Application of the behavior change wheel in supporting self-management among colorectal cancer survivors: A scoping review

Objective: Self-management is a cornerstone of colorectal cancer (CRC) care; however, many interventions lack explicit grounding in behavioral theory. The Behavior Change Wheel (BCW), underpinned by the Capability-Opportunity-Motivation Behavior (COM-B) model, provides a systematic framework for designing and evaluating behavior change interventions, yet its application in CRC self-management has not been comprehensively mapped. This scoping review aimed to synthesise the existing evidence on BCW-informed studies addressing CRC self-management and screening behaviors, and to identify implications for nursing practice and future research. Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA-ScR guideline. PubMed, Web of Science, Google Scholar, CNKI, and Wanfang were searched for studies published between April 2011 and April 2025 that applied the BCW framework (including COM-B) to CRC-related self-management or screening behaviors. Peer-reviewed articles and relevant grey literature were eligible. Study selection and data extraction were performed independently by two reviewers using a standardized form. Data were synthesised descriptively and thematically, with intervention components mapped to COM-B determinants and BCW intervention functions. Results: = 6), often in combination with additional BCW functions and targeting multiple COM-B components, particularly psychological capability and reflective motivation. Qualitative findings further elucidated contextual barriers and facilitators influencing CRC-related self-management and screening behaviors. Reported outcomes included improvements in self-care ability, self-efficacy, adherence, symptom management, emotional adjustment, and screening participation. Conclusions: BCW-informed approaches show potential for strengthening key behavioral determinants and supporting patient-centered outcomes across the CRC care continuum. Integrating explicit behavioral theory into nursing interventions may enhance their conceptual rigor, transparency, and effectiveness. Further robust, theory-driven studies are warranted to refine the application of the BCW and to evaluate its impact across diverse populations and health care settings.