03 · What You Need to Know
Understanding Participant Acceptability in Feasibility Research
What Is Participant Acceptability?
Participant acceptability concerns how individuals perceive and evaluate an intervention, research activity, or procedure that they are expected to experience.
It may involve whether the activity seems appropriate, manageable, worthwhile, consistent with personal values, or compatible with participants' circumstances.
For example, students may consider an AI-supported feedback intervention useful but feel uncomfortable with the collection of detailed learning analytics.
The intervention may therefore be acceptable in one respect and problematic in another.
Acceptability should not be understood as a single, fixed attitude that can always be captured adequately through one question.
Its meaning depends partly on the intervention, the participants, and the theoretical framework used to examine it.
Why Is Acceptability Important Before a Definitive Study?
Feasibility research examines whether and how a proposed study can be conducted.
Participant acceptability becomes important when the study depends on individuals undertaking activities that may involve substantial time, effort, inconvenience, discomfort, or changes to established practices.
For example, an intervention may require students to complete additional weekly tasks alongside their ordinary coursework.
If participants regard those requirements as excessively burdensome, the definitive study may encounter low engagement or withdrawal.
Acceptability evidence can help researchers identify these concerns before committing to a larger investigation.
However, the relationship is not deterministic. Participants may find an intervention acceptable without completing it consistently, or participate despite reservations.
Is Acceptability Always Necessary as a Feasibility Outcome?
No. The importance of acceptability depends on the proposed research.
It may be central to a study introducing an unfamiliar intervention, a sensitive assessment, or a demanding participant schedule.
By contrast, a feasibility investigation focused narrowly on whether an approved database can export specified variables may not require a participant acceptability outcome.
Researchers should identify whether uncertainty about participant experience could affect the definitive study's implementation or ethical suitability.
If existing evidence adequately addresses that uncertainty, further assessment may be less important.
The selection of feasibility questions before a definitive study should reflect the consequences of unresolved uncertainty rather than a universal checklist.
What Does the Theoretical Framework of Acceptability Explain?
Sekhon, Cartwright, and Francis developed the Theoretical Framework of Acceptability, commonly abbreviated TFA, to provide a more structured understanding of acceptability in healthcare interventions.
The framework conceptualizes acceptability as a multifaceted construct involving cognitive and emotional responses to an intervention.
It identifies seven constructs that may inform assessment.
| TFA construct |
Meaning |
Illustrative educational question |
| Affective attitude |
How participants feel about the intervention |
How do students feel about receiving AI-supported feedback? |
| Burden |
Perceived effort required to participate |
How demanding are the required weekly activities? |
| Ethicality |
Fit with participants' values |
Are the data collection practices consistent with participants' privacy expectations? |
| Intervention coherence |
Understanding of the intervention and how it works |
Do students understand why the feedback activities are required? |
| Opportunity costs |
Benefits or activities forgone to participate |
What other learning activities must students reduce or postpone? |
| Perceived effectiveness |
Beliefs about whether the intervention is likely to achieve its purpose |
Do participants believe the feedback will support learning? |
| Self-efficacy |
Confidence in performing required behaviors |
Do students believe they can complete the revision activities? |
The framework can help researchers avoid treating acceptability as simple satisfaction.
However, it was developed within a particular disciplinary context. Its application to educational interventions should be theoretically justified and sensitive to the setting.
Researchers should not assume that every study must measure all seven constructs.
What Is the Difference Between Prospective and Retrospective Acceptability?
Acceptability can be examined before individuals experience an intervention, during participation, or after its completion.
Prospective acceptability concerns expectations about an intervention that has not yet been experienced.
Retrospective acceptability concerns participants' evaluations after they have encountered it.
Prospective acceptability
How participants anticipate experiencing the proposed intervention or procedure.
Retrospective acceptability
How participants evaluate an intervention or procedure after experiencing it.
These assessments may produce different findings.
For example, students may initially expect an AI-supported activity to reduce workload but subsequently discover that reviewing and revising generated feedback requires substantial effort.
Researchers should distinguish anticipated experience from actual experience when interpreting acceptability evidence.
Should Acceptability Be Measured During the Intervention?
Sometimes. Concurrent assessment can reveal problems while the intervention is being implemented.
For example, teachers may initially accept a new assessment workflow but become concerned about its workload after several weeks.
Measuring acceptability only before implementation could miss these developments.
However, repeated acceptability assessments can themselves create participant burden or influence how individuals experience the intervention.
The timing and frequency should therefore correspond to the feasibility questions.
Researchers may use brief assessments at meaningful points rather than administer extensive questionnaires after every activity.
How Is Acceptability Different From Satisfaction?
Satisfaction generally concerns an evaluative response to an experience, often emphasizing whether expectations were met.
Acceptability may involve broader judgments about burden, ethical compatibility, perceived effectiveness, coherence, and other dimensions.
