Table 3. Enablers and barriers to adherence to the CO program as identfied and reflected by the COM-B model and the TDF component constructs.

Enablers	Barriers	Examples
Capability- Physical	Capability- Physical
None reported	Decreased physical skills Multiple chronic co-morbidities	Decreased capacity to walk Fear of falling Loss of independence Obesity, diabetes, etc.
Capability- Psychological	Capability- Psychological
Knowledge/procedural knowledge on self-management strategies e.g. bandaging	Lack of practical knowledge by medical practitioners	Reduced confidence in GP to deal with their infections
Opportunity- Physical	Opportunity- Physical
Access to medical appliance, aids and latest options	Difficulty access to hospital clinic physically	Limited disabled parking Limited hospital internal transport service Bus stop is too far from clinic
Tailored program to individual’s needs and capability	Limited appropriate personal resources	Limited choice of safe fitting footwear and clothes
Opportunity- Social	Opportunity- Social
Positive health provider-patient relationship	Social stigma
Continuity of care	Social pressure
Partner’s social support	Social comparison
Motivation-Reflective	Motivation-Reflective
Belief that therapy and medical appliance helps to reduce CO	Pessimism	Fatalistic attitude
	Belief that there is no cure	Resignation, Resilience
	Lack of Motivation, Intention and Goals	Diminished self-efficacy
Motivation-Automatic	Motivation-Automatic
To feel competent in social role Strive to stay positive	Emotion	Fear, Hurt, Depression, Anxiety

COM-B: Capability, Opportunity, Motivation-Behavior Model; TDF: Theoretical Domains Framework