Table 2.
Overview of the exercise professional training package including summary of content and behaviour change techniques
| Module (target behaviour) |
Summary of content | BCTs (coded in line with BCTTV1) | TDF domain |
|---|---|---|---|
| Level 1: online | |||
| Module 1: Introduction to prostate cancer and exercise (1) |
- Provide an overview of the STAMINA programme and NICE guidelines (text and video from consultant urologist) - Provide evidence-base for exercise as a treatment component (text and video from consultant urologist) - Present patient views on exercise (quotes) - Present information about prostate cancer, symptoms, mortality, treatment and side effects (text and video from consultant urologist) - Present information on the role of CBEPs in STAMINA (video from consultant urologist) - Summary of key points |
5.1 Health consequences, 5.3 Social & environmental consequences | Knowledge |
| 4.1 Instruction, 9.1 Credible source | Professional role | ||
| 5.6 Emotional consequences, 9.1 Credible source, 10.1 Material incentive | Beliefs about consequences | ||
| Module 2: Operationalising the STAMINA programme (1, 4) |
- Present information on communication with clinical teams (text and video from consultant urologist) - Present information on scheduling STAMINA patients for exercise - Present frequently asked questions and answers related to patient memberships, appointments and missed sessions. |
5.1 Health consequences, 5.3 Social & environmental consequences | Knowledge |
| 4.1 Instruction | Skill | ||
| 4.1 Instruction, 9.1 Credible source | Professional role | ||
| 5.6 Emotional consequences, 9.1 Credible source | Beliefs about consequences | ||
| Level 2: Face-to-face | |||
| Module 3: Working with clinical populations (1) |
- Discussion on prostate cancer treatment, side effects, symptoms, survival rates and role of exercise. - Discussion about patient feelings towards attending the gym and challenge beliefs - Present detailed information about side effects (case studies) - Discuss how best to respond to different side effects and consider pros and cons of each - Provide instruction and demonstration on active listening and helpful phrases to use |
2.2 Feedback on behaviour, 5.1 Health consequences, 5.3 Social & environmental consequences | Knowledge |
| 4.1 Instruction, 6.1 Demonstration | Skill | ||
| 4.1 Instruction, 9.1 Credible source | Professional role | ||
| 9.1 Credible source | Intention | ||
| 5.6 Emotional consequences, 9.1 Credible source, 9.2 Pros and cons, 10.1 Material incentive | Beliefs about consequences | ||
| 5.6 Emotional consequences, 9.1 Credible source, 11.2 Reduce negative emotions | Emotion | ||
| 3.2 Social support, 12.5 Adding objects | Environmental context | ||
| Module 4: Tailoring the exercise prescription (3) |
- Instruction on professional role - Discussion related to previous similar experiences and persuasion about capability - Demonstrate safe tailoring (case study) - Beliefs about patient capabilities discussed and challenged (case studies) - Evidence based information about tailoring for clinical populations provided in a handbook and pros and cons discussed - Information and example of a run-in period provided and discussed - Practical task with feedback - Access to case report forms and instruction on how to access NHS.net |
2.2 Feedback on behaviour, 4.1 Instruction, 5.1 Health consequences, 5.3 Social & environmental consequences, 5.6 Emotional consequences | Knowledge |
| 2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal | Skill | ||
| 4.1 Instruction, 15.1 Verbal persuasion | Professional role | ||
| 9.1 Credible source, 9.2 Pros and cons | Beliefs about consequences | ||
| 3.3 Social support, 11.2 Reduce negative emotions | Emotion | ||
| 12.5 Adding objects | Environmental context | ||
| Module 5: Delivering the exercise prescription (4) |
- Discussion about consequences of monitoring exercise and previous experience, focussing on success - Discussion about challenges of delivering to small groups and persuasion of capability - Instruction and demonstration of recording heart rate and exertion - Practical graded task delivering and recording tailored exercise to small groups, with feedback - Information that protected time to deliver exercise will be provided at an increased salary |
2.2 Feedback on behaviour, 4.1 Instruction, 8.1 Rehearsal, 8.7 Graded task | Skill |
| 2.2 Feedback on behaviour, 4.1 Instruction, 8.1 Rehearsal, 8.7 Graded task, 15.1 Verbal persuasion, 15.3 Focus on past success | Beliefs about capabilities | ||
| 5.1 Health consequences, 5.3 Social & environmental consequences, 5.6 Emotional consequences, 9.1 Credible source, 10.1 Material incentive, 10.8 Incentive | Beliefs about consequences | ||
| 3.3 Social support, 11.2 Reduce negative emotions | Emotion | ||
| 3.2 Social support, 12.1 Restructure, 12.5 Adding objects | Environmental context | ||
| Module 6: Reviewing the exercise prescription (6) |
- Discuss importance of reviewing exercise - Provide instruction on professional role - Provide instruction and demonstration of completing a progress report (case study) - Role play task: completing progress reports and discussing progress. Feedback provided. - Discuss importance of language used - Verbal persuasion about capabilities and focus on past success |
2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal | Skill |
| 4.1 Instruction | Professional role | ||
| 15.1 Verbal persuasion | Optimism | ||
| 3.3 Social support, 11.2 Reduce negative emotions, 15.1 Verbal persuasion | Emotion | ||
| 12.5 Adding objects | Environmental context | ||
| Module 7: Behaviour change (5) |
- Discuss what behaviour is, how it is influenced and how it can be changed, focus on past success - Introduce behaviour change theory - Discuss capability, opportunity and motivation of men on ADT and challenge beliefs (case study videos) - Present patient video discussing the importance of the exercise professional role and behavioural support - Role play task: respond to exercise ambivalence/ resistance (case studies). - Review task in group discussion and provide feedback. - Provide instruction/ demonstration of suitable BCTs for exercise ambivalence and resistance - Role play task: repeated with new skills learnt - Discussion and video examples of good and bad communication focusing on the spirit of motivational interviewing |
2.2 Feedback on behaviour, 4.1 Instruction, 5.6 Emotional consequences | Knowledge |
| 1.2 Problem solving, 2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task | Skill | ||
| 4.1 Instruction | Professional role | ||
| 2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task, 15.1 Verbal persuasion, 15.3 Focus on past success | Beliefs about capabilities | ||
| 5.1 Health consequences, 5.6 Emotional consequences, 9.1 Credible source | Beliefs about consequences | ||
| Module 7: Fitness Testing (2) |
- Introduce the fitness test and provide handouts (protocol, exertion scale, case report form) - Provide instruction and demonstration on the gym floor - Discuss safe parameters of exercise testing (case study) - Access to gym floor and heart rate monitors for practical, graded task with feedback using case report forms to record outcomes (i.e. heart rate, exertion, time, level) |
2.2 Feedback on behaviour, 4.1 Instruction, 5.1 Health consequences | Knowledge |
| 2.2 Feedback on behaviour, 4.1 Instruction, 6.1 Demonstration, 8.1 Rehearsal, 8.7 Graded task | Skill | ||
| 4.1 Instruction | Professional role | ||
| 5.6 Emotional consequences, 9.1 Credible source | Beliefs about consequences | ||
| 11.2 Reduce negative emotions | Emotion | ||
| 12.1 Restructure environment, 12.5 Adding objects | Environmental context | ||