Table 1.
Categories, category descriptions, and component behavior change techniques (BCTs) with example text messages
| Taxonomy category | Strategy title (if different from taxonomy category): Description given to participants | Component BCTs | Example text message |
|---|---|---|---|
| 1. Goals and planning* | Planning and problem-solving: Messages that support and encourage you to plan to take your medication as intended, along with messages that encourage you to solve problems to help you achieve those goals | 1.2 Problem solving 1.4 Action planning |
Plan when, where, and how you are going to take your medication |
| 2. Feedback and monitoring* | Self-monitoring: Messages that suggest monitoring how often you take your medication | 2.3 Self-monitoring of behavior | Make a note of when you take your medication so you know that you have not forgotten |
| 3. Social support* | Messages that encourage and support you to get help from friends, relatives, or services around you. This could be in terms of practical help such as taking you to the pharmacist, or emotional help such as supporting you when you feel fed up | 3.1 Social support (unspecified) 3.2 Social support (practical) 3.3 Social support (emotional) |
Struggling with medication? Can your friends and family help? You’re welcome to bring someone with you to your practice team appointments |
| 4. Shaping knowledge* | Messages that help you to understand how to take your medication and what might affect you taking your medication | 4.1 Instruction on how to perform behavior 4.2 Information about antecedents |
Are you out and about today? Remember that you still need to take your medication as prescribed in order to control your blood sugar |
| 5. Natural consequences* | Messages that either provide or remind you of information about what may happen if you do not take your medication, in terms of your health, feelings, and the effect on society and the people around you | 5.1 Information about health consequences 5.3 Information about social and environmental consequences 5.5 Anticipated regret 5.6 Information about emotional consequences |
Even when you are not experiencing diabetes symptoms, your tablets are still needed to maintain your health |
| 6. Comparison of behavior | Messages that encourage you to think about your medication taking in the context of others around you, for example by comparing it with others or considering what others think of your medication taking | 6.2 Social comparison 6.3 Information about others’ approval |
Compare yourself to other people who are taking diabetes medication. Are you more or less likely than them to take your meds as prescribed? |
| 7. Associations* presented together with 12. Antecedents* | Prompting: Messages that prompt you to take your medication or encourage you to place things around you that may prompt you to take your medication | 7.1 Prompts/cues 12.1 Restructuring the physical environment |
Why not set a reminder on your phone to prompt you to take your medication? |
| 8. Repetition and substitution* | Habits: Messages that help you to make good habits around medication taking | 8.3 Habit formation | Why not take your meds at the same time as something you do every day? For example, when you are brushing your teeth or after a meal |
| 9. Comparison of outcomes | Thinking about the pros and cons of taking medication regularly and comparing what may happen if you do, or do not. Where does the information for these decisions come from? | 9.1 Credible source 9.2 Pros and cons 9.3 Comparative imaginings of future outcomes |
List the benefits of taking your medication as prescribed against the reasons for not wanting to take it |
| 10. Reward and threat | Reward: Messages that congratulate you when you take medication as intended | 10.5 Social reward | |
| 11. Regulation | Managing negative emotions: Messages that help you manage any worries you may have around taking your diabetes medication as intended | 11.2 Reduce negative emotions | Give yourself one less thing to worry about. Take your diabetes medications as prescribed and take control |
| 13. Identity* | Messages that help you to think about how your health and medication fit with your sense of who you are | 13.5 Identity associated with changed behavior | Make successfully managing your medication part of who you are |
| 15. Self-belief | Messages that help to improve your confidence in your ability to take your medication as intended | 15.1 Verbal persuasion about capability 15.2 Mental rehearsal of successful performance 15.4 Self-talk |
If you are struggling with your diabetes meds, then don’t worry you will be able to master it in time. You will get on top of it |
| Dealing with side effects* | Messages that help you address the side effects of taking diabetes medication | NA | Some diabetes medication can give you an upset stomach, if this doesn’t settle speak to your Dr or nurse |
| Concerns with health care system and medications* | Messages that address concerns people have around the health care system and taking medications generally | 4.1 Instruction on how to perform a behavior | Questions about your diabetes medications? Make the most of your next appointment by writing down the questions you want to ask |
Note: *Indicates a category that was introduced spontaneously by participants, eg, before the moderator had introduced it and shown example messages.