Table 4 Synthesis of findings. Links between COM-B model, TDF domains and suggestions of intervention functions to enable HCPs to support physical activity in adolescents with T1DM
barriers and enablers for supporting adolescents with T1DM to be physically active | TDF domains linking to COM-B components | Possibly intervention functions | |
|---|---|---|---|
CAPABILITY | Psychological Capability: | ||
Limited knowledge on what to advise in terms of adjustments to insulin and carbohydrate intake, as well as how different forms of exercise may impact blood glucose levels | Knowledge and skills | Education, Training – increasing HCP knowledge and understanding of physical activity as well as skills training to help them motivate and encourage behaviour change in adolescents they care for | |
OPPORTUNITY | Physical opportunity: | ||
Time | Environmental context and resources | Environmental restructuring – Ensure HCPs have time to have discussions around physical activity or prioritise these conversations | |
Resources – have the necessary materials to be able to signpost to | Environmental context and resources | Enablement – Provide resources to allow HCPs to signpost to advice. Ensure guidance is easy to follow and accessible | |
Current guidelines that HCPs are meant to follow are Complex and so hard to implement in practice | |||
Social opportunity: | |||
Colleague support – having support from others to do it and people around them doing it | Social influences | Modelling, Enablement – Making conversations about physical activity a normal part of consultations. Having physical activity champions within clinics | |
MOTIVATION | Reflective motivation: | ||
Important part of clinical role – Have a sense that they should be doing it | Memory, attention and decision Processes | Training, environmental restructuring – Enuring that supporting physical activity remains an important part of clinical role through training and providing prompts to have conversations with patients | |
Auditing and tariff payments | Reinforcement | Incentivisation, Environmental restructuring – Making support for physical activity part of clinical care and auditable, or incentivising promotion of physical activity | |
Automatic motivation: | |||
Confidence | Beliefs about capabilities | Education, Modelling – education to boost confidence in providing evidence based advice to patients | |