Table 5 Barriers mapped to behavior change techniques
Barrier (n = cases) | TDF component | Intervention function | Behavior change technique |
|---|---|---|---|
Chiropractic treatments won’t help (9) No change/no goal (6) Not knowing how to manage condition (3) Because of type of condition nothing will help the pain (3) Not having chiropractic care would result in less or no improvement (3) Choosing other activities over assigned exercises (2) Not understanding exercises (1) Not an exerciser (1) Not capable of exercise (1) Not capable of being strong (1) Exercise needs to be difficult to be effective (1) Focused chiropractic treatment has less benefits (1) Non-prescribed exercises have the same benefit (1) Chiropractic treatment increased my pain (1) | Knowledge Behavioral regulation Social/professional role and identity Beliefs about capabilities Optimism Goals Beliefs about consequences | Education | Information about health consequences Feedback on behavior Feedback on outcome(s) of behavior Prompts/cues Self-monitoring of behavior Verbal persuasion to boost self-efficacy |
Chiropractic treatments won’t help (9) No change/no goal (6) Because of type of condition nothing will help the pain (3) Not having chiropractic care would result in less or no improvement (3) Guilt, shame (2) Fear (1) Not an exerciser (1) Not capable of exercise (1) Not capable of being strong (1) Exercise needs to be difficult to be effective (1) Focused chiropractic treatment has less benefits (1) Non-prescribed exercises have the same benefit (1) Chiropractic treatment increased my pain (1) | Emotion Social/Professional role and identity Beliefs about capabilities Optimism Goals Beliefs about consequences | Persuasion | Information about health consequences Feedback on behavior Feedback on outcome(s) of the behavior Focus on past success Framing/reframing Verbal persuasion about capability |
No change/no goal (6) Pain (5) Psychological impact of capabilities (2) Guilt, shame (2) Other medical conditions (1) Change in environment (1) Fear (1) | Reinforcement Emotion Goals | Incentivization | Feedback on behavior Feedback on outcome(s) of behavior Self-monitoring of behavior Discrepancy between current behavior and goal Remove adverse stimulus |
No change/no goal (6) Pain (5) Psychological impact of capabilities (2) Guilt, shame (2) Other medical conditions (1) Change in environment (1) Fear (1) | Reinforcement Emotion Goals | Coercion | Feedback on behavior Feedback on outcome(s) of behavior Self-monitoring of behavior Discrepancy between current behavior and goal Incompatible beliefs |
Time constraints (12) Pain (5) Difficulty performing exercises (4) Driving distance (3) Exercise schedule (3) Difficulty deciding to exercise (2) Choosing other activities over assigned exercises (2) Lacking video or in-person demonstration (2) Space constraints (2) Psychological impact of capabilities (2) Not recognizing correct performance of exercises (1) Difficulty pacing exercises (1) Working a desk job (1) Length of treatment visits (1) Visit frequency (1) Other medical conditions (1) Change in environment (1) | Physical skills Cognitive and interpersonal skills Memory, attention and decision processes Behavioral regulation Environmental context and resources Reinforcement | Training | Demonstration of the behavior Instruction on how to perform the behavior Feedback on the behavior Feedback on outcome(s) of the behavior Self-monitoring of the behavior Self-monitoring of outcome(s) of the behavior Behavior practice/rehearsal Habit formation Graded tasks |
Time constraints (12) Driving distance (3) Exercise schedule (3) Lacking video or in-person demonstration (2) Space constraints (2) Family opinions (1) Break in therapeutic alliance (1) Working a desk job (1) Length of treatment visits (1) Visit frequency (1) | Social influences Environmental context and resources | Restriction | *No BCTs are linked through restriction |
Time constraints (12) Pain (5) Driving distance (3) Exercise schedule (3) Difficulty deciding to exercise (2) demonstration (2) Space constraints (2) Psychological impact of capabilities (2) Family opinions (1) Break in therapeutic alliance (1) Lacking video or in-person Working a desk job (1) Length of treatment visits (1) Visit frequency (1) Other medical conditions (1) Change in environment (1) | Memory, attention and decision processes Social influences Environmental context and resources Reinforcement | Environmental restructuring | Adding objects to the environment Prompts/cues Restructuring the physical environment Restructuring the social environment |
Chiropractic treatments won’t help (9) No change/no goal (6) Because of type of condition nothing will help the pain (3) Not having chiropractic care would result in less or no improvement (3) Choosing other activities over assigned exercises (2) Guilt, shame (2) Family opinions (1) Break in therapeutic alliance (1) Fear (1) Not an exerciser (1) Not capable of exercise (1) Not capable of being strong (1) Exercise needs to be difficult to be effective (1) Focused chiropractic treatment has less benefits (1) Non-prescribed exercises have the same benefit (1) Chiropractic treatment increased my pain (1) | Behavioral regulation Social influences Emotion Social/professional role and identity Belief about capabilities Optimism Goals Beliefs about consequences | Modeling | Demonstration of the behavior |
Time constraints (12) No change/no goal (6) Driving distance (3) Exercise schedule (3) Difficulty deciding to exercise (2) Choosing other activities over assigned exercises (2) Lacking video or in-person demonstration (2) Space constraints (2) Guilt, shame (2) Family opinions (1) Break in therapeutic alliance (1) Working a desk job (1) Length of treatment visits (1) Visit frequency (1) Fear (1) | Memory, attention and decision processes Behavior regulation Social influences Environmental context and resources Emotion Goals | Enablement | Social support (unspecified) Social support (practical) Goal setting (behavior) Goal setting (outcome) Adding objects to the environment Problem solving Action planning Self-monitoring of behavior Restructuring the physical environment Restructuring the social environment Review behavior goal(s) Review outcome goal(s) Reduce negative emotions Verbal persuasion about capability |