Acceptability of healthcare interventions

An overview of reviews and development of a theoretical framework

Bibliographic Data

ID23371310
AuthorsMandeep Sekhon (0000-0002-5109-9536, Northampton Community College, corresponding author), Martin Cartwright (0000-0002-3404-5659, City, University of London), J Francis (0000-0001-5784-8895, City, University of London), Jill J Francis
Year2017
Volume17
Issue1
Pages88-88
Publication date2017-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC Health Services Research (JOURNAL)
Journal identifiersISSN: 1472-6963 • E-ISSN: 1472-6963
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12913-017-2031-8
PMID28126032
OpenAlexW2582406074
LanguageEN
Citations received446
References cited64

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.

Health administration · Health care · Health services research · Nursing research · Psychological intervention · Public health · Health Informatics · Health Policy Implementation Science · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing · Patient Satisfaction in Healthcare