| BCT | Definition | Coded excerpt example | Frequency (number of instances) | Frequency (%) | |
|---|---|---|---|---|---|
| 1. | Information about health consequences | “Provide information (e.g., written, verbal, visual) about health consequences of performing the behaviour” | “Anorexia can cause severe physical problems because of the effects of starvation on the body. It can lead to loss of muscle strength and reduced bone strength” | 27 | 22.5% |
| 2. | Social support (unspecified) | “Advise on, arrange or provide” social support (e.g., from friends, relatives, colleagues,’ buddies’ or staff) or noncontingent praise or reward for performance of the behaviour. It includes encouragement and counselling” | “Get counselling … in particular, look into cognitive behavioural therapy (CBT) … a CB therapist will help to break the patterns of disordered eating through the use of food monitoring, thought monitoring and meal regularity and nutritional monitoring” | 24 | 20.0% |
| 3. | Information about antecedents | “Provide information about antecedents (e.g., social and environmental situations and events, emotions, cognitions) that reliably predict performance of the behaviour” | “Predicting factors of anorexia include social pressure to be thin, difficulty expressing feelings, a lack of social or family support…” | 23 | 19.2% |
| 4. | Instruction on how to perform the behavior | “Advise or agree on how to perform the behaviour (includes ‘Skills training’)” | “Advise on eating a small or medium serving of a nutrient-dense food provides needed calories and nutrition” | 13 | 10.8% |
| 5. | Social support (practical) | “Advise on, arrange, or provide practical help (e.g., from friends, relatives, colleagues, ‘buddies’ or staff) for performance of the behaviour” | “A physician should be supervising the recovery process and meeting with you in a medical office on a regular basis … weekly weigh-ins, vital signs measurement, and periodic laboratory testing including CBC, serum electrolytes and serum amylase levels” | 5 | 4.2% |
| 6. | Information about social and environmental consequences | “Provide information (e.g., written, verbal, visual) about social and environmental consequences of performing the behaviour” | “The illness can affect people’s relationship with family and friends, causing them to withdraw” | 3 | 2.5% |
| 7. | Pharmacological support | “Provide, or encourage the use of or adherence to, drugs to facilitate behaviour change” | “Advise to be on life-long calcium, have normal levels of vitamin D (or take supplements to achieve normal levels)” | 3 | 2.5% |
| 8. | Salience of consequence | “Use methods specifically designed to emphasise the consequences of performing the behaviour with the aim of making them more memorable (goes beyond informing about consequences)” | “Complications of anorexia includes dehydration and can lead to highly concentrated urine and more urine production (image provided to emphasise the consequence)” | 3 | 2.5% |
| 9. | Social comparison | “Draw attention to others’ performance to allow comparison with the person’s own performance” | “Learn from others, seek out success stories from other people recovering from anorexia … figure out what they did to change their relationship with food and eating for the better” | 3 | 2.5% |
| 10. | Action planning | “Prompt detailed planning of performance of the behaviour (must include at least one of context, frequency, duration and intensity)” | “Eat throughout the day … eat regular meals, spaced about three to four hours apart” | 2 | 1.7% |
| 11. | Habit formation | “Prompt rehearsal and repetition of the behaviour in the same context repeatedly so that the context elicits the behaviour” | “Snack more frequently. Reminding yourself to eat more often, to snack between meal and to eat whenever you feel hungry … get into the habit of snacking throughout the day on small healthy foods” | 2 | 1.7% |
| 12. | Self-monitoring of behaviour | “Establish a method for the person to monitor and record their behaviour(s) as part of a behaviour change strategy” | “Keep a food journal. Keeping track of food intake can lead to healthier eating habits” | 2 | 1.7% |
| 13. | Adding objects to the environment | “Add objects to the environment in order to facilitate performance of the behaviour” | “Keep a small scale and measuring cups on hand when preparing meals” | 1 | 0.8% |
| 14. | Conserving mental resources | “Advise on ways of minimising demands on mental resources to facilitate behaviour change” | “Advise to measure and weigh your food, humans are not a good judge of size, so keep a small scale and measuring cups on hand when preparing meals” | 1 | 0.8% |
| 15. | Credible Source | “Present verbal or visual communication from a credible source in favour of or against the behaviour” | “I suffered from the age of 12 until I finally sought help at the age of 24 … I thought that change would never be possible and therapy was such hard work. It took a long time but I eventually entered recovery and have never looked back. My life now is wonderful!” | 1 | 0.8% |
| 16. | Distraction | “Advise or arrange to use an alternative focus for attention to avoid triggers for unwanted behaviour” | “Distract yourself with these unique and incredible images (series of photos were provided)” | 1 | 0.8% |
| 17. | Feedback on behaviour | “Monitor and provide informative or evaluative feedback on performance of the behaviour (e.g., form, frequency, duration, intensity)” |
“Time you have saved so far # Days, # Hours # Minutes” (a time that clocks the period you refrain from engaging in anorexic behaviour) | 1 | 0.8% |
| 18. | Information about emotional consequences | “Provide information (e.g., written, verbal, visual) about emotional consequences of performing the behaviour” | “What it is like to have anorexia … As I lost weight I began to feel tired and this made me more depressed, I couldn’t think straight or concentrate in school … I realise now I was suffering from the effects of starvation” | 1 | 0.8% |
| 19. | Monitoring emotional consequences | “Prompt assessment of feelings after attempts at performing the behaviour” | “Track how you’re feeling before and after you eat, and what kind of thoughts you’re having that may affect eating habits and lead to unnecessary food restriction” | 1 | 0.8% |
| 20. | Non specific reward | “Arrange delivery of a reward if and only if there has been effort and/or progress in performing the behaviour (includes ‘Positive reinforcement’)” | “Trophies are locked until your progress passes each phase. You are then awarded trophies to help you stay motivated and tract your progress” | 1 | 0.8% |
| 21. | Re-attribution | “Elicit perceived causes of behaviour and suggest alternative explanations (e.g., external or internal and stable or unstable)” | “Though the restrictive eating patterns that characterise this anorexic eating disorder are similar to dieting behaviours, there are stark differences … while someone may diet in an attempt to control weight, anorexia nervosa is often an attempt to gain control over one’s life and emotions” | 1 | 0.8% |
| 22. | Social support (emotional) | “Advise on, arrange, or provide emotional social support (e.g., from friends, relatives, colleagues, ‘buddies’ or staff) for performance of the behaviour” | “Advise on setting goals with your doctor, mental health professional and registered dietitian [and set] goals in the area of learning emotional self-care and developing trust in people who are trying to help you” | 1 | 0.8% |
| Total | 120 | 100.0% |