Finnish Immigrants' Affective Attitude Towards the IMPMS for Loneliness Detection: A Descriptive Qualitative Study.

Loneliness is a global health concern that contributes to morbidity in immigrant populations. However, traditional treatments for loneliness focus on symptom management rather than prevention. Technology-related solutions for preventing and assessing loneliness among immigrants are crucial. This study explored Finnish immigrants' affective attitude towards the IoT-based Multimodal Personalized mHealth System (IMPMS), a system for building predictive models for loneliness detection. In this descriptive qualitative study embedded within the DOMINO feasibility study, immigrants in Finland shared their experiences and perspectives of the IMPMS. Semi-structured interviews were conducted using an interview guide based on the Theoretical Framework of Acceptability (TFA). Data were analyzed using thematic analysis. Finnish immigrants considered the IMPMS acceptable, as evidenced by their positive experiences with the system. Areas for improvement highlighted in the results could be utilized to further refine and enhance the acceptability of the IMPMS for future implementation.

Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial.

Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.

Factors of communication disorders in ICU machinery ventilates patients based on the theoretical framework of acceptability:a phenomenological study / 中国实用护理杂志

Objective:To explore the factors leading to communication disorders in ICU patients during mechanical ventilation from the perspective of both patients and medical staff, and to use the theoretical framework of acceptability to identify the barriers that can be improved by intervention.Methods:Using the method of descriptive phenomenology from July to August 2022, 11 patients with mechanical ventilation and 8 medical staff in the comprehensive ICU of a Yuhuangding Hospital in Yantai were selected for interviews by the purpose sampling method, combined with participatory observation. The interviews of patients were conducted off ventilator. With Nvivo12.0 Plus software, the seven-step analysis method of Colaizzi phenomenology was adopted to summarize the theme and the theoretical framework of acceptability was used to identify the obstacle factors that could be improved by intervention.Results:The age of 11 patients was 18-46 years old, the duration of mechanical ventilation was 9.5-312.3 h. The age of 8 medical staff was 26-54 years old, the length of service in ICU was 2-30 years. A total of 14 themes were extracted. For patients: defensive mood, difficulty in presenting information, introverted personality, communication tools are hard to use, emergency treatment conflict, deny the ability to communicate, thought slowness. For medical staff: defensive mood, cognitive load, high time cost, lack of humane communication strategies, poor training, other priorities, loss of confidence in effective communication, awareness of the importance of communication was not enough.Conclusions:There are many factors that can be improved for patients with mechanical ventilation in ICU. It is suggested to speed up the research and development of high-tech and personalized alternative communication tools in China, reduce negative communication between doctors and patients and nurses and patients, and implement evidence-based multi-mode and progressive communication intervention strategies.

The Acceptability of Behavioural Swallowing Interventions for Head and Neck Cancer Patients During Radiotherapy: A Qualitative Study Exploring Experiences of Clinical Trial Speech-Language Pathologists.

The PRO-ACTIVE randomized clinical trial offers 3 swallowing therapies to Head and Neck Cancer (HNC) patients during radiotherapy (RT) namely: reactive, proactive low- ("EAT-RT" only) and high-intensity ("EAT-RT + exercises"). Understanding the experiences of the trial Speech-Language Pathologists (SLPs) will be useful to inform clinical implementation. This study assessed SLP opinions of acceptability and clinical feasibility of the 3 trial therapies. 8 SLPs from 3 Canadian PRO-ACTIVE trial sites participated in individual interviews. Using a qualitative approach, data collection and thematic analysis were guided by the Theoretical Framework of Acceptability. Member checking was conducted through a follow-up focus group with willing participants. Seven themes were derived: intervention coherence, burden, barriers/facilitators, self-efficacy, attitude, ethicality, and perceived effectiveness. SLPs felt all 3 therapies had potential benefit yet perceived more advantages of proactive therapies compared to reactive. Compared to exercises, SLPs particularly endorsed the EAT-RT component. A major barrier was keeping patients motivated, which was impacted by acute toxicity and sometimes conflicting instructions from the healthcare team. Strategies utilized by to overcome barriers included: scaling exercises and/or diet up/down according to the changing patient needs and communicating therapy goals with healthcare team. A model was derived describing the perceived acceptability of the swallowing therapies according to SLPs, based on the interconnection of main themes. Proactive therapies were perceived as more acceptable to trial SLPs, for facilitating patient engagement. The perceived acceptability of the swallowing therapies was related to seven interconnected aspects of providers' experience. These findings will inform the implementation and potential uptake of the PRO-ACTIVE swallowing therapies in clinical practice.

