Table 3

Supporting quotations for qualitative themes

Subtheme (TDF domain)Supporting quotations
Theme 1: Pre-existing beliefs and available support facilitated intervention engagement and positive outcomes
 Beliefs about capabilities‘I’m very good at, you know, if I have a program that I start with I’m very good at sticking to it…I’ve lost a considerable amount of weight. I’m getting more exercise than I ever did in the past, things like that. So, yeah, diet and exercise mainly, and staying on the meds that have been prescribed, following that to a T’. (P006)
‘I have been exercising vigorously and very dedicated for 40 years. I go to the gym four or five times a week and when I go to the gym I work hard…I’m a very disciplined person, a very disciplined person. No, they didn’t have to tell me to exercise, they didn’t have to change my diet, they didn’t need to tell me to lose weight, I’m disciplined’. (P015)
 Beliefs about consequences‘It wasn’t hard for me to make the changes, because my thinking is that I want to live. And, I want my health while I’m living. To be healthy. I’d rather make those changes than to run into a more difficult situation’. (P014)
‘I wanted to get back to the gym as fast as I can so I asked the doctor. This was probably a week after I had the angioplasty. He said well, give it about 10 days, and then go back so I went back to the gym. I took it easy for the first day, and then I went back to exactly what I was doing before’. (P021)
 Social influences‘The coaching at the rehab, the physiotherapists that were there, they really encourage you, they really tell you you’re doing great. You’re better, but just give it another five min, just try a little harder, I bet you can do it, you know, that’s very helpful for me. And it was helpful to the point where now when I’m at home working out myself, and, like you said, you get to that point where your knees are just aching, your ankle’s hurting. You’re like, ah, this is stupid, I've got to take a break. Then you’ve got to tell yourself, no, you can’t. And I think, basically, I’m kind of reflecting back on them telling me that, that’s still helping me, and you get through it’. (P006)
Theme 2: The intervention components provided knowledge and strategies to promote adherence
 Behavioural regulationEducational booklets
‘(There were) small things I would pick up. Again, the reminders, and although I can’t think of anything specific, but there were little things that (the booklets) said to do. I’d say ‘oh, I’m not doing that much so maybe I’d better pick up on that one a bit’ or something. They talk I guess quite a bit about missing medicines and stuff’. (P021)
 Reinforcement‘(The automated phone call) sort of of reinforces what you should do, even if you’re not doing what you’re supposed to do, and you get the phone call. Just by them asking you these questions, it would be like, oh, I should have been doing that, I forgot about that, or I missed that. To me, that aspect, it helped’. (P007)
 Knowledge‘I think the (automated) calls were more helpful than the literature. I think it was just a way of keeping me on track and realizing there was … even though it was automated and all that, that you could access something if you really needed help’. (P001)
 Social influence‘With (LHW calls), they ask you questions you wouldn’t think about. That would help you in the end because if it’s somebody who has been doing, asking these questions, they will think about things which you … well, I wouldn’t think of, some of the things. But just by them asking you, then it gets your mind going on it’. (P007)
Theme 3: Failure to address aberrant beliefs, emotion and identity contributed to non-adherence
 Beliefs about consequences‘I’m just kind of leery of that exercise and stuff. I have known people that went for them and died doing them…I even worked with a fellow. He’d come in and he said, I just dropped my aunt off and I worked in the office. Ten minutes later he got a call she dropped dead on one of the treadmills’. (P010)
‘I started doing laundry, but when they’re dry I bend and stretch to take out each piece individually, so I’m bending and stretching. That’s it. If I’m going for a walk I like a destination. If I’m doing bending and stretching, I want to accomplish something. And if I’m doing the laundry all the time, I’m getting that exercise’. (P022)
 Emotion‘I think I was surprised that shortly after the heart attack, maybe within a month or two, I was a little bit more emotional. It affected me more psychologically’. (P020)
‘I was paranoid. I cried a lot. I would have nightmares about going for a walk to the garage and I would fall over… I was even thinking about suicide about three or four months ago. I would just sit here and cry’. (P016)
 Identity‘I felt like I could do it on my own and go the holistic route, which did work until I decided to change my mind again’. (P008)
 Memory, attention and decision-making‘It’s a thing I’ve got to learn to deal. I can’t rely on people all the time to remind me every time I’m supposed to take my meds. It’s something I have to get into a routine’. (P026)
‘If you get tied up in something a little different, you’re going to go out and do something, it’s easy to just forget that it is something you have to take’. (P017)
  • TDF, Theoretical Domains Framework.