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Table 1 Intervention functions that are appropriate to target underlying theoretical domains

From: Improving medication adherence in stroke survivors: the intervention development process

TDF Domain

Intervention Function

Intervention Function Definitionsa

Included/excluded from next stage

Reasons for Inclusion/exclusion (against APEASE criteria)

Knowledge

Education

Increasing knowledge or understanding

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Training

Imparting skills

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Enablement

Increasing means/reducing barriers to increase capability (beyond education/ training) or opportunity (beyond environmental restructuring)

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Beliefs about consequences

Education

Increasing knowledge or understanding

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Persuasion

Using communication to induce positive or negative feelings or stimulate action

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Incentivisation

Creating an expectation of reward

Excluded

Not considered affordable, unlikely to be acceptable to policy makers and would possibly be impractical to incentivise over a sustained period of time

Coercion

Creating an expectation of punishment or cost

Excluded

Not considered practical to deliver (as HCPs often want to maintain good and balanced relationships with patients), unlikely to be acceptable to HCPs or patients morally and ethically, enforcing punishment or cost onto patients will also likely have unwanted side effects, and could reduce equity for some sectors of the community

Emotions

Persuasion

Using communication to induce positive or negative feelings or stimulate action

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

Incentivisation

Creating an expectation of reward

Excluded

Not considered affordable, unlikely to be acceptable to policy makers and would possible be impractical to incentivise over a sustained period of time

Coercion

Creating an expectation of punishment or cost

Excluded

Not considered practical to deliver (as HCPs often want to maintain good and balanced relationships with patients), unlikely to be acceptable to HCPs or patients morally and ethically, enforcing punishment or cost onto patients will also likely have unwanted side effects, and could reduce equity for some sectors of the community

Restriction

Using rules to reduce the opportunity to engage in the target behaviour (or to increase target behaviour by reducing the opportunity to engage in the competing behaviour)

Excluded

Not considered practical to deliver as medicine taking can be carried out alone and so there will be no one present to enforce rules, unlikely to be acceptable to patients, HCPs or policy makers as rules often require legislation changes to be enforceable and acted upon

Environmental Restructuring

Changing the physical or social context

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity unless patients do not have access to similar healthcare services or possess similar abilities

Modelling

Providing an example for people to aspire to or imitate

Excluded

Not considered to be practical to deliver as patients do not always have contact with HCPs or other patients when collecting prescriptions for medications, could potentially create disparities in equity

Enablement

Increasing means/reducing barriers to increase capability (beyond education/ training) or opportunity (beyond environmental restructuring)

Included

Considered affordable, practical, potentially effective, potentially acceptable, should have limited side effects and shouldn’t create significant issues of equity

  1. APEASE Affordability, practicality, effectiveness/cost-effectiveness, acceptability, side effects, equity, HCPs Healthcare Professionals, TDF Theoretical Domains Framework
  2. aDefinitions from Michie, S., L. Atkins, and R. West, The Behaviour Change Wheel: A Guide to Designing Interventions. 2014, UK: Silverback Publishing