Green, S. M. C. orcid.org/0000-0002-2622-5377, Hall, L. H., Ellison, R. et al. (13 more authors) (2025) Acceptability of acceptance and commitment therapy for medication-decision-making and quality of life in women with breast cancer: A qualitative process evaluation. British Journal of Health Psychology, 30 (2). e12802. ISSN 1359-107X
Abstract
Objectives Adjuvant endocrine therapy (AET) reduces breast cancer recurrence, but side effects and distress impact adherence. We co-designed an Acceptance and Commitment Therapy (ACT) intervention to support medication decision-making and quality of life in women prescribed AET (ACTION). In a qualitative process evaluation nested in the pilot trial, we aimed to elicit participant experiences of receipt and therapists experience of delivery of ACTION to enhance our understanding of acceptability.
Design Remote semi-structured interviews were conducted with women with breast cancer who received ACTION (n = 20) and trial therapists (n = 3).
Methods Interviews were guided by the Theoretical Framework of Acceptability (TFA). Rapid Assessment Procedure (RAP) sheets were completed after each interview to map responses onto TFA constructs, and sections of interviews were selectively transcribed. Individual RAP sheets were collated to identify key findings.
Results ACTION was generally liked, in particular, the group format (affective attitude). Participants and therapists felt ACTION was low effort, but therapists acknowledged the burden associated with trial procedures (burden). Participants generally felt able to engage with ACTION, and therapists felt they were able to deliver it (self-efficacy). The perceived effectiveness of ACTION on well-being was good, but was mixed for impact on treatment adherence (perceived effectiveness). Participants and therapists understood the aims of ACTION (coherence), and ACTION generally aligned with therapists' values (ethicality). Therapists questioned who would be most appropriate to deliver ACTION (opportunity costs).
Conclusion ACTION was acceptable to women with breast cancer and trial therapists. Rapid qualitative analysis can facilitate efficient process evaluations in time- and resource-limited contexts.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | acceptability, acceptance and commitment therapy, adjuvant endocrine therapy, breast cancer, process evaluation, rapid assessment procedure |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research NIHR300588 Yorkshire Cancer Research Account Ref: 2UOLEEDS L417 |
Depositing User: | Symplectic Publications |
Date Deposited: | 07 May 2025 09:44 |
Last Modified: | 12 Jun 2025 11:45 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/bjhp.12802 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:226249 |