Exploring the Acceptability of Behavioral Swallowing Interventions for Head and Neck Cancer Patients During Radiotherapy: A Qualitative Study of Patients' Experience.

The PRO-ACTIVE randomized clinical trial offers 3 swallowing therapies to Head and Neck Cancer (HNC) patients during radiotherapy namely: reactive, proactive low- ("EAT-RT" only), and high-intensity ("EAT-RT + exercises"). Understanding the perceived acceptability of these interventions is important to inform eventual implementation into clinical practice. This study explored patients' perspectives using qualitative methodology. At 2 Canadian PRO-ACTIVE trial sites, 24 trial participants were recruited for individual semi-structured interviews, representing each of the 3 trial arms. Data collection and thematic analysis were guided by the Theoretical Framework of Acceptability (TFA). Member checking was conducted through follow-up focus groups. Seven themes were derived reflecting the TFA constructs. Overall, regardless of trial arm, patients reported a positive experience with therapy. Patients identified benefits of EAT-RT therapy, reporting that it provided meaningful feedback on diet progress and supported goal setting for oral intake. Patients who received proactive therapies valued the opportunity to set expectations early, build mealtime routine iteratively over time, and have an extended engagement with the SLP. Regardless of trial arm, patients agreed proactive therapy aligned with what they think is best and that therapy intensity should accommodate individual needs. This study identified the value to HNC patients of receiving swallowing interventions during RT and setting realistic expectations around swallowing. Compared to reactive care, proactive therapies were perceived helpful in consolidating habits early, establishing realistic expectations around swallowing and building an extended rapport with the SLP. These findings will inform the implementation of proactive versus reactive swallowing therapies in clinical practice.

Assessing the feasibility, acceptability, and fidelity of a tele-retinopathy-based intervention to encourage greater attendance to diabetic retinopathy screening in immigrants living with diabetes from China and African-Caribbean countries in Ottawa, Canada: a protocol.

BACKGROUND: Diabetic retinopathy is a leading cause of preventable blindness in Canada. Clinical guidelines recommend annual diabetic retinopathy screening for people living with diabetes to reduce the risk and progression of vision loss. However, many Canadians with diabetes do not attend screening. Screening rates are even lower in immigrants to Canada including people from China, Africa, and the Caribbean, and these groups are also at higher risk of developing diabetes complications. We aim to assess the feasibility, acceptability, and fidelity of a co-developed, linguistically and culturally tailored tele-retinopathy screening intervention for Mandarin-speaking immigrants from China and French-speaking immigrants from African-Caribbean countries living with diabetes in Ottawa, Canada, and identify how many from each population group attend screening during the pilot period. METHODS: We will work with our health system and patient partners to conduct a 6-month feasibility pilot of a tele-retinopathy screening intervention in a Community Health Centre in Ottawa. We anticipate recruiting 50-150 patients and 5-10 health care providers involved in delivering the intervention for the pilot. Acceptability will be assessed via a Theoretical Framework of Acceptability-informed survey with patients and health care providers. To assess feasibility, we will use a Theoretical Domains Framework-informed interview guide and to assess fidelity, and we will use a survey informed by the National Institutes of Health framework from the perspective of health care providers. We will also collect patient demographics (i.e., age, gender, ethnicity, health insurance status, and immigration information), screening outcomes (i.e., patients with retinopathy identified, patients requiring specialist care), patient costs, and other intervention-related variables such as preferred language. Survey data will be descriptively analyzed and qualitative data will undergo content analysis. DISCUSSION: This feasibility pilot study will capture how many people living with diabetes from each group attend the diabetic retinopathy screening, costs, and implementation processes for the tele-retinopathy screening intervention. The study will indicate the practicability and suitability of the intervention in increasing screening attendance in the target population groups. The study results will inform a patient-randomized trial, provide evidence to conduct an economic evaluation of the intervention, and optimize the community-based intervention.

Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights.

