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Table 1 Specifying the intervention using a taxonomy of behavior change techniques (BCTs) [22, 23]

From: ‘Help for Hay Fever’, a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial

Core elements of the intervention

Label

Definition

How is it operationalized in the ‘Help for Hay Fever’ study?

Goals and planning

Goal-setting outcome

Set or agree a goal defined in terms of a positive outcome of wanted behavior.

Set a pre-determined outcome goal: ‘eliminate/minimize symptoms.’

Goal-setting behavior

Set or agree a goal defined in terms of the behavior to be achieved.

Set a pre-determined behavior goal: ‘avoid/minimize triggers’.

Problem solving

Analyze factors influencing the behavior and generate or select strategies that include overcoming barriers and/or increasing facilitators.

Identify specific barriers to achieving optimum management of hay fever, for example, not taking medication regularly, and suggest personalized strategies to overcome this, for example, provide prompts/cues for medication adherence.

Action planning

Prompt detailed planning of performance of the behavior.

Plan personalized strategies to achieve the two specified goals (avoid/minimize triggers and eliminate/minimize symptoms) and complete a personalized goals card:

  

a) Focus on personal symptoms and symptom triggers and help the person to develop specific behavioral strategies to achieve the goals.

  

b) Negotiate the strategies the person would like to use to control the symptoms/triggers and ask them to write these on the goals card.

Natural consequences

Information about health consequences

Provide information about health consequences of performing the behavior.

Present the likelihood of an improved quality of life, reduced symptom severity, better productivity.

Regulation

Pharmacological support

Provide, or encourage the use of or adherence to, drugs to facilitate behavior change.

Advise on hay fever medications and encourage medication adherence.

Feedback and monitoring

Self-monitoring of behavior

Establish a method for the person to monitor and record their behavior(s) as part of a behavior change strategy.

Ask the person to record daily whether or not they have taken their hay fever medication, using a diary booklet provided.

Self-monitoring of outcome(s) of behavior

Establish a method for the person to monitor and record the outcome(s) of their behavior as part of a behavior change strategy.

Ask the person to record daily their symptom severity score using a diary booklet provided.

Personalized elements of the intervention

Regulation

Social support (practical)

Advise on, arrange, or provide practical help (for example, from friends, relatives, colleagues, ‘buddies’ or staff) for performance of the behavior.

Provide if appropriate, based on discussion with customer about how social contacts might facilitate trigger avoidance for example, ask a friend, relative or neighbor to cut the grass for them.

Antecedents

Restructuring the physical environment

Change, or advise to change the environment in order to facilitate performance of the wanted behavior or create barriers to the unwanted behavior (other than prompts/cues, rewards and punishments).

Provide if appropriate, based on discussion with customer about any specific hay fever triggers.

  

a) Changes to physical environment might include moving indoor pot plants; removing visible mould with bleach/ anti-mould cleaner; closing windows.

Restructuring the social environment

Change, or advise to change the social environment in order to facilitate performance of the wanted behavior or create barriers to the unwanted behavior (other than prompts/cues, rewards and punishments).

b) Changes to social environment might include avoiding social occasions that trigger symptoms, for example, outdoor picnics.

Associations

Prompts/cues

Introduce or define environmental or social stimulus with the purpose of prompting or cueing the behavior.

Provide if appropriate, based on discussion with customer about any barriers to the target behavior, for example, leaving hay fever medication in an obvious place to remind people to take it in the morning (beside car keys, next to toothbrush, and so on).