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Table 1 Example behavioural analysis for reflective motivation component of COM-B

From: Developing a group intervention to manage fatigue in rheumatoid arthritis through modifying physical activity

COM-B Theoretical domain What needs to happen for the target behaviour to occur? Example evidence of need for change or support for inclusion
Reflective motivation Professional/social role and identity Encourage being active as part of identity 011: “it’s a long ongoing battle where you’ve had to forget your old life, what you used to do, I’ve given up work and stayed home.”
015: “… [RA] it’s changed my life, I get depression. I have changed, I am not the same person I was 3 years ago. I can’t talk for anybody else, but I’ve changed, I know I have.”
  Beliefs about capabilities Explore acceptance of having RA and fatigue and its effect on ability
Address confidence with PA
Identify PA that feel capable of doing, that is achievable
014: “You can’t work to a regime of fitness because you never know what you’re allowed to do the next day.”
016: “Mine’s quite bad in my joints. I’ve got chronic in my shoulders, in my neck, my feet, my hands, that’s it. I’ve got bare movement so I can’t do nothing.”
  Optimism Explore confidence with achieving PA goals 011: “The minute you mentally make yourself kitted up ready to do it and then you fail at the first hurdle.”
013: “And it’s horrible failing.”
  Beliefs about consequences Address beliefs about the effects of PA on fatigue and general consequences of PA
Encourage belief that managing PA will have positive benefits for managing fatigue
Address negative beliefs
011: “I think physical activity does increase your fatigue, but also, on the other foot, decrease it as well.”
021: “… I tried swimming and it caused flares in my shoulders. So I went to see the doctor about it and they said try an exercise bike for a minute a day, and that used to set off in my knees.”
s Intentions Explore plans/intentions to be more active or to manage PA
Encourage formulation of plans to carry out PA and implementation of specific PA goals
Address setbacks and potential barriers to PA
011: “Just like getting up and thinking, “Right, am I going to be able to do this today,” to try and do that and get myself to the swimming pool. Then the minute you get out of bed you collapse because you can’t put your foot to the floor”
007:“if a patient comes in and they’ve had a sudden setback […] we would look at where they are in that setback, look at setback planning and how to think about and learn from that setback.”
  Goals Explore expectations and desired achievements
Set specific goals for PA
024: “…finding out what their goals are and working towards them, and building their confidence with that.”
  1. COM-B=Capability, opportunity, motivation, behaviour; GP = general practitioner; PA = physical activity; RA = rheumatoid arthritis
  2. Underlined text = quotations from healthcare professionals in interviews (phase 1b)
  3. Bold text = quotations from RA patients in focus groups (phase 2a)
  4. Italic text = quotations from rheumatology healthcare professionals in focus groups (phase 2b)