Table 1 Summary of COM-B Themes classified as Mechanisms, Enablers and Barriers for Children
COM-B component | Identified Theme | Mechanism/ Barrier/ Enabler | Frequency (n transcripts) | Interviewees (Parents/Child, n) | Described as important (Yes/No) | Sample Quote |
|---|---|---|---|---|---|---|
Physical Capability | Breathe Magic enables children to independently perform physical day-to-day tasks | Mechanism | 25 | Child (15) Parents (10) | No | Six months ago, I couldn’t tie a shoelace, now I can. Six months ago, I couldn’t even flap my hand. Now I can. (Child) |
Breathe Magic improves function in children’s affected hand | Mechanism | 12 | Child (7) Parents (5) | No | I can do pinch and I can move my hand more, and I’ve got this exercise I do. And then hold it for 30 s. (Child) | |
Participating in Breathe Magic can be exhausting for children and parents | Barrier | 2 | Parent (2) | No | We would get some challenges sometimes and she would be fatigued and I was exhausted. (Parents) | |
Psychological Capability | Breathe Magic develops children’s independence | Mechanism | 1 | Parents (1) | No | He′s calmer in himself and will just sit there, maybe not ask for help. (Parents) |
Breathe Magic makes children to become capable of regulating emotion | Mechanism | 1 | Child (1) | No | I just used to go up to my bedroom sometimes every once in a while and just cry. I sometimes do that now, but I know how to get it better and stuff. Yeah. (Child) | |
Physical Opportunity | Weekend session is not favoured by children | Barrier | 1 | Child (1) | No | The thing I don’t like, it’s on a Saturday, it’s when I do my football. (Child) |
Breath Magic has two weeks back-to-back intense practice | Enabler | 1 | Parents (1) | No | and the fact that it is two weeks back-to-back, that works because it’s just so intense, it’s all about the two handed and I know you won’t (Parents) | |
Social Opportunity | Breathe Magic creates opportunity to form new friendships | Mechanism | 17 | Child (15) Parents (2) | No | I’ve made a lot of new friends and loads of friends and stuff. And I get to socialise a lot, because at school I don’t really socialise. I’m a bit shy. (Child) |
The Breathe magic team, magicians and mentors provide good learning environment | Mechanism | 6 | Child (1) Parents (5) | No | I like the teachers, the magic trainers. Especially Ed. … … … ..They give you enough time to do the trick, and if you get stuck they can help you. (Child) | |
Breathe Magic creates a team spirit for children | Mechanism | 4 | Parents (4) | Yes | It was about a bunch of kids coming together for magic tricks … because they were, like you said, they were all in the same boat. (Parents) | |
Social environment makes children feel that they are not alone | Mechanism | 4 | Child (2) Parents (2) | No | It gives them that little boost that I’m not on my own, I′ not the only person who’s got hemi.”. That helped them to see that socially, it’s kind of like you’re not alone. (Parents) | |
Breathe Magic provides environment where children help each other | Mechanism | 1 | Child (1) | No | Q. What was the favourite thing about the camp. Ans. I like how people help people at different difficult times. Say if someone was stuck on something, some people might help them. (Child) | |
Breathe Magic creates opportunity to see old friends | Enabler | 1 | Child (1) | No | Favourite thing about the camp - Ans. Probably seeing old friends again. (Child) | |
Breath Magic improves integration with other children in mainstream schooling | Mechanism | 2 | Parents (2) | No | So she is, now, entirely immersed in mainstream education, whereas since nursery, she’s had an education plan and we’ve had to go in and targets and all that sort of stuff but she’s completely | |
The holistic experience of Breathe Magic provides an engaging environment | Mechanism | 3 | Child (1) Parents (2) | Yes | And in terms of the best thing about the camp, I genuinely can’t think of anything that you could do to improve it. It’s the total sum of the different things, it’s the activities, it’s the people, it’s the environment, it’s everything (Parents) | |
