Table 2.

Facilitators: relationship between survey statement, TDF domain, and COM-B source of behavior, and intervention function.

Statement (facilitator)
TDF domainDomain descriptionkConFab womenCliniciansCOM-B source of behaviorIntervention function
Social/professional role and identityA coherent set of behaviors and displayed personal qualities of an individual in a social or work settingIf I thought RRMs would improve the chance I will stay healthy for my familyIf it were endorsed as part of my professional role by the relevant college or other peak body
GoalsMental representations of outcomes or end states that an individual wants to achieveTaking RRMs can reduce BC risk for up to 20 yearsThe beneficial effects of RRMs, e.g., better blood lipid profile and improvements in bone density with tamoxifenEducation
If I thought RRMs would improve the chance I will stay healthy for my familyPersuasion
Beliefs about capabilitiesAcceptance of the truth, reality or validity about an ability, talent or facility that a person can put to constructive useNot applicableNot applicableReflective motivationIncentivization
Coercion
OptimismThe confidence that things will happen for the best or that desired goals will be attainedNot applicableI expect positive outcomes for women who take RRMs
Beliefs about consequencesAcceptance of the truth, reality, or validity about outcomes of a behavior in a given situationTaking RRMs can reduce BC risk for up to 20 yearsI expect positive outcomes for women who take RRMS
IntentionsA conscious decision to perform a behavior or a resolve to act in a certain wayNot applicableNot applicable
ReinforcementIncreasing the probability of a response by arranging a dependent relationship, or contingency, between the response and a given stimulusIf family/friends were supportive of me taking RRMsNot applicablePersuasion
EmotionA complex reaction pattern, involving experiential, behavioral, and physiologic elements, by which the individual attempts to deal with a personally significant matter or eventBecause they would reduce my stress and worry about BCSometimes it is easier to discuss RRMs than bilateral mastectomyAutomatic motivationIncentivization
Coercion
Environmental restructuring
Modeling
Enablement
Memory, attention, and decision processesThe ability to retain information, focus selectively on aspects of the environment, and choose between two or more alternativesTaking a daily tablet to reduce my BC risk would make me feel more in control of my healthIf my medical software prompted me to discuss RRMs
KnowledgeAn awareness of the existence of somethingTaking RRMs can reduce BC risk for up to 20 yearsKnowing some RRMs are PBS funded
Knowing RRMs can be taken prior to risk-reducing surgeryEducation
Knowing I have high breast cancer riskPsychological capabilityTraining
Once I stop taking RRMs any side-effects will diminishEnablement
Behavioral regulationAnything aimed at managing or changing objectively observed or measured actionsTaking a daily tablet to reduce my BC would reassure me
Environmental context and resourcesAny circumstance of a person's situation or environment that discourages or encourages the development of skills and abilities, independence, social competence, and adaptive behaviorHaving an abnormal biopsy that increased my risk of developing BCIf the patient is diagnosed with atypical hyperplasia that increases their risk of BCPhysical opportunityRestriction
Knowing that some of these medicines help prevent or treat osteoporosisIf the patient is diagnosed with LCIS that increases their risk of BCEnvironmental restructuring
Knowing some of these medicines reduce cholesterol levelsIf a patient has a strong family history of BCEnablement
Having a family history of BCIf I had better tools to help me identify patients who were suitable
Clear guidelines/recommendations e.g., RACGP and Cancer Australia guidelines
Support from specialists
Support from peers
Social influencesThose interpersonal processes that can cause individuals to change their thoughts, feelings, or behaviorsIf my family/friends recommended taking RRMsIf I knew my colleagues discuss it with their ptsSocial opportunityRestriction
If my doctor recommend taking RRMsEnvironmental restructuring
Enablement
SkillsAn ability or proficiency acquired through practiceNot applicableNot applicablePhysical capabilityTraining Enablement
  • Abbreviations: BC, breast cancer; COM-B system, capability, opportunity, and motivation behavior system; LCIS, lobular carcinoma in situ; pts, patients; RACGP, Royal Australian College of General Practitioners; RRM, risk-reducing medication; TDF, Theoretical Domains Framework.