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Table 2 Overview of the exercise professional training package including summary of content and behaviour change techniques

From: Towards implementing exercise into the prostate cancer care pathway: development of a theory and evidence-based intervention to train community-based exercise professionals to support change in patient exercise behaviour (The STAMINA trial)

Module
(target behaviour)
Summary of content BCTs (coded in line with BCTTV1) TDF domain
Level 1: online
 Module 1: Introduction to prostate cancer and exercise (1) - Provide an overview of the STAMINA programme and NICE guidelines (text and video from consultant urologist)
- Provide evidence-base for exercise as a treatment component (text and video from consultant urologist)
- Present patient views on exercise (quotes)
- Present information about prostate cancer, symptoms, mortality, treatment and side effects (text and video from consultant urologist)
- Present information on the role of CBEPs in STAMINA (video from consultant urologist)
- Summary of key points
5.1 Health consequences, 5.3 Social & environmental consequences Knowledge
4.1 Instruction, 9.1 Credible source Professional role
5.6 Emotional consequences, 9.1 Credible source, 10.1 Material incentive Beliefs about consequences
 Module 2: Operationalising the STAMINA programme (1, 4) - Present information on communication with clinical teams (text and video from consultant urologist)
- Present information on scheduling STAMINA patients for exercise
- Present frequently asked questions and answers related to patient memberships, appointments and missed sessions.
5.1 Health consequences, 5.3 Social & environmental consequences Knowledge
4.1 Instruction Skill
4.1 Instruction, 9.1 Credible source Professional role
5.6 Emotional consequences, 9.1 Credible source Beliefs about consequences
Level 2: Face-to-face
 Module 3: Working with clinical populations (1) - Discussion on prostate cancer treatment, side effects, symptoms, survival rates and role of exercise.
- Discussion about patient feelings towards attending the gym and challenge beliefs
- Present detailed information about side effects (case studies)
- Discuss how best to respond to different side effects and consider pros and cons of each
- Provide instruction and demonstration on active listening and helpful phrases to use
2.2 Feedback on behaviour, 5.1 Health consequences, 5.3 Social & environmental consequences Knowledge
4.1 Instruction, 6.1 Demonstration Skill
4.1 Instruction, 9.1 Credible source Professional role
9.1 Credible source Intention
5.6 Emotional consequences, 9.1 Credible source, 9.2 Pros and cons, 10.1 Material incentive Beliefs about consequences
5.6 Emotional consequences, 9.1 Credible source, 11.2 Reduce negative emotions Emotion
3.2 Social support, 12.5 Adding objects Environmental context
 Module 4: Tailoring the exercise prescription (3) - Instruction on professional role
- Discussion related to previous similar experiences and persuasion about capability
- Demonstrate safe tailoring (case study)
- Beliefs about patient capabilities discussed and challenged (case studies)
- Evidence based information about tailoring for clinical populations provided in a handbook and pros and cons discussed
- Information and example of a run-in period provided and discussed
- Practical task with feedback
- Access to case report forms and instruction on how to access NHS.net
2.2 Feedback on behaviour, 4.1 Instruction, 5.1 Health consequences, 5.3 Social & environmental consequences, 5.6 Emotional consequences Knowledge
2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal Skill
4.1 Instruction, 15.1 Verbal persuasion Professional role
9.1 Credible source, 9.2 Pros and cons Beliefs about consequences
3.3 Social support, 11.2 Reduce negative emotions Emotion
12.5 Adding objects Environmental context
 Module 5: Delivering the exercise prescription (4) - Discussion about consequences of monitoring exercise and previous experience, focussing on success
- Discussion about challenges of delivering to small groups and persuasion of capability
- Instruction and demonstration of recording heart rate and exertion
- Practical graded task delivering and recording tailored exercise to small groups, with feedback
- Information that protected time to deliver exercise will be provided at an increased salary
2.2 Feedback on behaviour, 4.1 Instruction, 8.1 Rehearsal, 8.7 Graded task Skill
2.2 Feedback on behaviour, 4.1 Instruction, 8.1 Rehearsal, 8.7 Graded task, 15.1 Verbal persuasion, 15.3 Focus on past success Beliefs about capabilities
5.1 Health consequences, 5.3 Social & environmental consequences, 5.6 Emotional consequences, 9.1 Credible source, 10.1 Material incentive, 10.8 Incentive Beliefs about consequences
3.3 Social support, 11.2 Reduce negative emotions Emotion
3.2 Social support, 12.1 Restructure, 12.5 Adding objects Environmental context
 Module 6: Reviewing the exercise prescription (6) - Discuss importance of reviewing exercise
- Provide instruction on professional role
- Provide instruction and demonstration of completing a progress report (case study)
- Role play task: completing progress reports and discussing progress. Feedback provided.
- Discuss importance of language used
- Verbal persuasion about capabilities and focus on past success
2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal Skill
4.1 Instruction Professional role
15.1 Verbal persuasion Optimism
3.3 Social support, 11.2 Reduce negative emotions, 15.1 Verbal persuasion Emotion
12.5 Adding objects Environmental context
 Module 7: Behaviour change (5) - Discuss what behaviour is, how it is influenced and how it can be changed, focus on past success
- Introduce behaviour change theory
- Discuss capability, opportunity and motivation of men on ADT and challenge beliefs (case study videos)
- Present patient video discussing the importance of the exercise professional role and behavioural support
- Role play task: respond to exercise ambivalence/ resistance (case studies).
- Review task in group discussion and provide feedback.
- Provide instruction/ demonstration of suitable BCTs for exercise ambivalence and resistance
- Role play task: repeated with new skills learnt
- Discussion and video examples of good and bad communication focusing on the spirit of motivational interviewing
2.2 Feedback on behaviour, 4.1 Instruction, 5.6 Emotional consequences Knowledge
1.2 Problem solving, 2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task Skill
4.1 Instruction Professional role
2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task, 15.1 Verbal persuasion, 15.3 Focus on past success Beliefs about capabilities
5.1 Health consequences, 5.6 Emotional consequences, 9.1 Credible source Beliefs about consequences
 Module 7: Fitness Testing (2) - Introduce the fitness test and provide handouts (protocol, exertion scale, case report form)
- Provide instruction and demonstration on the gym floor
- Discuss safe parameters of exercise testing (case study)
- Access to gym floor and heart rate monitors for practical, graded task with feedback using case report forms to record outcomes (i.e. heart rate, exertion, time, level)
2.2 Feedback on behaviour, 4.1 Instruction, 5.1 Health consequences Knowledge
2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task Skill
4.1 Instruction Professional role
5.6 Emotional consequences, 9.1 Credible source Beliefs about consequences
11.2 Reduce negative emotions Emotion
12.1 Restructure environment, 12.5 Adding objects Environmental context