PURPOSE: Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research. METHOD: Acceptability was assessed in a consecutive sample of 15 patients at least 3 months post-joint replacement surgery via theory-informed semi-structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings. RESULTS: Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled 'perceived safety and risk', and relabelling and redefining an existing construct (new label: 'opportunity costs and gains'). Methodological recommendations for theory-informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis. CONCLUSION: The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory-informed interview studies.

Patients' acceptance of a shared cancer follow-up model of care between general practitioners and radiation oncologists: A population-based survey using the theoretical Framework of Acceptability.

INTRODUCTION: International and national guidelines highlight the need for general practitioner involvement during and after active cancer treatment and throughout long-term follow-up care. This paper aimed to evaluate patients' acceptance of radiation oncology shared follow-up care using the Theoretical Framework of Acceptability (TFA). METHODS: This cross-sectional study was conducted at two cancer care centres in the Illawarra Shoalhaven region of Australia. A sample of patients scheduled for a radiation oncology follow-up consultation in 2021 were sent a 32-point self-complete paper-based survey. Data were analysed using descriptive, parametric and non-parametric statistical analysis. This paper followed the Checklist for Reporting of Survey Studies (CROSS). RESULTS: Of the 414 surveys returned (45% response rate), the acceptance for radiation oncology shared cancer follow-up care was high (80%). Patients treated with only radiotherapy were 1.7 times more likely to accept shared follow-up care than those treated with multiple modalities. Patients who preferred follow-up care for fewer than three years were 7.5 times more likely to accept shared care than those who preferred follow-up care for five years. Patients who travelled more than 20 minutes to their radiation oncologist or to the rural cancer centre were slightly more likely to accept shared care than those who travelled less than twenty minutes to the regional cancer centre. A high understanding of shared care (Intervention Coherence) and a positive feeling towards shared care (Affective Attitude) were significant predictive factors in accepting shared radiation oncology follow-up care. CONCLUSION: Health services need to ensure patient preferences are considered to provide patient-centred cancer follow-up care. Shared cancer follow-up care implementation should start with patients who prefer a shorter follow-up period and understand the benefits of shared care. However, patients' involvement needs to be considered alongside other clinical risk profiles and organisational factors. Future qualitative research using the TFA constructs is warranted to inform clinical practice change.

A survey of speech pathologists' opinions about the prospective acceptability of an online implementation platform for aphasia services.

BACKGROUND: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far-reaching dissemination of current evidence and best-practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. AIMS: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. METHODS & PROCEDURES: A mixed-methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. OUTCOMES & RESULTS: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. CONCLUSIONS & IMPLICATIONS: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian-based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work? Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in-depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia.

A qualitative exploration of women's perspectives and acceptability of including new cancer awareness information in all-clear breast or cervical screening results.

OBJECTIVE: This study explored women's perspectives on the acceptability of including new cancer information with an all-clear breast or cervical screening result letter (using ovarian cancer as a case study). METHODS: In 2016, six focus group discussions were conducted with women aged 25-70 years old, eligible for invitation to the NHS breast or cervical screening programme and resident in England. The focus groups lasted 60-90 min and were held in community venues. Data were analysed using thematic analysis. RESULTS: Thirty-eight women aged 25-67 years old participated in the focus groups. Data analysis yielded six descriptive themes: general cancer awareness, taking advantage of a 'teachable moment', a double-edge sword, barriers to accepting and using new cancer information, motivators for accepting and using new cancer information and wider strategies to increase cancer awareness in women. Women welcomed the inclusion of new cancer information in all-clear screening results but highlighted pertinent lessons to be considered to maximise the usefulness of the approach. CONCLUSION: While women perceived this approach as acceptable, it is pertinent to note the potential of the new cancer information to stimulate anxiety and potentially widen inequalities by excluding non-attenders at screening programmes. Specific complementary and tailored approaches are necessary to mitigate these limitations.

HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing): a qualitative exploration of the acceptability of a complex oral health intervention.

