Drivers of behaviour: barriers (−) and facilitators (+) | COM-B domain |
---|---|
Remaining smokefree during pregnancy | |
 Knowledge of potential harm (+), including from health professionals (+/−); high (+) or low (−) Carbon Monoxide test readings; belief that harm from smoking is real (+) or exaggerated (−) | Capability – psychological |
Opportunity - social | |
Motivation - reflective | |
 Pregnancy related nausea (+) | Capability - physical |
 Stress (−) | Capability - psychological |
Stigma related to smoking during pregnancy and pressure to stop smoking leads to hidden smoking in the home and car (−); smoking in pregnancy normalised (−); strong family views that smoking is bad (+) | Opportunity – social |
Opportunity – environmental | |
Motivation - reflective | |
 Nicotine addiction (−); cravings to smoke (−); feeling that e-cigarettes were unable to deliver sufficient nicotine to reduce cravings (−); life long non-smoker (+); association between drinking alcohol and smoking leads to reduced cravings when not drinking alcohol (+) | Motivation- automatic |
Remaining abstinent from alcohol during pregnancy | |
 Knowledge of guidelines (+/−) including from health professionals (+/−); belief that any alcohol is dangerous (+) or only heavy alcohol use is dangerous (−); belief that alcohol is dangerous reduces appeal (−) | Capability – psychological |
Opportunity - social | |
Motivation - reflective | |
 Pregnancy related nausea and tiredness reduce appeal (+); age and caring responsibilities for children make ‘hangovers’ unappealing (+) | Capability – physical |
Opportunity - social | |
Motivation - reflective | |
 Alcohol consumption in public is highly stigmatised (+/−); partners and family members encourage alcohol consumption in the home (−); | Opportunity - social |
Opportunity – environmental | |
 Socialising largely takes place in premises serving alcohol and few non-alcoholic options (−); feelings of isolation from social group when not drinking alcohol (−) | Opportunity - social |
Opportunity – environmental | |
 Willpower sufficient to resist alcohol (+); alcohol associated with relaxation and pleasure, leading to strong desire to drink alcohol (−) | Motivation- automatic |
Opportunity - social | |
Breastfeed exclusively for six months | |
 Knowledge of guidelines (+/−) including from health professionals (+/−); belief that breastmilk is superior to formula (+/−); belief that exclusive breastfeeding is important (+/−); belief that breastfeeding beyond the early days and weeks is important (+/−) | Capability – psychological |
Opportunity - social | |
Motivation - reflective | |
 Breastfeeding (+) or formula feeding (−) positioned as the convenient or ‘normal’ choice by the mother, and those around her; Formula feeding culture (−) | Capability – psychological |
Capability – physical | |
Opportunity – social | |
Motivation - reflective | |
 Pressure to breastfeed from health professionals, family, friends and strangers in the antenatal and early post-natal period (−) | Capability – psychological |
Opportunity - social | |
 Understanding of how to physically breastfeed (including latch and positioning) (+/−); physical challenges, including soreness, latch and tongue-tie (−); recovering from traumatic birth or C-section (−); support to overcome physical challenges from health professionals or others (+/−); hospitals have adequate/inadequate resources to support the initiation of breastfeeding (+/−) | Capability – psychological |
Capability – physical | |
Opportunity – social | |
Opportunity - environmental | |
 Confidence in ability to breastfeed (+/−); inability to see how much milk baby is taking (−); belief in adequacy of milk supply (+/−); exposure to breastfeeding role models (+) or formula feeding role models (−); experience of formula feeding babies (−) | Capability – psychological |
Capability – physical | |
Opportunity - social | |
 Belief that it is OK to breastfeed in public (+); Confidence to breastfeed in public (+/−); belief in ability to ‘discreetly’ breastfeed in public (+/−); knowledge of ‘safe’ places to breastfeed in public (+); confidence-building support from health professionals or others (+) | Capability – psychological |
Capability – physical | |
Opportunity – social | |
Opportunity - environmental | |
 Partners and family encourage bottle feeding to ‘help’ with care (−) – expressing breastmilk for bottle feeding takes additional time and maternal energy (−); mothers desire/ability to reject formula feeding (+/−); belief breastfeeding takes extra time (−) and lack of support for household chores and caring responsibilities (−) | Opportunity – social |
Motivation – reflective | |
Capability – psychological | |
 Breasts identified as sexual (−); Desire to stop breastfeeding to ‘get my body back’ (−) and quickly return to non-maternal activities/self identity (−) | Opportunity – social |
Motivation - reflective |