of behaviour Individuals urged to keep weekly reflection notebooks to track their progress in developing their skills
Physiological capability Knowledge Individuals do not understand or have wrong knowledge of the guidelines
Intergenerational transmission of insufficient and/or inaccurate knowledge
Education Instruction on how to perform behaviour Individuals will be given extensive verbal and written information about the behavioural guidelines, as well as the opportunity to ask any questions they may have — to avoid misinformation from being spread. Performed during the intervention session
Individuals will be given comprehensive information on cancer symptoms, management, and complications
Baseline data will be analysed prior to intervention to identify any pre-existing beliefs/behaviours indicative of misinformation. This will be brought up in a proactive manner for discussion with participants
Behavioural regulation Individuals find it challenging to self-regulate their behaviour because they perceive new guidelines to be restrictive and difficult to implement into their daily lives Enablement Self-monitoring of behaviour Individuals are requested to keep weekly reflection records in which they track their progress towards achieving the goals specified for desired behaviours that will be discussed during the intervention
Goal setting (behavioural) The goal is to successfully address the social, spiritual, and information needs and improve the quality of life of adults living with cancer and their family caregivers and strengthen their knowledge and skills to mobilise social networks
Individuals are prompted to develop their own goals that they believe are attainable — goals that take into account their preferences and willingness to change. The goals will be SMART
Action planning Individuals will be urged to make detailed plans outlining how they intend to accomplish each goal
Prompts and cues Individuals are encouraged to leave the intervention booklet in a frequented location to encourage them to read it and participate in the agreed-upon actions
Information about emotional consequences Facilitators should communicate with individuals the potential for improved mood if they choose to engage in desirable behaviours
Social opportunity Social influences and emotion It is easier to adopt a new behaviour when surrounded by family members who are also doing so Enablement Social/spiritual support (practical) Individuals are advised to seek assistance from family members (including those who are not participating in the intervention) and friends if they are having difficulty engaging in the desired behaviours
Encourage participants to read spiritual writings, such as the Bible, Koran, or other faith-based texts. Seek the assistance of others; for example, you could initiate an ongoing dialogue with your clergy or counsellor, or you could join a community for meditation, prayer, and support, as well as listening to classical or spiritual music
Problem-solving During the “barriers and solutions” section of the intervention, facilitators will encourage participants to consider scenarios in which they believe they will struggle to engage in desirable behaviours (social situations) and devise strategies to overcome these obstacles. These will be discussed further during follow-up sessions
Environmental restructuring Restructuring of physical and social environment Individuals are encouraged to socialise with friends and family in settings that enhance the participation of desired behaviours, such as a church, mosque, or park
Physical opportunity Environmental context and resources Life circumstances that such as illness or a new job can diminish their available capacity/resources/time to follow the guidelines Training Instruction on how to perform the behaviour The instructions given by facilitators to individuals will be tailored to their specific care needs and other conflicting occurrences in their lives that require their attention. Individuals will receive instructions on how to achieve the desired behaviours in their existing situation
A scarcity of resources such as finances and infrastructure in the environment Incentivisation
Social support (emotional) Facilitators will provide emotional support to participants during intervention sessions by discussing what else is going on in their lives and how this is affecting their ability to adhere to guidelines. Individuals are also encouraged to seek emotional support from friends and relatives
Reflective motivation Professional/social role and identity   Persuasion Framing/reframing Individuals are communicated with cancer-specific guidelines, as opposed to general health guidelines that are offered to everyone. The benefits of following cancer management and caregiving suggestions, in addition to the benefits to general health, will be emphasised
Verbal persuasion about capabilities Tell the person that they can successfully perform the wanted behaviour, arguing against self-doubts, and asserting that they can and will succeed
Feedback on outcomes of behaviour Individuals will be evaluated at the start and end of the intervention on their ability to adhere to the guidelines and maintain their behaviour after the intervention
Modelling Credible sources The intervention will be guided by facilitators who will detail the training they went through to get that title — to help individuals, recognise the validity of their advice. Furthermore, all individuals will be informed that their physician/nurse is aware of and supportive of them receiving the intervention as part of their clinical care
Review goal (behavioural) Each session will begin with a recap of the previous session’s goals. Participants will determine whether to keep the current goal, modify it, or create a new one. These decisions will be made based on an individual’s level of achievement and willingness to change
Reinforcement Participants are incentivised (subsidy from the government) where appropriate to ensure that they follow instructions and achieve the best possible health outcomes Persuasion Comparative imaging of future outcomes Facilitators should urge people to think about the potential health consequences of following recommendations vs not following them, with a focus on the potential health effects
Enablement Social support (emotional) Facilitators should encourage participants to offer support to one another and to engage in the behaviours throughout the session
  1. SMART, specific, measurable, acceptable, realistic, and time based