Table 1

Mapping CYPHP components to the constructs of the Theoretical Domains Framework

DomainCYPHP model of careEnhanced usual care
CYPHP care for tracer conditionsCYPHP ‘in-reach’ clinicsCYPHP
Health Checks for tracer conditions
Support tools and services for health professionalsEducation and training
Knowledge: an awareness of the existence of somethingOne-to-one appointments where patients can ask specific questions.One-to-one learning in joint clinics where there is opportunity to learn knowledge.Health Packs describe to patients the causes and triggers of their condition.Evidence-based guidelines, algorithms and referral guidance for common conditions (eg, urinary tract infection, headache, allergies).Training to improve awareness of difficulties within CYP’s health to:
  • General practices;

  • Personal advisors;

  • Teaching staff.

Skills: ability or proficiency acquired through practice
  • Multidisciplinary working within health team fosters improved competence to tackle mental and social concerns of CYP.

  • One-to-one visits with CYP helps improve self-management skills (eg, use inhaler correctly).

General practices working with consultant to impart skills in managing certain conditions.Health Packs designed to provide valuable skills-based techniques in managing condition rather than simply provide information.Training for:
  • General practices on how to communicate more effectively with CYP.

  • Personal advisors to better support CYP leaving care.

  • Teachers on promoting emotional resilience in CYP.

Social or professional role and identity: a coherent set of behaviours and displayed personal qualities of an individual in a social or work settingMultidisciplinary culture of health staff team places emphasis and responsibility on treating social and mental health concerns in addition to focusing on physical condition.
Beliefs about capabilities: self-efficacy or acceptance of the truth, reality or validity about an ability, talent or facility that a person can put to constructive useEncouraging CYP and families to better self-manage the child’s condition.Teaching other general practices how they can better manage a child’s presentation of illnesses.
Beliefs about consequences: acceptance of the truth, reality or validity about outcomes of a behaviour in a given situationRoutine visits help encourage positive patterns of behaviour and deter negative patterns of behaviour by providing feedback by health team.Information about what will happen if CYP do not better manage their condition.Training on the lasting impact of not treating CYP mental and physical health early to general practices, teachers and personal advisors.
Motivation and goals: intention or mental representations of outcomes or end states that an individual wants to achieveGoal-based outcomes used routinely as part of clinical care to help encourage CYP to manage condition for a reason that is salient to them.Goal setting exercises help CYP realise why managing their condition is relevant.
Memory attention and decision processes: the ability to retain information, focus selectively on aspects of the environment and choose between alternativesClinical templates to aid nurses to talk through physical, mental and social barriers for CYP not self-managing their condition effectively.Health Pack material for CYP focuses on self-monitoring techniques (eg, take medication, plan for likely triggers).
  • Clinical templates guide general practices on how to talk about issues commonly faced by teens.

  • Guidelines advise appropriate actions.

Environmental context and resources: any circumstance of a person’s situation or environment that discourages or encourages the development of skills and abilities, independence, social competence and adaptive behaviourCYPHP nurses are flexible to allow some patients home visits so that they can better understand the triggers for poor health symptoms. Appointments also longer to allow time for CYP to express their concerns.Patients can receive specialist advice, with their general practice, within practices close to home rather than having to go to secondary or tertiary settings.Resources embedded into local general practice data systems so that they can be accessed easily during a consultation to help general practices provide evidence-based best practice.
Social influences: those interpersonal processes that can cause individuals to change their thoughts, feelings or behavioursCYPHP clinics designed to encourage interaction with health professional peers to gain better understanding of condition.
Emotion: a complex reaction pattern, involving experiential, behavioural and physiological elements, by which the individual attempts to deal with a personally significant matter or eventCYPHP health team is trained to focus on the emotional impact of the condition and treat with equal emphasis as the physical condition.Health Pack material has sections focused on techniques to manage mood and emotional concerns.Clinical templates to guide care place focus on asking about any emotional concerns the CYP may be experiencing.All training is focused on the emotional concerns of CYP.
Behavioural regulation: anything aimed at managing or changing objectively observed or measured actionsClinical templates promote standardised way of documenting care delivered and received.Clinical templates and guidelines provide framework to guide clinical care.
Nature of the behaviours: description of how the behaviour is conductedDocumented procedures on how to manage the physical, social and emotional concerns of CYP.Behaviours taught through collaborative clinics will be taken by general practices to use in regular practice.Visual information on how to conduct positive self-management behaviours.Guidance on appropriate behaviours to follow in providing support.Training to discourage maladaptive behaviours and foster new patterns.
  • Green, active delivery (eg, face-to-face, guided demonstration).

  • Yellow, passive delivery (eg, written text, leaflet).

  • CYPHP, Children and Young People’s Health Partnership ; CYP, children and young people.