Reflective Motivation | Breathe Magic increases children’s self-confidence | Mechanism | 18 | Child (2) Parents (16) | No | The confidence for Alex from the first day 10 days later is just through the roof (Parents) |
Breathe Magic makes children determined | Mechanism | 13 | Child (8) Parents (5) | No | That I can at least come away thinking it’s not like a terrible, terrible thing. You know I can try and I can try. I might not get it, but I can still give it a go. (Child) | |
Breathe Magic increases children’s self-motivation | Mechanism | 7 | Parents (7) | No | she kind of became really confident and motivated with that side of it as well, which is good. (Parents) | |
Breathe Magic increases children’s self-esteem | Mechanism | 5 | Child (1) Parents (4) | Yes | the best thing to come out of the camp is Erin’s self-esteem. (Parents) | |
Children who participated in Breathe Magic would recommend participating the intervention to others | Enabler | 4 | Child (4) | No | Q. What would you say to somebody who was thinking about coming on this camp, someone else with USCP? Ans. Yes I would probably say something nice like just about coming in to the camp. (Child) | |
Breathe Magic enables children to feel comfortable talking about their condition with others | Mechanism | 3 | Parents (3) | Yes | One of the ground-breaking things for her was that she was the confident to tell people about her USCP (Parents) | |
Breathe Magic increases children’s willingness to try new things | Mechanism | 2 | Parents (2) | No | he was much more willing to give everything a go. (Paremts) | |
Breathe Magic increase children’s self-awareness that they need to improve | Mechanism | 2 | Parents (2) | No | this is the self awareness that he should try (Parents) | |
Breathe Magic increases child agency | Mechanism | 1 | Parents (1) | No | Q. it sounds like a lot of you have found that it was more self driven during those two weeks? Ans. Yes” (Child) | |
Breathe Magic makes children to become optimistic about the future | Mechanism | 1 | Parents (1) | No | And then start looking negatively at herself and not wanting to be here, it’s quite hard for us because it’s been a very, very positive thing up until now … ..she, up to a few weeks ago, looked to the future with great optimism (Parents) | |
Automatic Motivation | Breathe Magic reinforces children’s positive feeling about themselves | Enabler | 10 | Child (9) Parents (1) | No | They (Magic Camp) won’t do stuff for you. You have to do it all by yourself. Because they push you to feel good about yourself. (Child) |
Magic is a fun skill for children to learn | Mechanism | 8 | Child (7) Parents (1) | No | I guess just … This might seem a bit obvious, but just learning the magic and just practise it, practising, and trying and just learning new tricks. I like it all really. It’s a nice feeling just doing magic and, yeah, and just have magic, yes. (Child) | |
Breathe Magic makes children to feel proud of their achievement | Mechanism | 6 | Children (5) Parents (1) | Yes | Proud, to be honest. Like it was a sense of ... but at the same time it was kind of like, “Oh I can do this now.” It was kind of surreal because I was just like slowly progressing and I was watching myself do it (Child) | |
Breathe Magic makes children become less frustrated | Mechanism | 4 | Parents (4) | No | The frustration was reduced. (Parents) | |
Breathe Magic is not seen as therapy but fun practice to learn Magic | Mechanism | 2 | Parent (2) | Yes | that’s the important thing, isn’t it, that it’s therapy without being therapy (Parents) | |
Breathe Magic makes children feel more independent | Mechanism | 1 | Child (1) | No | It makes me feel more independent. (Child) | |
Breathe Magic helps children discontinue self-punishing behaviours | Mechanism | 1 | Child (1) | No | Alex had some quite negative physical behaviours towards himself because of how he felt before the camp. He′d sort of bite himself, hit himself, call himself ridiculous, directly because of the USCP and what he couldn’t do at any given time and I haven’t actually seen any of that, which is marvellous (Parents) | |
Breathe Magic makes children feel helpful | Mechanism | 1 | Child (1) | No | It’s good to be able to feel like I can help in some way I guess. (Child) |