Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

Authors: Mandeep Sekhon, Martin Cartwright, Jill J. Francis

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

It is increasingly acknowledged that ‘acceptability’ should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients.

Methods

Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators.

Results

From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews).
From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy.

Conclusion

Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions.
Appendix
Available only for authorised users
Literature
1.
MRC U. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008.
2.
3.
4.
Diepeveen S, Ling T, Suhrcke M, Roland M, Marteau TM. Public acceptability of government intervention to change health-related behaviours: a systematic review and narrative synthesis. BMC Public Health. 2013;13(1):756.CrossRefPubMedPubMedCentral
5.
Stok FM, de Ridder DT, de Vet E, Nureeva L, Luszczynska A, Wardle J, Gaspar T, de Wit JB. Hungry for an intervention? Adolescents’ ratings of acceptability of eating-related intervention strategies. BMC Public Health. 2016;16(1):1.
6.
Fisher P, McCarney R, Hasford C, Vickers A. Evaluation of specific and non-specific effects in homeopathy: feasibility study for a randomised trial. Homeopathy. 2006;95(4):215–22.CrossRefPubMed
7.
Hommel KA, Hente E, Herzer M, Ingerski LM, Denson LA. Telehealth behavioral treatment for medication nonadherence: a pilot and feasibility study. Eur J Gastroenterol Hepatol. 2013;25(4):469.CrossRefPubMedPubMedCentral
8.
Borrelli B, Sepinwall D, Ernst D, Bellg AJ, Czajkowski S, Breger R, DeFrancesco C, Levesque C, Sharp DL, Ogedegbe G. A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. J Consult Clin Psychol. 2005;73(5):852.CrossRefPubMed
9.
Proctor EK, Landsverk J, Aarons G, Chambers D, Glisson C, Mittman B. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health Ment Health Serv Res. 2009;36(1):24–34.CrossRef
10.
Medical Research Council (Great Britain), Health Services and Public Health Research Board. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000;321(7262):694–6.CrossRef
11.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
12.
Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, Moore L, O’Cathain A, Tinati T, Wight D. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258.CrossRefPubMedPubMedCentral
13.
Becker CB, Darius E, Schaumberg K. An analog study of patient preferences for exposure versus alternative treatments for posttraumatic stress disorder. Behav Res Ther. 2007;45(12):2861–73.CrossRefPubMed
14.
Sidani S, Epstein DR, Bootzin RR, Moritz P, Miranda J. Assessment of preferences for treatment: validation of a measure. Res Nurs Health. 2009;32(4):419.CrossRefPubMedPubMedCentral
15.
Tarrier N, Liversidge T, Gregg L. The acceptability and preference for the psychological treatment of PTSD. Behav Res Ther. 2006;44(11):1643–56.CrossRefPubMed
16.
Dillip A, Alba S, Mshana C, Hetzel MW, Lengeler C, Mayumana I, Schulze A, Mshinda H, Weiss MG, Obrist B. Acceptability–a neglected dimension of access to health care: findings from a study on childhood convulsions in rural Tanzania. BMC Health Serv Res. 2012;12(1):113.CrossRefPubMedPubMedCentral
17.
18.
Staniszewska S, Crowe S, Badenoch D, Edwards C, Savage J, Norman W. The PRIME project: developing a patient evidence‐base. Health Expect. 2010;13(3):312–22.PubMedPubMedCentral
19.
Andrykowski MA, Manne SL. Are psychological interventions effective and accepted by cancer patients? I. Standards and levels of evidence. Ann Behav Med. 2006;32(2):93–7.CrossRefPubMed
20.
21.
Campbell M, Egan M, Lorenc T, Bond L, Popham F, Fenton C, Benzeval M. Considering methodological options for reviews of theory: illustrated by a review of theories linking income and health. Syst Rev. 2014;3(1):1–11.CrossRef
22.
23.
Giles EL, Sniehotta FF, McColl E, Adams J. Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups. BMC Public Health. 2015;15(1):1.CrossRef
24.
ICEBeRG. Designing theoretically-informed implementation interventions. 2006.
25.
Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010;29(1):1.CrossRefPubMed
26.
Rimer BK, Glanz K. Theory at a glance: a guide for health promotion practice. 2005.
27.
Berlim MT, McGirr A, Van den Eynde F, Fleck MPA, Giacobbe P. Effectiveness and acceptability of deep brain stimulation (DBS) of the subgenual cingulate cortex for treatment-resistant depression: a systematic review and exploratory meta-analysis. J Affect Disord. 2014;159:31–8.CrossRefPubMed
28.
Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JPT, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373:746–58.CrossRefPubMed
29.
Kedge EM. A systematic review to investigate the effectiveness and acceptability of interventions for moist desquamation in radiotherapy patients. Radiography. 2009;15:247–57.CrossRef
30.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
31.
Carpiano RM, Daley DM. A guide and glossary on postpositivist theory building for population health. J Epidemiol Community Health. 2006;60(7):564–70.CrossRefPubMedPubMedCentral
32.
Epstein LH. Integrating theoretical approaches to promote physical activity. Am J Prev Med. 1998;15(4):257–65.CrossRefPubMed
33.
Hox JJ. From theoretical concept to survey question. 1997): Survey Measurement and Process Quality. New York ua: Wiley; 1997. p. 45–69.
34.
Locke EA. Theory building, replication, and behavioral priming Where do we need to go from here? Perspect Psychol Sci. 2015;10(3):408–14.CrossRefPubMed
35.
Thompson JD. On Building an Administrative Science. Adm Sci Q. 1956;1(1):102–11.CrossRef
36.
Weick KE. Drop Your Tools: An Allegory for Organizational Studies. Adm Sci Q. 1996;41(2):301–13.CrossRef
37.
