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Table 2 Summary of COM-B Themes Classified as Enablers and Barriers for Parents

From: Identifying mechanisms of change in a magic-themed hand-arm bimanual intensive therapy programme for children with unilateral spastic cerebral palsy: a qualitative study using behaviour change theory

COM-B component Identified Theme Mechanism/ Barrier/ Enabler Frequency
(n transcripts)
Interviewees (Parents/Child, n) Described as important
Sample Quote
Physical capability 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 helps parents to take a step back to allow the child to become more independent Enabler 5 Parents (5) No just step back right from today and I had to say to myself emotionally because, to be clear and to just prepare myself where I’m going to step back and from the day, just stepping back just helped to give them the opportunity as well (Parents)
Physical opportunity The location of Breathe Magic is (not) difficult to access Barrier/ Enabler 3 Parents (3) No Because were offered some of these (Breath) services based on where you live and they are broad (Parents-Enabler)
really mean like Heathrow because you can take direct Trains there, or you could drive there because central London is just so congested and when you have little ... kids, it’s just too much. The journey just tired them out as well. So, if it’s a simpler journey it would be much easier for the child (Parents-Barrier)
  Cost of attending the Breathe Magic is high Barrier 2 Parents (2) No while we were doing it but then finding accommodation and the cost and everything involved, it is massive and it (Parents)
Social opportunity Breathe Magic creates social interaction among parents of a child with USCP Enabler 3 Parents (3) Yes meeting other people, I think, because I’d never met another parent of a child with USCP or ... So that has been really important for us as well. (Parent)
  Parents wish social interaction could be continued long-term Barrier 2 Parents (2) No I do want to keep in contact with people and see how they’re getting on, and you mentioned about learning to drive and that’s something that bothers me with Jasmine because, obviously, adapted cars and things like that don’t come easy, do they? So I just ... And jobs and things like that. So keeping that connection, maybe, long term rather than just short term. (Parents)
Reflective motivation Breathe Magic makes therapy sound positive to talk about Enabler 2 Parents (2) No friends and family ask you about Amelie and how she’s getting on, a lot of it is, “Oh, we’ve got this hospital visit and we’re going to do physio and we’re going to do this” and a lot of it’s quite negative, so it’s nice to have something quite positive to talk about. (Parents)
  Breathe Magic provides confidence to parents that their children can do things on their own in day-to-day activities Mechanism 2 Parents (2) No I am so confident now that he will be able to do things without asking for help (Parents)
  Breathe Magic still requires parents to keep reminding children to practice their hands Barrier 1 Parents (1) No but, again, I’ve noticed if you don’t keep reminding him now, he’s not thinking to do it again and he will just not ... As you say, it’s easier not to, he won’t necessarily do it. (Parents)
  Breathe Magic allows parents to encourage less for children to practice their hands Enabler 1 Parents (1) No I am not so heavy on “Come on, come on you need to do that” (Parents)
Automatic motivation Breathe Magic gives parents the chance to see unexpected achievement from their children Enabler 1 Parents (1) No I think for me, being surprised by the things she could do after hard work. (Parents)