Table 3.

Key facilitators to swallowing exercises

Key facilitators	COM-B	Examples
Support from clinician and family	Social opportunity	So I think it was before and it was during, right up until I could eat again, I was constantly getting advice and help (P13) I started doing exercises, the throat exercises and eventually… it took some time, but I was told by my family as well that don’t give up. Because at that time I was just about to be a grandfather as well and that also gave me the strength (P10)
Desire to prevent negative consequences from treatment	Reflective motivation	But I don’t know, I just knew I had to eat, you know. And my object was not to use that… what do you call it? The tube they stick in you. And I managed it. I didn’t really use the tube (P6) I thought, well, if you don’t use muscles, they, sort of, stop working, don’t they? I’ve seen it with people with broken legs. If they don’t use them the muscles wither. And so I thought if that’s just going to happen to my throat, I don’t want that happening (P7)
Knowing how to do the exercises (skills)	Physical capability	The exercises themselves were pretty simple exercises using the tongue and biting, protruding the tongue between your lips and holding onto the tongue and trying to swallow, to do with breathing and holding your breath while you swallow. They were pretty simple tasks (P3) After the first week you could do them whatever they were, even just go through them through your head. Yes. It would be like going to the gym and doing ten different classes and you know all the steps. It’s the very same. It’s familiarity, isn’t it? (P4)
Having a routine and/or having a trigger to do the exercises (behavioural regulation)	Psychological capability	My exercises at the beginning, I’d actually write them on the chart. But what I used to do is I’d put them on… I’ve got an iPhone (P3) I had a form from the team and I used to mark down how many - on a Monday, four times, I’d mark it off four times, Tuesday four times, all the way up to Thursday. And I didn’t do them on Friday. It was a Friday morning. I had it marked out on the chart and you give the chart when you come in for the exercises, she’d have a look at it. She’d say, ‘Yes, you are doing well’ (P4)
Receiving feedback on outcome (re-inforcement)	Automatic motivation	You are achieving something every time. And they tell you, yes, you are doing very good and they tell you it’s open so many centimetres today, and then they’d compare it from last week. They’d have it written down (P4) I took a short drink, the energy drink, and I started drinking it and he was… my son and my daughter as well were so pleasantly surprised. They were, sort of, overcome with joy. So there was a joy that I could drink at least (P10)