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
38.
Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.CrossRefPubMedPubMedCentral
39.
Higgins JPT, Green SP, Wiley Online Library EBS, Cochrane C, Wiley I. Cochrane handbook for systematic reviews of interventions. Hoboken; Chichester: Wiley-Blackwell; 2008.
40.
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.CrossRefPubMed
41.
Moher D, Schulz KF, Altman DG, Group C. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001;357(9263):1191–4.CrossRefPubMed
42.
Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, Liberati A, O’Connell D, Oxman AD, Phillips B. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;4(1):38.CrossRefPubMedPubMedCentral
43.
Armijo‐Olivo S, Stiles CR, Hagen NA, Biondo PD, Cummings GG. Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. J Eval Clin Pract. 2012;18(1):12–8.CrossRefPubMed
44.
Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, Atkins D, Preventive MWGTU, Force ST. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3):21–35.CrossRefPubMed
45.
Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One. 2010;5(10):e13196.CrossRefPubMedPubMedCentral
46.
Blenkinsopp A, Hassey A. Effectiveness and acceptability of community pharmacy‐based interventions in type 2 diabetes: a critical review of intervention design, pharmacist and patient perspectives. Int J Pharm Pract. 2005;13(4):231–40.CrossRef
47.
Kulier R, Helmerhorst FM, Maitra N, Gülmezoglu AM. Effectiveness and acceptability of progestogens in combined oral contraceptives–a systematic review. Reprod Health. 2004;1(1):1.CrossRefPubMedPubMedCentral
48.
Kaltenthaler E, Sutcliffe P, Parry G, Rees A, Ferriter M. The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychol Med. 2008;38:1521–30.CrossRefPubMed
49.
Brooke-Sumner C, Petersen I, Asher L, Mall S, Egbe CO, Lund C. Systematic review of feasibility and acceptability of psychosocial interventions for schizophrenia in low and middle income countries. BMC Psychiatry. 2015;15:19.CrossRefPubMedPubMedCentral
50.
Muftin Z, Thompson AR. A systematic review of self-help for disfigurement: Effectiveness, usability, and acceptability. Body Image. 2013;10(4):442–50.CrossRefPubMed
51.
El-Den S, O’Reilly CL, Chen TF. A systematic review on the acceptability of perinatal depression screening. J Affect Disord. 2015;188:284–303.CrossRefPubMed
52.
Littlejohn C. Does socio-economic status influence the acceptability of, attendance for, and outcome of, screening and brief interventions for alcohol misuse: a review. Alcohol Alcohol. 2006;41:540–5.CrossRefPubMed
53.
Figueroa C, Johnson C, Verster A, Baggaley R. Attitudes and acceptability on HIV self-testing among key populations: a literature review. AIDS Behav. 2015;19(11):1949–65.CrossRefPubMedPubMedCentral
54.
Botella C, Serrano B, Baños RM, Garcia-Palacios A. Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: A review of its efficacy, the adequacy of the treatment protocol, and its acceptability. Neuropsychiatr Dis Treat. 2015;11:2533–45.CrossRefPubMedPubMedCentral
55.
Rodriguez MI, Gordon-Maclean C. The safety, efficacy and acceptability of task sharing tubal sterilization to midlevel providers: a systematic review. Contraception. 2014;89(6):504–11.CrossRefPubMed
56.
Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The revised illness perception questionnaire (IPQ-R). Psychol Health. 2002;17(1):1–16.CrossRef
57.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191.CrossRefPubMed
58.
Lee C, Bobko P. Self-efficacy beliefs: comparison of five measures. J Appl Psychol. 1994;79(3):364.CrossRef
59.
Clement S. The self‐efficacy expectations and occupational preferences of females and males. J Occup Psychol. 1987;60(3):257–65.CrossRef
60.
Rixon L, Baron J, McGale N, Lorencatto F, Francis J, Davies A. Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review. BMC Health Serv Res. 2016;16:1.CrossRef
61.
Eborall HC, Stewart MCW, Cunningham-Burley S, Price JF, Fowkes FGR. Accrual and drop out in a primary prevention randomised controlled trial: qualitative study. Trials. 2011;12(1):7.CrossRefPubMedPubMedCentral
62.
Sanders C, Rogers A, Bowen R, Bower P, Hirani SP, Cartwright M, Fitzpatrick R, Knapp M, Barlow J, Hendy J, et al. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. 2012.
63.
Wickwar S, McBain H, Newman SP, Hirani SP, Hurt C, Dunlop N, Flood C, Ezra DG. Effectiveness and cost-effectiveness of a patient-initiated botulinum toxin treatment model for blepharospasm and hemifacial spasm compared to standard care: study protocol for a randomised controlled trial. Trials. 2016;17(1):1.CrossRef
64.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. The BMJ. 2009;339:b2535. http://​doi.​org/​10.​1136/​bmj.​b2535.​CrossRefPubMedPubMedCentral
65.
66.
Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.
Metadata
Title
Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework
Authors
Mandeep Sekhon
Martin Cartwright
Jill J. Francis
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2031-8

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue

Research article

Socioeconomic inequalities in the uptake of maternal healthcare services in Ethiopia

Research article

Trends in hospital admissions due to antidepressant-related adverse drug events from 2001 to 2011 in the U.S.

Research article

Cost-effectiveness of Human Papilloma Virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and programme coverage

Research article

Measurement of special access to home visit nursing services among Japanese disabled elderly people: using GIS and claim data

Research article

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

Research article

Distribution of essential medicines to primary care institutions in Hubei of China: effects of centralized procurement arrangements