FIGURE 2
Behaviour change competencies in the self-management of chronic disease ( Train4Health © )
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BC1 Knowledge of health behaviour and health beliefs
BC2 Knowledge of appropriate behaviour change models / theories
BC4 Knowledge of clinical features of chronic diseases and target behaviours for their self-management
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Ability to identify selfmanagement needs in relation to target behaviour ( s ) relevant for the chronic disease ( s )
BC8
Ability to identify and select behaviour change techniques that are tailored to behavioural determinants ( opportunities and barriers ) in developing an intervention plan
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BC5
Ability to identify opportunities and barriers ( determinants ) to implementing change in the target behaviour
BC10
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BC6 Ability to engage and empower individuals with chronic disease in self-management
BC7 Ability to foster and maintain a good intervention alliance with individuals
BC9 Ability to work in partnership to prioritiese target behaviours to develop an intervention plan
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BC11
Ability to apply behaviour changes techniques and implement the intervention plan , adapting and tailoring as required
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Ability to select behaviour change techniques that are appropriate to the length of the intervention ( brief or long-term )
BC12
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BC14 Ability to provide access to appropriate information and education materials tailored to individual needs |
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BC13 |
Ability to plan for follow-up and maintenance when the target behaviour has been achieved |
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are represented in Figure 2 . The central part of the figure depicts , from a behaviour change perspective , the traditional assessment – planning – intervention – monitoring cycle , familiar to health and other professionals . BC1 , BC2 , BC3 and BC4 , depicted on the left side of Figure 2 , indicate knowledge required to deliver behaviour change support in chronic disease . On the right side , BC6 , BC7 , BC9 and BC14 are communication and relationship abilities , essential across the assessment – planning – intervention – monitoring cycle .
In what pertains the secondary aim , a core set of 21 BCTs common to the five target behaviours in high priority chronic diseases ( Table 1 ) was derived and associated to Train4Health competency statements . 2 The core set of 21 BCTs can be found elsewhere . 2
Applying BCTs in medication adherence consultations Tailoring the intervention to medication adherence barriers increases the likelihood of success . 18 For example , a pillbox or reminders will do little for a person deciding not to take a medication due to concerns about side effects ; such barrier requires techniques increasing knowledge or understanding , such as information about health consequences ( 5.1 ), or inducing a feeling to stimulate action , such as pros and cons ( 9.2 ). These BCTs consist of , respectively , highlighting the positive and negative consequences of taking the medication and advising the person to compare reasons for wanting and not wanting to perform the behaviour . 7 Examples of how to apply BCTs in relation to common adherence barriers are presented in Table 2 for forgetfulness and in Table 3 for beliefs about lack of necessity and concerns about medicines .
Increasing the likelihood of success of adherence interventions also requires tailoring BCTs and its application to the person ’ s unique combination of morbidities , functional status , activities of daily living , preferences , and resources . An important consideration is that it might be unnecessary and potentially inappropriate to deliver all BCTs listed in Table 2 to a person forgetting to take a medication ( likewise for Table 3 for BCTs addressing beliefs about medication ). The patient
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