Question44 A 52-year-old man was diagnosed with hypertension and type 2 diabetes two years ago. He struggles to adopt recommendations from his general practitioner about healthy eating, as he loves eating and thoroughly enjoys chatting with friends over meals with high-fat and high carbohydrate content. These behaviour determinants are: Select one alternative: Barriers, encompassed in the motivation component of the COM-B model. Barriers, encompassed in the opportunity component of the COM-B model. Facilitators, encompassed in the capability component of the COM-B model. Facilitators, encompassed in the opportunity component of the COM-B model. ResetMaximum marks: 1 Flag question undefined

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BlackTom AI · Accepted Answer

The scenario presents a patient who loves eating and social meals with friends that are high in fat and carbohydrates, and he struggles to adopt dietary recommendations. This points to factors that reduce his motivation or make healthy changes harder to adopt, rather than limitations in capability or opportunities.
Option 1: Barriers, encompassed in the motivation component of the COM-B model.
This aligns with the description: the patient’s enjoyment of eating and social eating creates internal drives, desires, and habitual impulses that hinder behavior change. In COM-B terms, motivation includes both reflective and automatic processes (e.g., desires, impulses, social influences) that can serve as barriers when they oppose the desired new behavior. The social enjoyment and reward of meals are classic motivational barriers.
Option 2: Barriers, encompassed in the opportunity component of the COM-B model.
Opportunity refers to external factors that enable or hinder behavior, such as time, resources, social cues, or physical environment. While social dining could be viewed as an external context, the core issue described is the internal pull and enjoyment of high-fat, high-carb meals rather than a lack of external opportunity or access. Therefore this option misattributes the barrier to external circumstances rather than internal motivation.
Option 3: Facilitators, encompassed in the capability component of the COM-B model.
Facilitators would imply abilities or skills that make change easier (e.g., cooking skills, knowledge, or physical ability). The vignette does not highlight enhanced capability; instead, it describes a preference that makes change difficult. Thus this option is inconsistent with the scenario.
Option 4: Facilitators, encompassed in the opportunity component of the COM-B model.
Facilitators under opportunity would be external enablers that make change possible (e.g., supportive social networks, convenient access to healthier options). The description emphasizes a barrier created by personal taste and social eating, not facilitators in the external environment. Hence this option does not fit the case.
In summary, the strongest match to the described determinants is that the barriers arise from the individual’s motivational processes (desires, cravings, social rewards) rather than from lack of opportunity, capability, or external facilitators. Therefore, Option 1 best characterizes the scenario within the COM-B framework.

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