Table 6 Behaviour change technique mapping of Living Well with Asthma resource

1.1 Goal setting (behaviour)

Set or agree on a goal defined in terms of the behaviour to be achieved

4 week challenge

Users commit to taking their preventer inhaler regularly for 4 weeks.

1.2 Problem solving

Analyse, or prompt the person to analyse, factors influencing the behaviour and generate or select strategies that include overcoming barriers and/or increasing facilitators (includes ‘Relapse Prevention’ and ‘Coping Planning’)

My asthma Concerns & queries 4 week challenge

Users are prompted to consider reasons why they find it difficult to take their inhaler regularly (choosing from a list or free texting own). Users are then presented with sample strategies to overcome identified barriers.

1.3 Goal setting (outcome)

Set or agree on a goal defined in terms of a positive outcome of wanted behaviour

Intro

Users are asked to identify how their asthma can negatively affect their everyday lives. They are then asked to review positive outcome goals to overcome these negative effects.

1.6 Discrepancy between current behaviour and goal

Draw attention to discrepancies between a person’s current behaviour (in terms of the form, frequency, duration, or intensity of that behavior) and the person’s previously set outcome goals, behavioural goals or action plans (goes beyond self-monitoring of behaviour)

Asthma Review

Asks validated questions to determine if currently putting up with asthma symptoms while believing themselves to be well controlled.

1.9 Commitment

Ask the person to affirm or reaffirm statements indicating commitment to change the behaviour Note: if defined in terms of the behaviour to be achieved also code 1.1, Goal setting (behaviour)

4 week challenge

Users tick three statements confirming they are committed to taking their preventer inhaler regularly for the duration of the 4 week challenge.

3.1 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

Concerns & queries

‘Where can I talk to other people about asthma’ section details and links to online forum, local support groups, and advice lines.

4.1 Instruction on how to perform a behavior

Advise or agree on how to perform the behaviour (includes ‘Skills training’)

Treatments Asthma Review Exercise

Users are given step by step instructions on how to use an inhaler correctly. This is followed up by a video demonstration.

4.3 Re-attribution

Elicit perceived causes of behaviour and suggest alternative explanations (e.g. external or internal and stable or unstable)

Concerns & queries

Describe common reasons why people with asthma put up with symptoms, illustrating that these beliefs are mistaken and providing alternative explanations for the symptoms.

5.1 Information about health consequences

Provide information (e.g. written, verbal, visual) about health consequences of performing the behaviour

Intro My asthma Treatments Asthma review Exercise Concerns & queries Action plans

Information provided that people who attend for regular asthma reviews have fewer symptoms and fewer asthma attacks.

5.3 Information about social and environmental consequences

Provide information (e.g. written, verbal, visual) about social and environmental consequences of performing the behaviour

Asthma review Exercise

Information provided that people who attend for regular asthma reviews have fewer days off school and work, and fewer limitations in activities.

5.6 Information about emotional consequences

Provide information (e.g. written, verbal, visual) about emotional consequences of performing the behaviour

Concerns & queries

People with asthma describe feeling embarrassed or ashamed taking inhalers in public. Information provided to overcome these concerns and increase confidence about using medications in public.

6.1 Demonstration of the behaviour

Provide an observable sample of the performance of the behaviour, directly in person or indirectly e.g. via film, pictures, for the person to aspire to or imitate (includes ‘Modelling’).

My asthma Treatments Asthma review Exercise Action plans

Quotes for adults with asthma demonstrating how their lives changed for the better when they started taking their inhalers regularly.

6.2 Social comparison

Draw attention to others’ performance to allow comparison with the person’s own performance

My asthma Concerns & queries

In those who have identified that their asthma affects their work they are advised that this is the case with up to 40 % of people with asthma.

6.3 Information about others’ approval

Provide information about what other people think about the behaviour. The information clarifies whether others will like, approve or disapprove of what the person is doing or will do

Asthma review

Quote from practice nurse praising people who proactively attend for asthma reviews.

7.1 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 performance

4 week challenge Emails

Users who sign up to the 4 week challenge are sent weekly emails to remind them of the challenge and prompt them to continue.

8.2 Behavior substitution

Prompt substitution of the unwanted behaviour with a wanted or neutral behaviour

Exercise

Users are provided with sample strategies to increase their levels of physical activity such as walking to the shops rather than taking the car, or giving up a TV programme for a dance class.

8.3 Habit formation

Prompt rehearsal and repetition of the behaviour in the same context repeatedly so that the context elicits the behaviour

4 week challenge

Strategies for prompting users to remember to take inhalers are suggested such as using them at the same time as teeth brushing or the evening meal.

9.1 Credible source

Present verbal or visual communication from a credible source in favour of or against the behaviour

Exercise

Bradley Wiggins quote describing how asthma doesn’t stop him exercising.

12.5 Adding objects to the environment

Add objects to the environment in order to facilitate performance of the behaviour.

4 week challenge

Strategies for prompting users to remember to take inhalers are suggested such having an extra inhaler at work, if they regularly forget their morning dose.

15.1 Verbal persuasion about capability

Tell the person that they can successfully perform the wanted behaviour, arguing against self-doubts and asserting that they can and will succeed

Exercise (external video)

Users are directed to a video which promotes the message that anyone regardless of health status and fitness levels can successfully increase their levels of physical activity.