BACKGROUND: To explore the acceptability of the oral health intervention, HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) to parents with young children aged 9-12 months and health visitors. METHODS: Following the delivery of the universal oral health intervention called HABIT, qualitative semi-structured interviews with parents and focus groups with health visitors were undertaken. Interviews were audio-recorded and transcribed. Health visitors completed self-reported diaries after delivering the HABIT intervention with parents. The qualitative data was analysed using framework analysis (guided by a theoretical framework of acceptability). RESULTS: Seventeen parents were interviewed, and five health visitors and three nursery nurses participated in two focus groups. Parents reported health visitors to be 'trusted' and valued the reassurance provided during the HABIT visit. Health visitors found the HABIT training and resources useful and valued the consistency and increased confidence in undertaking oral health conversations. There were, however, challenges in changing behaviour where families faced competing demands on time and resources. Both health visitors and parents described the importance of the intervention's timing and suggested that multiple visits may be needed to support optimal oral health habits. CONCLUSION: The HABIT intervention was acceptable to parents and health visitors. Health visitors would welcome a further refinement to enhance intervention delivery that specifically achieves a balance between using a guided script and retaining the flexibility to adapt the conversation to suit the needs of individual families. This, in turn, will maximise impact and enable parents of young children to adopt and maintain optimal home-based oral health behaviours for their child.

"That was quick, simple, and easy": Patient perceptions of acceptability of point-of-care hepatitis C RNA testing at a reception prison.

INTRODUCTION: Current diagnostic pathways require multiple healthcare provider visits and lead to a drop-off in the hepatitis C virus (HCV) testing and treatment care cascade. In prison settings, frequent transitioning between prisons and the community further reduces uptake of testing and treatment. The PIVOT study evaluated a 'one-stop-shop' intervention integrating point-of-care HCV RNA testing, Fibroscan®-based liver disease assessment, and treatment prescription at a reception prison in Australia. This qualitative sub-study was undertaken to assess patient acceptability of point-of-care HCV RNA testing in the reception prison setting. METHODS: Twenty-four men in prison enrolled in the PIVOT study participated in semi-structured interviews; all of whom had undergone point-of-care HCV RNA testing in the PIVOT study. Patients were purposefully selected to ensure comparable representation of people with and without a history of injecting drug use and people with and without prior HCV testing experience (standard venepuncture). Sekhon's Theoretical Framework of Acceptability, consisting of seven components (affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness, and self-efficacy), informed this qualitative analysis. RESULTS: Acceptability of fingerstick point-of-care HCV RNA testing was evident across four components: affective attitude, burden, self-efficacy, and perceived effectiveness. Patients described point-of-care testing as "quick and easy" (affective attitude), while swift results were viewed as alleviating anxiety associated with long wait times for standard pathology (burden). Patients averse to venepuncture (e.g., fear of needles or poor vein health) found the fingerstick method accessible, thereby enabling participation in HCV screening (self-efficacy). Participants attributed confidence in test results predominantly due to trust in the healthcare system or trust in the personnel administering the test (perceived effectiveness). CONCLUSION: People entering custody perceive fingerstick HCV RNA point-of-care testing to be an acceptable method and preferred this method to standard HCV testing via venepuncture. In light of these findings, prison health authorities should consider the role of opt-out point-of-care HCV RNA testing upon prison entry.

Acceptability of a complex team-based quality improvement intervention for transient ischemic attack: a mixed-methods study.

BACKGROUND: The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurologic Symptoms (PREVENT) program was a complex quality improvement (QI) intervention targeting transient ischemic attack (TIA) evidence-based care. The aim of this study was to evaluate program acceptability among the QI teams and factors associated with degrees of acceptability. METHODS: QI teams from six Veterans Administration facilities participated in active implementation for a one-year period. We employed a mixed methods study to evaluate program acceptability. Multiple data sources were collected over implementation phases and triangulated for this evaluation. First, we conducted 30 onsite, semi-structured interviews during active implementation with 35 participants at 6 months; 27 interviews with 28 participants at 12 months; and 19 participants during program sustainment. Second, we conducted debriefing meetings after onsite visits and monthly virtual collaborative calls. All interviews and debriefings were audiotaped, transcribed, and de-identified. De-identified files were qualitatively coded and analyzed for common themes and acceptability patterns. We conducted mixed-methods matrix analyses comparing acceptability by satisfaction ratings and by the Theoretical Framework of Acceptability (TFA). RESULTS: Overall, the QI teams reported the PREVENT program was acceptable. The clinical champions reported high acceptability of the PREVENT program. At pre-implementation phase, reviewing quality data, team brainstorming solutions and development of action plans were rated as most useful during the team kickoff meetings. Program acceptability perceptions varied over time across active implementation and after teams accomplished actions plans and moved into sustainment. We observed team acceptability growth over a year of active implementation in concert with the QI team's self-efficacy to improve quality of care. Guided by the TFA, the QI teams' acceptability was represented by the respective seven components of the multifaceted acceptability construct. CONCLUSIONS: Program acceptability varied by time, by champion role on QI team, by team self-efficacy, and by perceived effectiveness to improve quality of care aligned with the TFA. A complex quality improvement program that fostered flexibility in local adaptation and supported users with access to data, resources, and implementation strategies was deemed acceptable and appropriate by front-line clinicians implementing practice changes in a large, national healthcare organization. TRIAL REGISTRATION: clinicaltrials.gov : NCT02769338 .

