Table 2.

Mapping of behavioral determinants to intervention options and content and implementation options

Step 4		Step 5		Step 6
Determinants of referral		Intervention options		Content and implementation options
COM-B	TDF	Intervention functions	Policy categories	Behavior-change techniques	Mode of delivery	Also addressed in …
Capability	Knowledge	Education, training, modeling	Communication/marketing	Commitment, social support (practical), instruction on how to perform the behavior, information about social and environmental consequences, demonstration of the behavior, information about others’ approval, credible source, material reward, framing/reframing	Continuing education workshop: Expanding Treatment Options for Urological Cancer Patients, Professional society offering delivered by physician champion and endorsed by South Central Section of the AUA, Clinical trial flow sheet	Toolkit website
				Review outcome goals, Feedback on outcomes of behavior, social support (emotional), instruction on how to perform the behavior, information about social and environmental consequences, information about others’ approval, credible source, social reward, identification of self as role model	Quarterly Newsletter featuring AUA president endorsement, trial briefs, Why I Do This segment, Meet the Cancer Center segment, and referral and accrual audit and feedback	Continuing education workshop, newsletter, toolkit website
				Problem-solving, goal-setting, discrepancy between current behavior and goal behavior, self-monitoring of behavior, social support-unspecified, instruction on how to perform the behavior	Talking About Trials in-service curriculum
				Prompts/cues, adding objects to the environment; instruction on how to perform behavior -non-specified; non-specified reward	Point-of-care interactive patient education table tent
	Memory, attention and decision processes	Enablement	Service provision, environmental/social planning	Prompts/cues	Available clinical trials’ point-of-care flow sheet
Opportunity	Environmental resources		Service provision	Prompts/cues, restructuring social environment	Clinical trial referral prescription pad
				Prompts/cues, restructuring social environment	Cancer center “hotline” referral process
				Restructuring social environment, adding objects to the environment, instruction on how to perform behavior (patient)	What this Trial Entails patient video series
				Restructuring social environment, adding objects to the environment, instruction on how to perform behavior (patient)	Participating in a Cancer Clinical Trial patient brochure
	Social influences	Persuasion, environmental restructuring	Environmental/social planning, service provision	Social support (practical), restructuring the social environment, instruction on how to perform the behavior	Meet the investigator Breakfast/lunch	Continuing education workshop, newsletter
Motivation	Social professional role and identity	Enablement	Environmental/social planning, guidelines	Restructuring social environment	Referral role delineation	Continuing education workshop, toolkit website
				Feedback on outcome of behavior	Cancer center eligibility screening feedback
				Feedback on outcome of behavior, information on how to perform the behavior, information about consequences	GU Trial Chart Note
				Generalization of target behavior	Align role delineation with perceived roles and identity
	Beliefs about consequences	Incentivization, enablement	Education	Instruction on how to perform the behavior, information about social and environmental consequences, material incentive	Co-management discussion
				Prompts/cues, social reward, non-specific incentive	Branding through stationary, pens, brochures and media

Step 1 is provided in Fig. 2. Steps 2 and 3 are provided in Table 1

All behavior-change techniques are directed at the urology provider, unless otherwise indicated in parentheses

AUA American Urological Association, COM-B Capability, Opportunity, Motivation and Behavior Model GU genitourinary, TDF Theoretical Domains Framework