Testing the validity of the Theoretical Framework of Acceptability: an experimental vignette study

Acceptability has been defined as “doing something that is considered to be socially appropriate or within the sphere of what is appropriate, or something that is considered tolerable but not necessarily desired”. The... [ view full abstract ]

Acceptability has been defined as “doing something that is considered to be socially appropriate or within the sphere of what is appropriate, or something that is considered tolerable but not necessarily desired”. The Medical Research Council (MRC) suggests that, healthcare professionals should take acceptability into account while designing, implementing and evaluating healthcare interventions. Considering such factor, can have a great impact on health professionals and patients, while influencing the outcomes and effectiveness of the interventions. However, acceptability is conceived differently by individuals as there is no consensus within the literature, on a formalised definition. Moreover, there are neither formally validated measures, nor pre-specified criteria for assessing and evaluating the acceptability of healthcare interventions, respectively. The main objective of this paper is to evaluate the Theoretical Framework of Acceptability (TFA) and its dimensions (affective attitude, burden, effectiveness, opportunity costs, self-efficacy, ethicality and intervention coherence). The TFA intends to help healthcare professionals and patients, in order to objectively evaluate and improve the acceptability of existing interventions. The TFA has been validated via seven textual hypothetical vignette scenarios. During the validation stage, 206 participants were involved (males, females and participants classifying themselves as ‘other’,  being ≥18 years at the time of their entry into the study, and suffering from a long-term condition) reaching sample saturation. The Qualtrics online platform was used for the data collection, and SPSS was also used for the data analysis. Results suggested that burden, effectiveness and ethicality affect global acceptability, while effectiveness, intervention coherence and ethicality affect individual acceptability. Dispositional coping styles were also related to the global acceptability scores of the participants. Finally, conclusions regarding global and individual acceptability are drawn in this paper, as well as recommendations for the applicability of the proposed TFA for healthcare providers, and patients experiencing various conditions and disorders (i.e. psychosis).