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Table 2 Selected formats for delivering behaviour change technique (BCTs) as part of a community pharmacy-based intervention

From: Development of a complex community pharmacy intervention package using theory-based behaviour change techniques to improve older adults’ medication adherence

BCTDefinition provided in BCT Taxonomy Version 1 (BCCTTv1) [15]Potential formats for delivering the BCTFinal selected format(s) for delivering the BCT (including reasons)
Health consequences‘Provide information (e.g. written, verbal, visual) about health consequences of performing the behaviour’Option 1: Provision of verbal information by pharmacists
Option 2: Provision of printed and/or written information by pharmacists
Options 1 and 2: These were deemed practical to deliver in community pharmacies. Based on findings from previous focus groups, these formats were deemed likely to be well accepted by patients. These options are both low-cost and giving patients a choice would aim to overcome potential equity issues (e.g. poor literacy).
Restructuring the physical environment‘Change or advise to change the physical environment in order to facilitate performance or create barriers to the unwanted behaviours (other than prompts/cues, rewards and punishment)’Option 1: Verbal record of agreed changes
Option 2: Written instructions of agreed changes
Social support (unspecified)‘Advise on, arrange or provide social support (e.g. from friends, relatives, colleagues, ‘buddies’ or staff) or non-contingent praise or reward for performance of the behaviour. It includes encouragement and counselling but only when it is directed at the behaviour’Option 1: Verbal record outlining a social support plan
Option 2: Written instructions outlining the social support plan
Feedback on behaviour‘Monitor and provide information or evaluative feedback on performance of the behaviour (e.g. form, frequency, duration, intensity)’Option 1: Provision of verbal information by the pharmacist
Option 2: Provision of printed/written information by the pharmacist
Option 1: This was considered to be low-cost and practical to deliver. This format was also deemed likely to be accepted by pharmacists/patients. Option 2 was not chosen as it could be time-consuming to prepare written/printed feedback for each patient given the time constraints in community pharmacies. The selected format will also aim to overcome equity issues (e.g. poor literacy).
Prompts/
Cues
‘Introduce or define environmental or social stimulus with the purpose of prompting or cueing the behaviour. The prompt or cue would normally occur at the time or place of the performance’Option 1: Reminder stickers
Option 2: Visual or situational prompts (e.g. location, time)
Option 3: Electronic devices (e.g. Reminder app/smartwatches)
Options 1 and 2: These were deemed to be low-cost, likely to be accepted by patients/pharmacists and practical to recommend in community pharmacies. Option 3 was not chosen because of the high costs associated with providing electronic devices to patients, potential reach to patients without access to devices and acceptability to older patients.
Self-monitoring of the behaviour‘Establish a method for the person to monitor and record their behaviour(s) as part of a behaviour change strategy’Option 1: Paper medicines diary
Option 2 Electronic device (e.g. mobile phone app)
Option 1: This was selected due to the low-costs involved in development, practicality of providing this in community pharmacies and likely acceptability to older patients.
Option 2 was not chosen due to the high costs associated with designing an app and provision of devices, as well as user-training requirements, and potential equity issues (e.g. reach to patients without mobile phone access).
Goal setting-behaviour‘Set or agree a goal defined in terms of the behaviour to be achieved’Option 1: Verbal agreement of goal(s)
Option 2: Written record of agreed goal(s)
Options 1 and 2: These were selected as both may be required, depending on each patient’s circumstances. Both options were considered low-cost, likely to be acceptable to patients and pharmacists and practical to deliver in the proposed setting. The inclusion of both formats would also aim to overcome equity issues (e.g. poor literacy).
Goal setting-outcome‘Set or agree a goal defined in terms of a positive outcome of wanted behaviour’
Review of behaviour goal‘Review behaviour goal(s) jointly with the person and consider modifying goal(s) or behaviour change strategy in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of (or in addition to) the first, or no change.’Option 1: Verbal review of goal(s)
Option 2: Written record of goal review discussion
Review of outcome goal‘Review outcome goal(s) jointly with the person and consider modifying goal(s) in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of, on in addition to the first’
Action planning‘Prompt detailed planning of performance of the behaviour (must include at least one of context, frequency, duration and intensity). Context may be environmental (physical or social) or internal (physical, emotional or cognitive’Option 1: Verbal agreement of an action plan
Option 2: Written record of agreed action plan