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. 2017 Mar 9;12:33. doi: 10.1186/s13012-017-0561-4

Table 2.

Barriers and facilitators of key household TB contact investigation activities in terms of their behavioral determinants

Behavioral determinant Arranging home visits Visiting households to screen contacts Evaluating contacts in clinics
A. Barriers
Capabilitya
 Psychological Lack of TB knowledge among contacts Lack of local contact investigation guidelines
Language barrier for LHWs and contacts
 Physical
Opportunityb
 Physical Insufficient personnel at TB unit Difficulty locating households Lack of funds for travel for contacts
Lack of dedicated clinic space for TB care Difficulty finding contacts at home
 Social Stigma felt by index patients Avoidant behaviors of contacts Stigma felt by contacts
Motivationc
 Automatic Fear of getting TB among clinic staff Fear of TB diagnosis among contacts
 Reflective Distrust of clinic- staff among contacts
B. Facilitators
Capability
 Psychological Interpersonal skills of LHWs
Ability of LHWs to persuade index patients
 Physical
Opportunity
 Physical Task shifting to LHWs Flexible scheduling of home evaluation Streamlining contact evaluation at clinic
Communication with patients via mobile phones Fare for transport of LHWs to homes Family physical support for contacts
 Social Trust between index patients and LHWs Trust between contacts and LHWs Family social support for contacts
Privacy provided by home evaluation
Motivation
 Automatic
 Reflective Personalizability of home visit
Pay for LHWs

Abbreviations: COM-B Capability, Opportunity, Motivation Determine Behavior Model, LHWs lay health workers, TB tuberculosis

aCapability represents the faculty to engage in a behavior and has a “physical” domain (e.g., strength, skills, stamina) and a “psychological” domain (e.g., knowledge, memory)

bOpportunity represents environmental factors that affect the capability to perform the behavior and has a “physical” domain (e.g., time, physical environment) and a “social” domain (e.g., interpersonal influences, social cues, cultural norms).

cMotivation represents the internal factors that allow one to employ capability and opportunity to perform a behavior, and has a “reflective” domain (e.g., beliefs and intentions) and an “automatic” domain (e.g., wants, needs, impulses)