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. 2019 May 5;9(5):e023545. doi: 10.1136/bmjopen-2018-023545

Table 1.

Behavioural frameworks used to develop text messages

Technique
(theoretical framework)
Definition Examples
Provide information about behaviour link
(information–motivational–behavioural skills model)
General info re: behavioural risk (eg, susceptibility to poor health outcomes or mortality risk in relation to behaviour) Look out for symptoms of high potassium levels. Nausea, tiredness, muscle weakness and an irregular heartbeat. Check your blood tests regularly.
Provide information on consequences
(theory of reasoned action, theory of planned behaviour, social cognitive theory, information–motivational–behavioural skills model)
Information about the benefits and costs of action or inaction, focusing on what will happen if the person does/does not perform the behaviour Did you know that having a low or high potassium can cause a heart attack? Aim for a potassium level between 4 and 6 mmol/L.
Having high blood phosphate levels for a long time causes your bones to become weak and fragile. To keep them strong follow a low phosphate diet.
Prompt intention formation
(theory of reasoned action, theory of planned behaviour, social cognitive theory, information–motivational–behavioural skills model)
Encouraging the person to decide to act or set a general goal (eg, make behavioural resolutions ‘I will exercise more this week’) Getting enough physical activity? Set regular goals to help you get to your target. Start small and build up over time. Every bit helps. Get on the move!
Prompt barrier identification
(social cognitive theory)
Identify barriers to performing the behaviour and plan ways of overcoming them A high salt diet will make you thirstier and harder to stick to your fluid restriction. Avoid adding salt to your meals and limit takeaways and processed foods.
Set graded tasks
(social cognitive theory)
Set easy tasks and increase difficulty until target behaviour is performed Getting enough physical activity? Set regular goals to help you get to your target. Start small and build up over time. Every bit helps. Get on the move!
Provide instruction
(social cognitive theory)
Telling person how to perform a behaviour and/or preparatory behaviours Did you know the way you cook your vegetables will change their potassium content? Boil vegetables in water to get rid of potassium.
Prompt self-monitoring of behaviour
(control theory)
Person is asked to keep a record of specified behaviours (eg, a diary) Not sure what is causing high potassium levels? Write down everything you are eating and drinking and discuss with your dietitian.
Teach to use prompts/cues
(operant conditioning)
Teach person to identify environ cues which can be used to remind them to perform behaviour, including times of day, contexts Having trouble sticking to your fluid restriction? Drink only out of a water bottle so you can measure how much you are drinking!
Relapse prevention
(relapse prevention theory)
Following initial change, help identify situations likely to result in readopting risk behaviours or failure to maintain new behaviours and help the person plan to avoid or manage these situations Had a lapse in exercise? This is normal, but it is important to get back on track. Plan exercise into your day. Park your car further away or take the stairs.
Time management Helping person make time for the behaviour (eg, to fit it into daily schedule) Aim for 30 min of exercise most days. You can break your daily exercise into smaller 10–15 min blocks.