Table 2.

Overview of the telehealth bariatric behavior intervention^a.

Session number and overview	Topics	Content- and relation-based techniques (motivation and behavior change techniques, and motivational interviewing techniques)
1. Welcome to the trial	Discuss importance of PAb within context of bariatric surgery Identify health risks of a sedentary lifestyle and health benefits of an active lifestyle Evaluate perceived benefits and personal barriers related to PA adoption Establish baseline daily average PA minutes and steps Discuss PA target Provide PA monitoring logbook, pedometer, and instructions for recording daily bout-related walking exercise minutes and steps Provide information about the benefits and costs of action or inaction to participants	Review specific guidelines for PA participation Discuss benefits of PA and elicit participants’ reasons for increasing PA Examine cost and benefit of current PA behavior and changing behavior Acknowledge any internal conflict regarding PA adoption Offer clear rationale for PA adoption Self–re-evaluation (explore congruence between values, goals, and lifestyle) Assess motivational readiness Shaping knowledge: Instruction on how to perform the behavior, and how to monitor behavior and affect Comparison of outcomes: Credible source, pros and cons Natural consequences: Information about health consequences
2. Goal setting for behavior resolution	Introduce goal-setting principles, set goals targeting behaviors to increase PA Identify pleasant or unpleasant aspects of PA Differentiate extrinsic and intrinsic motives and rewards Identify ways to make PA more enjoyable	Review SMARTc goal approach Facilitate short- and long-term goal development Emphasize enjoyable aspects of PA Goal setting: Goal setting, problem solving, action planning, discrepancy between current behavior and goal, review outcome goal or goals, behavior contract, and commitment Self-belief: Verbal persuasion about capability, focus on past success, and self-talk Natural consequences: Information about health consequences, salience of consequences, monitoring of emotional consequences, and anticipated regret Scheduled consequences: Reward alternative behavior
3. Building a preoperative PA program	Differentiate lifestyle and structured PA Brainstorm ways to increase lifestyle PA Teach talk test to gauge PA intensity Discuss making PA a habit Record of PA behavior Record of outcomes related to PA Instruction to perform behavior Prompt practice	Review methods of self-monitoring Encourage the use of a self-monitoring technique to evaluate progress postintervention Goal setting: Goal setting, problem solving, action planning, discrepancy between current behavior and goal, review outcome goal or goals, behavior contract, and commitment Feedback and monitoring: Feedback on behavior, self-monitoring of outcome or outcomes of behavior, self-monitoring of behavior Self-belief: Verbal persuasion about capability, focus on past success, and self-talk Reward and threat: Self-reward Associations: Prompts or cues
4. Creating an active environment: Making physical and social cues work for you	Environmental restructuring Identify positive environmental cues to increase PA Provide information on where and when to perform PA Identify strategies to eliminate or avoid inactivity cues Plan social support or social change	Review main types of social support Encourage participants to examine social network Develop reasons and plans to include others in their lifestyle changes Have participants examine their current environment and determine methods for creating a PA-promoting environment Goal setting: Goal setting, problem solving, action planning, discrepancy between current behavior and goal, review outcome goal or goals, behavior contract, and commitment Feedback and monitoring: Feedback on behavior, self-monitoring of outcome or outcomes of behavior, and self-monitoring of behavior Antecedents: Restructuring the physical environment, restructuring the social environment, and body changes Social support: Social support (unspecified), social support (practical), and social support (emotional)
5. Resolving issues and planning	Problem-solving Action planning Barrier identification or problem solving Increasing self-efficacy	Elicit potential barriers that participants may experience Develop plans to overcome barriers Goal setting: Goal setting, problem solving, action planning, discrepancy between current behavior and goal, review outcome goal or goals, behavior contract, and commitment Feedback and monitoring: Feedback on behavior, self-monitoring of outcome outcomes of behavior, and self-monitoring of behavior Self-belief: Verbal persuasion about capability, focus on past success, self-talk Repetition and substitution: Behavior substitution
6. Putting it all together and establishing commitment or habit	Develop new contract to facilitate commitment to maintenance of PA change consisting of short-, medium-, and long-term goals Relapse prevention or coping planning	Behavior contracting or self-liberation Social support or helping relationships Self–re-evaluation Mastery experiences Goal setting: Goal setting, problem solving, action planning, discrepancy between current behavior and goal, review outcome goal or goals, behavior contract, and commitment Self-belief: Verbal persuasion about capability, focus on past success, and self-talk Feedback and monitoring: Feedback on behavior, self-monitoring of outcome or outcomes of behavior, and self-monitoring of behavior Antecedents: Restructuring the physical environment, restructuring the social environment, and body changes Social support: Social support (unspecified), social support (practical), and social support (emotional) Repetition and substitution: Habit formation Associations: Prompts or cues

^aBehavior change technique groupings refer to the hierarchically clustered 93 techniques presented in the behavior change technique taxonomy (v1), are italicized, and specific techniques to be used follow the colons.

^bPA: physical activity.

^cSMART: specific, measurable, attainable, relevant, time-based.