Table 5

Frequency of theoretically congruent behaviour change techniques (BCTs) within the key Theoretical Domains Framework (TDF) domains

BCTs theoretically congruent with the key TDF domains
(based on a predefined matrix12 †)
BCT frequency% Potentially relevant BCTs used ¶
National interventionsResearch interventions
(n=26) ‡(n=5) §
TDF domain 1: beliefs about consequences
Information about health consequences14360% (9/15)
Information about social and environmental consequences52
Salience of consequences20
Pros and cons10
Credible source71
Information about emotional consequences00
Covert sensitisation00
Anticipated regret00
Vicarious reinforcement00
Comparative imagining of future outcomes00
Self-monitoring of behaviour60
Self-monitoring of outcome(s) of behaviour30
Feedback on behaviour72
Feedback on outcome(s) of behaviour50
TDF domain 2: social influences
Social comparisons6160% (6/10)
Social support (practical)61
Social support (unspecified)24
Demonstration of the behaviour43
Social support (emotional)00
Information about others’ approval00
Vicarious consequences00
Restructuring the social environment00
Identification of self as role model60
Social reward20
TDF domain 3: skills
Instruction on how to perform the behaviour*12524% (4/17)
Demonstration of the behaviour43
Behavioural practice / rehearsal30
Pharmacological support*10
Graded tasks00
Habit reversal00
Habit formation00
Goal setting (outcome)00
Goal setting (behaviour)10
Monitoring by others without feedback10
Reward (outcome)00
Material reward10
Non-specific reward20
Generalisation of target behaviour00
TDF domain 4: environmental context and resources
Adding objects to the environment9367% (4/6)
Restructuring the physical environment10
Discriminative cue00
Avoidance/reducing exposure to cues for the behaviour00
Restructuring the social environment00
TDF domain 5: intentions
Commitment1050% (1/2)
Behavioural contract00
TDF domain 6: emotions
Reduce negative emotions000% (0/5)
Information about emotional consequences00
Self-assessment of affective consequences00
Social support (emotional)00
Conserving mental resources00
  • *BCTs that were not included in the matrix,12 but corresponded with that TDF domain in the coded intervention components.

  • †The BCTs were matched with theoretically congruent TDF domains based on the matrix developed previously and available elsewhere (p93,12). BCT ‘biofeedback’ was removed from the TDF domain ‘beliefs about consequences’ and BCT ‘body changes’ was removed from TDF domain ‘skills’ (despite being listed in the matrix) as they are considered not relevant to antimicrobial stewardship interventions, and therefore not ‘possible’ BCTs.

  • ‡Twenty-six national interventions identified in the previous project,6 including four effective research interventions.

  • §Five effective research interventions identified in this project, without the four effective research interventions that were also nationally implemented.

  • ¶Proportion of all possible BCTs theoretically congruent with each TDF domain (according to the matrix12) that were used at least once in interventions.