Table 3.

COM-B model and TDF domains: suggested intervention strategies to improve perioperative hypothermia prevention

TDF domain	COM-B	Intervention function	BCT taxonomy	Individual BCT	Strategy example
Knowledge	C (Psychological)	Education	Goals and planning Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Audit and feedback of key prevention activities (temperature monitoring, warming – behavior) and rates of hypothermia (outcomes) Reminders of prevention activities in all key clinical areas; computerized reminders
Memory, attention, and decision processes	C (Psychological)	Training	Shaping knowledge	Demonstration of behavior Feedback on behavior and outcome of behavior Self-monitoring Behavioral practice/rehearsal	Education: when to monitor; how to monitor; when and how to warm; how to document Education: scenarios that allow for practice and feedback
		Environmental restructuring	Associations Antecedents	Adding objects to the environment Prompts/cues Restructuring of physical environment	Reminders (see above) Ensure monitoring is visibly obvious with reminders
Enablement	Goals and planning Feedback and monitoring Antecedents	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior and outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway
Skills	C (Physical)	Training	Shaping knowledge Feedback and monitoring	Demonstration of behavior Feedback on behavior and outcome of behavior Self-monitoring Behavioral practice/rehearsal	Education (see above) Audit and feedback (see above)
Social/Professional Role and Identity	M (reflective)	Education	Shaping knowledge Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Make information available about consequences of not monitoring, warming, and outcomes of condition Prompts (see above) Audit and feedback (see above)
		Persuasion	Comparison of outcomes Natural consequences Feedback and monitoring	Credible source Information about social, environmental and health consequences Feedback on behavior and outcome of behavior	“High status” professional to provide information/education re importance of prevention Patients’ perspective of condition (and consequences) Audit and feedback (see above)
Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
Beliefs about capabilities	M (reflective)	Education	Shaping knowledge Natural consequences Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Make information available about consequences of not monitoring, warming and outcomes of condition (as above) Prompts (see above) Audit and feedback (see above)
		Persuasion	Comparison of outcomes Natural consequences Feedback and monitoring	Credible source Information about social, environmental, and health consequences Feedback on behavior and outcome of behavior	High status’ professional to provide information (as above) Patients’ perspective of condition (and consequences) Audit and feedback (see above)
		Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
		Enablement	Social support Goals and planning Antecedents Goals and planning Feedback and monitoring	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior and outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway
Optimism	M (reflective)	Education	Shaping knowledge Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Make information available (as above) Prompts (see above) Audit and feedback (see above)
		Persuasion	Comparison of outcomes Natural consequences Feedback and monitoring	Credible source Information about social, environmental, and health consequences Feedback on behavior and outcome of behavior	High status’ professional to provide information (as above) Patients’ perspective of condition (and consequences) Audit and feedback (see above)
		Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
		Enablement	Social support Goals and planning Antecedents Goals nd planning Feedback and monitoring	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior and outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway
Beliefs about consequences	M (reflective)	Education	Goals and planning Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Make information available (as above) Prompts (see above) Audit and feedback (see above)
		Persuasion	Comparison of outcomes Natural consequences Feedback and monitoring	Credible source Information about social, environmental, and health consequences Feedback on behavior and outcome of behavior	High status’ professional to provide information (as above) Patients’ perspective of condition (and consequences) Audit and feedback (see above)
		Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
Goals	M (reflective)	Education	Goals and planning Feedback and monitoring Associations	Information about consequences Feedback on behavior and outcome of behavior Prompts/cues Self-monitoring	Make information available (as above) Prompts (see above) Audit and feedback (see above)
		Persuasion	Comparison of outcomes Natural consequences Feedback and monitoring	Credible source Information about social, environmental, and health consequences Feedback on behavior and outcome of behavior	High status’ professional to provide information (as above) Patients’ perspective of condition (and consequences) Audit and feedback (see above)
		Incentivization	Feedback and monitoring	Feedback on behavior and outcome of behavior Monitoring of behavior, and/or outcomes of behavior, by others, without evidence of feedback Self-monitoring of behavior	Audit and feedback (see above)
		Coercion	Feedback and monitoring	Feedback on behavior and outcome of behavior Monitoring of behavior, and/or outcomes of behavior, by others, without evidence of feedback Self-monitoring of behavior	Audit and feedback (see above)
		Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
		Enablement	Social support Goals and planning Antecedents Goals nd planning Feedback and monitoring	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior and outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway
Reinforcement	M (automatic)	Training	Shaping knowledge Feedback and monitoring	Demonstration of behavior Feedback on behavior and outcome of behavior Self-monitoring Behavioral practice/rehearsal	Education: when to monitor; how to monitor; when and how to warm; how to document Education: scenarios that allow for practice and feedback
		Incentivization	Feedback and monitoring	Feedback on behavior and outcome of behavior Monitoring of behavior, and/or outcomes of behavior, by others, without evidence of feedback Self-monitoring of behavior	Audit and feedback (see above)
		Coercion	Feedbackand monitoring	Feedback on behavior and outcome of behavior Monitoring of behavior, and/or outcomes of behavior, by others, without evidence of feedback Self-monitoring of behavior	Audit and feedback (see above)
		Environmental restructuring	Associations Antecedents	Adding objects to the environment Prompts/cues Restructuring of physical environment	Prompts (see above) Provide hypothermia prevention pathway
Environmental context and resources	O (physical)	Training	Shaping knowledge Feedback and monitoring	Demonstration of behavior Feedback on behavior and outcome of behavior Self-monitoring Behavioral practice/rehearsal	Education: when to monitor; how to monitor; when and how to warm; how to document Education: scenarios that allow for practice and feedback
		Restriction	No BCTs	No BCTs
		Environmental restructuring	Associations Antecedents	Adding objects to the environment Prompts/cues Restructuring of physical environment	Prompts (see above) Provide hypothermia prevention pathway
		Enablement	Social support Goals and planning Antecedents Goals and planning Feedback and monitoring	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior & outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway
Social influence	O (social)	Restriction	No BCTs	No BCTs
		Environmental restructuring	Associations Antecedents	Adding objects to the environment Prompts/cues Restructuring of physical environment	Prompts (see above) Provide hypothermia prevention pathway
		Modeling	Comparison of behavior	Demonstration of behavior	Provide demonstration of prevention pathway (ie, film/poster)
		Enablement	Social support Goals and planning Antecedents Goals and planning Feedback and monitoring	Social support (unspecified and/or practical) Goal-setting (behavior and/or outcome) Adding objects to the environment Problem-solving Action planning Self-monitoring of behavior Restructuring of physical environment Review behavior & outcome goal(s)	Identified champion to monitor and provide encouragement Monthly agreed goals (based on audit and feedback) Reminders and equipment (see above) Provide hypothermia prevention pathway

Abbreviations: BCT, Behavior Change Theory; TDF, Theoretical Domains Network.