Scoping review finds inconsistent acceptability reporting in healthcare research

A scoping review found that the Theoretical Framework of Acceptability (TFA) is increasingly used across healthcare intervention research, but studies vary in how they define, assess and report acceptability. Researchers searched six biomedical and trial databases for records published from 2017 through July 2025, finding that the details needed to compare acceptability findings across studies were often missing or inconsistently presented.

The review, published in BMC Health Services Research, examined how the TFA is conceptualised, operationalised and reported in studies of patient-facing healthcare interventions. The framework assesses how interventions are perceived by the people who deliver and receive them. Its use in this review was not intended to determine whether particular interventions were effective, acceptable or preferable to alternatives. Instead, the authors mapped the methods researchers use to investigate perceptions of acceptability and identified gaps in the documentation of those methods.

Researchers followed JBI scoping-review methodology and reported the work in accordance with PRISMA-ScR. Their searches covered MEDLINE, EMBASE, CINAHL, the Cochrane Library, ClinicalTrials.gov and ISRCTN. The evidence base included empirical studies, trial registrations and published protocols, provided that they applied the TFA to assess the acceptability of patient-facing healthcare interventions. Information was extracted and synthesised using descriptive and narrative approaches. This mixed evidence base allowed the review to examine both completed research and methods that had been planned but for which results were not yet available.

The analysis showed that use of the TFA has increased over time and extends across diverse clinical contexts. When findings from all source types were combined, questionnaires were the most common method used, or planned for use, to assess acceptability. Acceptability was typically positioned as a post-intervention outcome, and assessments were conducted most often with patients or service users at one time point. The reviewers also found that the TFA most frequently informed data collection across the full sample.

A sensitivity analysis restricted to empirical studies produced a different methodological profile. Within this subset, assessment was predominantly qualitative and interview-based, although acceptability was still commonly treated as an outcome and assessed after the intervention. Among empirical studies, the TFA was most often used during analysis, reporting and interpretation rather than data collection. The difference between the full sample and the empirical-study subset also revealed that trial registrations frequently failed to specify the TFA constructs they intended to examine. Together, these findings show that the apparent dominance of questionnaires in the combined sample was not uniform across evidence types.

Although the framework has achieved widespread adoption, the review identified variability in its application and insufficient reporting detail. The available information did not always make it possible to appraise how acceptability had been conceptualised or to compare results confidently across studies. The authors noted that limited transparency can hinder efforts to identify recurring drivers of acceptability and make findings more useful when interventions are developed or implemented. The scoping review addressed the use and reporting of the TFA; it did not establish that the framework changes intervention outcomes or that more consistent reporting alone would improve implementation.

The authors proposed a reporting checklist to help address the gaps identified in the evidence. More consistent descriptions of the acceptability constructs, assessment methods, timing, participants and the analytical role of the TFA could make framework use easier to appraise and compare. The proposed checklist is presented as a response to the reporting problems documented in the review, rather than as a tool whose effects have already been evaluated. Overall, the findings point to a central reporting problem: as the TFA becomes more common in healthcare research, the methods used to apply it must also become clearer if its findings are to be interpreted consistently and compared across different interventions and clinical contexts.

Subject of Research: Use and reporting of the Theoretical Framework of Acceptability in healthcare intervention research

Article Title: Application of the Theoretical Framework of Acceptability in healthcare interventions: a scoping review and proposed reporting checklist

Article References: Ghiglieri, C., McCullough, B., McLeese, R. H., O’Neill, B., Bannister, E., Connolly, B., & Bradley, J. M. (2026). Application of the Theoretical Framework of Acceptability in healthcare interventions: a scoping review and proposed reporting checklist. BMC Health Services Research, 26(1), Article 1306. https://doi.org/10.1186/s12913-026-15616-6

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DOI: 10.1186/s12913-026-15616-6

Keywords: healthcare interventions, acceptability, scoping review, TFA, research reporting, qualitative interviews, questionnaires, implementation science, Application, Theoretical, Framework, healthcare