Table 4.
Summary of barriers and facilitators to HCS implementation mapped to six domains on the Theoretical Domains Framework
| Barrier | Facilitator | Domain |
|---|---|---|
| Theme (i): Practical context for facilitating MECC HCS | ||
| Lack of time | Having time to deliver it | 11. Environmental Context and Resources |
| Limited access to resources | Up to date reminders, reference materials, and reminders about what is available | |
| The impact of COVID-19 | ||
| Theme (ii): Support from organisation for facilitating MECC HCS implementation | ||
| Lack of support and understanding of MECC from leadership | Buy-in from leadership | 11. Environmental Context and Resources |
| Lack of/difficulty training staff | Access to education and training in MECC HCS | |
| Support from other colleagues | 12. Social influences | |
| Theme (iii): Positive personal perceptions of MECC HCS | ||
| Lack of motivation and ignorance towards MECC HCS | Motivation for MECC HCS and its principles | 9. Goals |
| Seeing the benefits of MECC HCS | 6. Beliefs about Consequences | |
| Theme (iv): Patient-related factors | ||
| Patients being resistant to behaviour change | Patients being open to behaviour change | 6. Beliefs about Consequences |
| A poor relationship with the patient | A good rapport with the patient | 3. Social/Professional Role and Identity |
| Theme (v): Staff ability to successful deliver MECC HCS | ||
| Not being confident or remembering to use the skills | Having and remembering to use the skills | 2. Skills |
| Lack of interpersonal qualities for facilitating MECC HCS delivery | Good interpersonal qualities for facilitating MECC HCS delivery | |