Acceptability, reach and implementation of a training to enhance teachers' skills in physical activity promotion.

BACKGROUND: To achieve real-world impacts, behavior change interventions need to be scaled up and broadly implemented. Implementation is challenging however, and the factors influencing successful implementation are not fully understood. This study describes the nationwide implementation of a complex theory-based program targeting physical activity and sedentary behavior in vocational schools (Lets's Move It; LMI). The implementation primarily involved a systematic and theory-based training and user manual for school staff. We explore how the perceived acceptability of this training (in line with the Theoretical Framework of Acceptability) relates to (un) successful implementation. The study evaluates (1) the experienced acceptability of the training and anticipated acceptability of later delivering the program; (2) reach and implementation, including adaptations and barriers; (3) whether acceptability ratings predict teachers' intentions for implementation. METHODS: Upper secondary school staff from vocational and high schools (n = 194) enrolled in a two-part training, covering implementation of the LMI program and training in motivational interaction styles. One hundred fifty-one participants attended both parts of the training. Participants reported their perceived acceptability of the training and their implementation efforts in online questionnaires at baseline, after training sessions and at long-term follow-up. Qualitative data (open-ended questions) were analysed with content analysis to collate responses. Quantitative data analyses involved correlations and logistic regression. RESULTS: Participants rated the training as highly acceptable on all dimensions (average ratings exceeded 4.0 on a 5-point scale). The implementation reached at least 6100 students and 341 school classes. Most teachers intended to continue program implementation. Acceptability ratings explained 51.7% of teachers' intentions to implement the student program (훘2 = 30.08; df = 8; p < .001), with affective attitude, perceived effectiveness and self-efficacy the most influential. Teachers commonly reported condensing program content, and reported deficits of time and collegial support as common barriers to implementation. CONCLUSION: High acceptability and reach of the training indicate strong potential for implementation success. Multiple facets of acceptability seem important to successful implementation. Future research should explore ways to improve acceptability, thereby promoting successful implementation in real-world settings.

Pharmacists' acceptability of a men's mental health promotion program using the Theoretical Framework of Acceptability.

INTRODUCTION: Community pharmacists are accessible, knowledgeable, and capable of providing mental health promotion and care in communities. This may not be a role that is recognized by the public, and men in particular. Differences between men and women exist in help seeking practices. Headstrong-Taking Things Head-On is a men's mental health promotion program for community pharmacies that was designed to increase the capacity of community pharmacists in caring for men with lived experience of mental illness and addictions. The program's core components included signage in pharmacies, education and training for pharmacists, and a website for use with patients. METHODS: We applied the Theoretical Framework of Acceptability as the coding scheme to pharmacists' qualitative interviews to examine the acceptability of Headstrong for pharmacists. RESULTS: Nine pharmacists consented to participate and all chose telephone interviews. With the exceptions of ethicality, affective attitude, and opportunity costs, all components from the TFA were coded in each of the nine transcripts. The most frequently coded constructs were perceived effectiveness of the intervention, burden, and self-efficacy. These were coded at least 20 times. The remaining categories ethicality, intervention coherence, affective attitude, and opportunity costs were coded between 11 to 17 times. Pharmacists' perceptions of the effectiveness of the program was mixed. The overall burden was perceived to be low, but opportunity costs appear to have limited the participation of some pharmacists in the program. CONCLUSION: Use of the Theoretical Framework of Acceptability as a coding scheme for qualitative data from community pharmacists in a men's mental health program was helpful for identifying issues with the program that may require redesign (e.g., signage). Program design should consider how services are advertised in the pharmacy setting, how personal values of pharmacists influence intervention coherence, and whether minimizing the burden of an intervention negates issues related to opportunity costs.