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Table 1 Preliminary mapping of behavior change barriers for antibiotic prescribing to theoretical constructs

From: Computer-supported feedback message tailoring: theory-informed adaptation of clinical audit and feedback for learning and behavior change

COM-B categories [ 42 ] TDF domain [ 40 ] TDF construct [ 40 ] Barrier to antibiotic prescribing [ 47 ] Hypothetical causal mechanism
Capability Knowledge Knowledge of condition/ scientific rationale Lack of knowledge and training Feedback can change awareness to impart new knowledge that leads to behavior change
  Skills Interpersonal skills Perception of patient demands and preferences None (feedback has no direct influence on interpersonal skills)
Opportunity Environmental context and resources Material resources Inadequate drug supply infrastructure None (feedback has no direct influence on material resources)
  Social influences Social pressure Peer pressure and social norms None (feedback has no direct influence on social pressure)
Motivation Beliefs about capabilities Self-efficacy None (barriers are indirect via beliefs about capability constructs) Feedback can influence perceptions of ability, improving or worsening self-efficacy, which can lead to behavior change
  Emotion Fear Fear of bad clinical outcomes Feedback can cause emotional reactions that influence motivation, leading to behavior change