Table 1.

Use of behavior change techniques in developing an intervention for people living with primary biliary cholangitis.

Enabler	Barrier	COM-Ba/TDFb/IFc	Behavior change technique	Implementation of a behavior change technique
Interactions with program facilitators enhanced accountability		COM-B: reflective motivation TDF: goals IF: persuasion	1.5 Review behavior goal(s) 1.6 Discrepancy between current behavior and goal 3.1 Social support (unspecified)	1.5 Weekly adherence vs target adherence goal were discussed during check in 1.6 Weekly adherence vs target adherence goal were discussed during check in 3.1 Weekly check ins employed motivational interviewing techniques to support program adherence
Able to integrate in everyday routine	Difficulty integrating program into daily routine	COM-B: psychological capability TDF: behavioral regulation IF: enablement, persuasion	1.4 Action planning (Future consideration 1.6 Discrepancy between current behavior and goal 2.2 Feedback on behavior 15.3 Focus on past success (self-belief)	1.4 In week 1, participants watched an interactive video prompting them to plan their performance of the target behavior (adherence to the program at or above the set minimum adherence goal). This included committing to a personal adherence goal at or above the set minimum, and writing down (1) potential obstacles to meeting their adherence goal; and (2) actions that could be taken to avoid or overcome these obstacles.  1.6 The host website recorded weekly participation (indicated by accessed content). At the top of the website, the user’s current weekly participation was presented beside the user’s adherence goal. 2.2 The host website recorded weekly participation (indicated by accessed content). At the top of the website, the user’s current weekly participation was presented. 15.3 In week 1, participants watched an interactive video that prompted them to think about instances in which they successfully adhered to a goal.
Access to accommodations to physical activity program where needed	Insufficient access to accommodation to physical activity program	COM-B: physical capability TDF: skills IF: enablement	4.1 Instruction on how to perform a behavior 6.1 Demonstration of the behavior	4.1 Instruction for accommodations were provided 6.1 Demonstration of accommodations were provided
Interaction with others in program associated with increased motivation		COM-B: social opportunity TDF: social influences IF: persuasion, modeling	3.1 Social support (unspecified)	3.1 Participants were invited to weekly live group sessions in which they had the opportunity to participate in program practices with peers
Desire to feel better		COM-B: reflective motivation TDF: goals IF: persuasion	5.1 Information about health consequences 5.2 Information about emotional consequences	5.1 Introductory videos provided information about health consequences associated with participating in the program 5.2 Introductory videos provided information about health consequences associated with participating in the program
	Difficult to participate when feeling unwell due to disease	COM-B: physical capability, psychological capability TDF: environmental context and resources IF: environmental restructuring	12.1 Restructuring of the physical environment	12.1 Short meditations were provided that could be completed when individuals are not feeling as well 12.1 All mindful movement was low intensity
Able to navigate website	Difficulty navigating website	COM-B: psychological capability TDF: memory attention and decision processes IF: training	4.1 Instruction on how to perform a behavior 6.1 Demonstration of the behavior (comparison of a behavior)	4.1 Individuals received an introduction to the online platform via zoom, in which the research assistant provided instruction on accessing the intervention. Written instructions were also forwarded to all participants in an email. 6.1 Individuals received an introduction to the online platform via zoom in which the research assistant demonstrated accessing the intervention
Web-based format enhanced accessibility		COM-B: psychological capability TDF: environmental context and resources IF: environmental restructuring	12.1 Restructuring the physical environment	12.1 Web-based format was maintained
	Physical movement was too difficult	COM-B: physical capability TDF: physical skills IF: enablement, training, environmental restructuring	4.1 Instruction on how to perform a behavior 6.1 Demonstration of the behavior (comparison of a behavior) 12.1 Restructuring of the physical environment	4.1 Within each stream, the mindful movement videos featured description of how to perform each specific posture/exercise 6.1 Within each stream, the mindful movement videos featured demonstration of how to perform each specific posture/exercise 12.1 Two streams of mindful movement were implemented, which were differentiated by difficulty
	Physical movement was not difficult enough	COM-B: reflective motivation TDF: beliefs about capabilities IF: environmental restructuring	12.1 Restructuring of the physical environment	12.1 Two streams of mindful movement were implemented, which were differentiated by difficulty
Feeling better/good after participating in intervention	Uncertain about benefit	COM-B: reflective motivation TDF: beliefs about consequences, reinforcement IF: persuasion	5.1 Information about health consequences 5.2 Information about emotional consequences 9.1 Credible source	5.1 Introductory videos provided information about health consequences associated with participating in the program 5.2 Introductory videos provided information about health consequences associated with participating in the program 9.1 Introductory videos featured health care professionals discussing potential benefits associated with participating in the program
	Fear of getting injured during physical activity	COM-B: reflective motivation TDF: beliefs about consequences IF: education, environmental restructuring	9.1 Credible source 12.1 Restructuring of the physical environment	9.1 Welcome video featured a health care professional explaining that mindful movement was designed to be safe for PBC. 12.1 Various streams of mindful movement were available, separated by difficulty. Adaptations were available within mindful movement.
Repetition in physical activity program helped build routine		COM-B: psychological capability TDF: memory, attention, and decisional processes IF: enablement	8.3 habit formation	8.3 Routine varied but structure was conveyed through repetition of the same type of activity from week to week (eg, 1 day of each week was dedicated to a breath program, 1 day a flow day)

^aCOM-B: Capability, Opportunity, Motivation and Behaviour.

^bTDF: theoretical domains framework.

^cIF: intervention functions.