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Table 1 Example of behaviour change techniques [24] used at the initial assessment (t1) and subsequent reviews (t2-t18)

From: Effect of early and intensive nutrition care, delivered via telephone or mobile application, on quality of life in people with upper gastrointestinal cancer: study protocol of a randomised controlled trial

  Behaviour change technique Definition [24] Example Classificationa
Initial assessment (t1) Goal setting (behaviour) Set or agree on a goal defined in terms of the behaviour to be achieved Set the goal of eating 5 pieces of fruit per day Routinely Used
Goal setting (outcome) Set or agree on a goal defined in terms of a positive outcome of wanted behaviour Set a weight gain goal (e.g. 0.5 kg over one week) as an outcome of changed eating patterns Supplementary
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 Prompt the patient to identify potential barriers to them drinking a particular supplement (e.g. bad taste) and discuss ways in which they could overcome them (e.g. mix with strawberries) Supplementary
Action planning Prompt detailed planning of performance of the behaviour (must include at least one of context, frequency, duration and intensity). Context may be environmental (physical or social) or internal (physical, emotional or cognitive) Prompt planning the drinking of a supplement at a particular time (e.g. before work) on certain days of the week Routinely Used
Monitoring of behaviours (by self) Establish a method for the person to monitor and record their behaviour(s) as part of a behaviour change strategy Ask the person to record daily, in a diary, the amount of food they have eaten Supplementary
Monitoring of outcome (by self) Establish a method for the person to monitor and record the outcome(s) of their behaviour as part of a behaviour change strategy Ask the person to weigh themselves at the end of each day, over a two week period, and record their daily weight on a graph to increase food intake Supplementary
Instruction on how to perform behaviour Advise or agree on how to perform the behaviour (includes ‘Skills training’) Demonstrate or describe to person how to prepare thickened fluids Routinely Used
Information about antecedents Provide information about antecedents (e.g. social and environmental situations and events, emotions, cognitions) that reliably predict performance of the behaviour Discuss how people find it difficult to follow their diet when they attend social events Supplementary
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 Put a sticker on fridge to avoid eating cheesecake Supplementary
Graded tasks Set easy-to-perform tasks, making them increasingly difficult, but achievable, until behaviour is performed Ask patient to consume supplement once per day the first week, then twice per day the second week. Supplementary
Body changes Alter body structure, functioning or support directly to facilitate behaviour change Prompt use of dentures to promote food consumption Supplementary
Review sessions (t2-t18)b Review goal (behaviour) Review behaviour goal(s) jointly with the person and consider modifying goal(s) or behaviour change strategy in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of (or in addition to) the first, or no change. Ask if the patient drank the supplement as planned Routinely Used
Review goal (outcome) Review outcome goal(s) jointly with the person and consider modifying goal(s) in light of achievement. This may lead to resetting the same goal, a small change in that goal or setting a new goal instead of, or in addition to the first Ask if the patient achieved the weight gain goal Supplementary
Highlight discrepancy between current and goal (behaviour or outcome) Draw attention to discrepancies between a person’s current behaviour (in terms of the form, frequency, duration, or intensity of that behaviour) or outcome and the person’s previously set behavioural goals or action plans Point out that the recorded supplement intake fell short of the goal set Routinely used
Monitoring of behaviours (by others, without feedback) Observe or record behaviour with the person’s knowledge as part of a behaviour change strategy Have partner observe food intake behaviours and make notes on content and frequency Supplementary
Monitoring of behaviours (by others, with feedback) Monitor and provide informative or evaluative feedback on performance of the behaviour (e.g. form, frequency, duration, intensity) Have partner observe food intake behaviours and make notes on content and frequency, inform patient of how many calories they are likely to have ingested per day Supplementary
Monitoring of outcome (by others, without feedback) Observe or record outcomes of behaviour with the person’s knowledge as part of a behaviour change strategy Weigh the person every two weeks Supplementary
Monitoring of outcome (by others, with feedback) Observe or record outcomes of behaviour with the person’s knowledge and provide informative or evaluative feedback Inform the person of how much weight they have gained lost following the implementation of a new supplement program Supplementary
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 Arrange for a partner to encourage patient to use supplements Supplementary
Social support (practical) Advise on, arrange, or provide practical help (e.g. from friends, relatives, colleagues, ‘buddies’ or staff) for performance of the behaviour Ask the partner to mix the supplement with strawberries for the patient Supplementary
Consider pros and cons Advise the person to identify and compare reasons for wanting (pros) and not wanting to (cons) change the behaviour Advise the person to list and compare the advantages and disadvantages of drinking the supplement Supplementary
  1. t1 indicates week one of the intervention, t2-t18 indicates the subsequent weeks of the intervention
  2. aBehaviour change techniques have been classified as routinely used techniques to be used with all participants, and supplementary techniques that can be optionally be used
  3. bThese behaviour change techniques are either tied to subsequent sessions because they cannot logically take place during the first session (e.g. review goals), or they are considered to be secondary techniques that one would use if the initial techniques in the Table above had failed