Table 1 Description of the sessions and the different factors assessed along the I-Change Gout tool, and the source of the questions

I: Pre-motivational

To improve person’s awareness of the importance of ULT and their personal behavior towards ULT adherence

Demographics

Socio-economic background (e.g. age, gender, educational level, marital status, and work situation)

Adapted from previous effective I-Change tool and input from experts

Comorbidities

Common diagnosed comorbidities influencing the management and control of gout

Rheumatic Disease Comorbidity Index questionnaire adapted for the purpose of the tool [59]

Gout knowledge

The understanding of factual information regarding gout related to the pathogenesis, treatment of acute attacks and also management of chronic gout

Gout Knowledge Questionnaire adapted for purpose of the tool [36]

Perceived ULT adherence

Person’s perception about his or her own ULT adherence behavior

Previous effective I-Change tools

Objective ULT adherence

The degree to which the person’s ULT adherence behavior corresponds with recommended ULT use from a health care provider

ProMAS questionnaire adapted for ULT use [46]

Risk perception

The perceived risk of gout flares or other gout problems as a result of non-adherence to ULT

Adapted from previous effective I-Change tool and input from experts

Cues to action

Hints or signals a person is perceiving within his/her environment (external) or within him/herselff (internal) that trigger an action linked to the ULT adherence behavior

Adapted from previous effective I-Change tool and input from experts

Intention

A person’s motivation in the sense of his or her conscious plan or decision to improve the ULT adherence behavior. The intention to adapt behavior detemines the navigation of the sessions. Decisive to move first to session II or immediately to session III

As in previous effective I-Change tool

II: Motivational

To improve motivation to take action regarding their ULT adherence behavior

Attitudes

A person’s overall evaluative opinion about their ULT adherence behavior as a result of the perceived advantages and disadvantages of the ULT adherence for this person

Adapted from previous effective I-Change tool and literature

Social influence

The processes whereby person’s thougths, feelings, and actions about ULT adherence are directly or indirectly influenced by others

Adapted from previous effective I-Change tool

Self-efficacy

The level of one's own belief to successfully carry out the desired ULT adherence behavior in certain difficult situations

Adapted from previous effective I-Change tool and input from experts

III: Post-motivational

To support patients in translating intentions into pre-formulated actions and coping plans to promote desired behavior

Plans ULT adherence

The process of choosing and planning specific actions and plans that may help to successfully adopt and maintain the ULT adherence behavior

Adapted from previous effective I-Change tool

Plans difficult situations

The types of plans needed to maintain a behavioral change attempt and can contribute in a person’s pursuit to cope and overcome obstacles and difficulties by anticipating how to address these obstacles and difficult situation

Adapted from previous effective I-Change tool