Tier 3 (Behaviour change models [COM-B / stages of change]

Question 1

What is the COM-B Behaviour change model

Answer 1

Capability, Opportunity, Motivation → Behaviour.

Question 2

What is “Capability” in cardiac rehab?

Answer 2

Does the patient have the physical ability and psychological understanding to perform the exercise safely?

Question 3

What is “Opportunity” in cardiac rehab?

Answer 3

Do they have the environmental and social support to exercise?
(e.g., transport, family support, safe space, time)

Question 4

What is “Motivation” in cardiac rehab?

Answer 4

Their beliefs, confidence, fears, and personal goals (e.g., return to work, play with grandchildren).

Question 5

How would you apply COM-B in practice?

Answer 5

Assess which component is limiting behaviour and target that barrier specifically — not just give more exercise advice.

Question 6

What are the 5 stages of change within the Transtheoretical Model?

Answer 6

• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance

Question 7

How do you manage someone in pre-contemplation?

Answer 7

Education and awareness.
No pressure — focus on risk and benefits.

Question 8

How do you manage someone in contemplation?

Answer 8

• Explore ambivalence.
• Discuss pros/cons.
• Build confidence.

Question 9

How do you manage someone in preparation?

Answer 9

• Set realistic goals.
• Provide structured plan.
• Reduce barriers.

Question 10

How do you manage someone in action/maintenance?

Answer 10

• Reinforce success.
• Monitor progress.
• Prevent relapse.

Question 11

Why are behaviour change models important in cardiac rehab?

Answer 11

Because exercise adherence determines long-term cardiovascular outcomes — not just what happens during supervised sessions.