Table 2 Determinants of self-management behaviour and behaviour change techniques
Determinants of self-management behaviour | Needs assessment component that provided evidence of the determinant | TDF domain | Behaviour change techniques as per behaviour change technique taxonomy v1 (Michie et al. [42, 44]) |
|---|---|---|---|
Self efficacy | Systematic reviews of mediators for SM behaviour in CMP including OA, CLBP [48, 49] | Beliefs about capabilities To improve participants’ perceived competence to use each SM behaviour | 1.2. Problem solving 2.2 Feedback on behavioura 2.3. Self-monitoring of behaviour 2.7 Feedback on outcome of behaviour 3.1. Social support (unspecified) 3.2. Social support (practical) 3.3. Social support (emotional) 8.1 Behavioural practice/rehearsal 8.7 Graded tasks 12.5 Adding objectives to the environment 15.1. Verbal persuasion about capabilitya |
Catastrophizinga | Systematic reviews of mediators of CLBP outcomes [48, 50] CLBP guidelines [47] | Beliefs about consequences To reduce negative expectancies (catastrophizing) about consequences of engaging in specific SM behaviours | 2.2 Feedback on behavioura 2.3. Self-monitoring of behaviour 2.7 Feedback on outcome of behaviour 5.1 Information re health consequences of behaviour 5.6 Information re emotional consequences of behaviour 9.1. Credible source |
Fear | Systematic reviews of mediators of CLBP outcomes [51] CLBP guidelines [47] Focus groups barrier to patient participation to be addressed within intervention | Emotion To reduce negative emotional responses (fear) of specific SM behaviours | 3.3 Social support—emotional 5.6 Information re emotional consequences of behaviour 11.2 Reduce negative emotions |
Knowledge | Conceptual definition of SM [12] Focus groups barrier to patient participation to be addressed within intervention | Knowledge To increase participants knowledge for each SM behaviour | 2.2 Feedback on behavioura 2.7 Feedback on outcome of behaviour 4.2 Information about antecedents of behaviour 5.1 Information about the health consequences of behaviour |
Skills | Conceptual definition of SM [12] Focus groups barrier to patient participation to be addressed within intervention | Skills To develop participants proficiency to uptake each SM behaviour | 1.1. Goal setting (behaviour) 1.2. Problem solving 1.3. Goal setting (outcome) 2.3. Self-monitoring of behaviour 4.1 Instruction on how to perform the behaviour 6.1. Demonstration of the behaviour 8.1 Behavioural practice/rehearsal 8.6 Generalisation of the targeted behaviour 8.7 Graded tasks 11.1 Pharmacological support 13.2 Framing/reframing 12.6 Body changes |
Motivationa | Review of behaviour change theories [41], evidence of effectiveness in group interventions [58–61] and target patient and physiotherapist groups in Ireland [67, 68] Focus groups and manager interviews potential barrier to patient participation to be addressed within intervention | Intentions and goals To improve autonomous motivation of participants to engage in each SM behaviour | 1.1 Goal setting (behaviour) 1.2 Problem solving 1.3. Goal setting (outcome) 1.4 Action planning 1.5 Review behavioural goal 1.6 Discrepancy between current behaviour and goal 1.7 Review outcome goal 1.8 Behavioural contracta 3.1. Social support (unspecified) 3.2. Social support (practical) 3.3. Social support (emotional) 5.1 Information about health consequences 6.2 Social comparison 8.7 Graded tasks 9.1. Credible source 10.4 Social rewards |
Behaviour regulation | Advice from behaviour change expert (S Dean) Focus groups barrier to patient participation to be addressed within intervention | Behavioural regulation Strategies to manage or change objectively observed or measured SM behaviour of participants | 2.3 Self-monitoring of behaviour |