For example, a student may report being satisfied with the quality of feedback while objecting to the amount of personal information collected by the system.
A satisfaction score alone may conceal that concern.
Researchers should avoid using a single satisfaction item as a comprehensive measure of acceptability without appropriate justification.
How Is Acceptability Different From Adherence?
Adherence concerns whether participants complete or engage with prescribed activities.
Acceptability concerns how participants perceive and evaluate those activities.
A participant may complete every intervention task despite finding it burdensome.
Another may consider the intervention valuable but be unable to participate because of scheduling or accessibility barriers.
These observations have different implications for intervention redesign.
When sustained participation matters, researchers may need to measure intervention adherence separately rather than infer acceptability from completion records.
Is Acceptability the Same as Feasibility?
No. Acceptability is one possible dimension of feasibility.
An intervention may be acceptable to participants but impossible to deliver within available staffing or financial resources.
Conversely, an intervention may be technically feasible but regarded as inappropriate or excessively burdensome.
Proctor and colleagues distinguish acceptability from other implementation outcomes, including feasibility and appropriateness.
These constructs may overlap in practice, but they should not be treated as interchangeable.
Researchers should identify the specific construct their measures are intended to represent.
How Can Participant Acceptability Be Measured Quantitatively?
Questionnaires can assess selected dimensions of acceptability using structured response options.
Researchers might ask participants to evaluate perceived burden, clarity, appropriateness, or confidence in completing required activities.
However, the suitability of an instrument depends on its conceptual basis and available measurement evidence.
Researchers should not assume that a newly assembled set of Likert-type items automatically forms a valid acceptability scale.
Where an existing instrument is adapted, its suitability for the new population and intervention should be considered.
Quantitative summaries can describe patterns but may provide limited explanation of why participants hold particular views.
How Can Acceptability Be Assessed Qualitatively?
Qualitative interviews, focus groups, and open-ended responses can help researchers understand how participants experience an intervention and why particular components are acceptable or problematic.
For example, teachers may describe how a proposed AI-supported assessment procedure conflicts with existing institutional expectations.
Such accounts may reveal issues that a general acceptability score would not identify.
However, qualitative findings should be interpreted according to the sampling strategy and analytic approach.
A few favorable interviews cannot establish that the entire target population will accept the intervention.
The value of qualitative evidence lies in understanding experiences, variation, and contextual conditions rather than automatically estimating population prevalence.
Should Quantitative and Qualitative Acceptability Evidence Be Combined?
Combining methods may be useful when researchers need both a structured description of acceptability and an explanation of the experiences underlying it.
For example, questionnaire responses may indicate that participants perceive substantial burden, while interviews reveal that the burden arises from repetitive reporting requirements.
However, using both methods does not automatically produce meaningful integration.
The research design should explain how the evidence will be connected and how disagreements will be interpreted.
Researchers should select mixed methods because they answer consequential feasibility questions, not merely because multiple forms of data appear more comprehensive.
Whose Acceptability Should Be Assessed?
The relevant stakeholders depend on the intervention and research setting.
Participants receiving the intervention may evaluate it differently from those responsible for delivering it.
For example, students may appreciate frequent feedback while teachers find the required verification workload difficult to sustain.
Both perspectives may matter for feasibility, but they should not be combined into an undifferentiated average.
Researchers should distinguish participant acceptability from implementer or organizational acceptability when these groups have different roles and experiences.
Sampling should include relevant perspectives without assuming that every stakeholder group requires identical questions.
Should Acceptability Be Evaluated Across Participant Subgroups?
It may be important when participants differ in characteristics that affect their ability to experience the intervention.
For example, students with limited connectivity may perceive an online intervention differently from those with reliable access.
Similarly, participants with accessibility requirements may encounter burdens not experienced by others.
A feasibility study should consider whether important differences are being concealed by aggregate findings.
However, small subgroup samples may not support precise quantitative comparisons.
Qualitative evidence may help identify consequential variation without implying statistical representativeness.
Can High Acceptability Predict Recruitment and Retention?
Acceptability may be associated with willingness to enroll or continue participating, but the relationship is not guaranteed.
For example, students may express positive attitudes toward an intervention yet decline participation because of time constraints.
Others may remain in a study despite dissatisfaction because they value its broader purpose.
Researchers should therefore assess recruitment performance and retention directly when those outcomes matter.
Acceptability findings may help explain participation patterns but should not substitute for them.
How Can Social Desirability Affect Acceptability Findings?
Participants may provide favorable evaluations because they believe positive responses are expected or because they are concerned about consequences of criticism.
This may be particularly relevant when researchers are also teachers, supervisors, or institutional administrators.
For example, students may hesitate to criticize an intervention introduced by someone responsible for their grades.
Researchers should consider confidentiality, interviewer independence, timing, and the perceived consequences of responding.
However, anonymity alone does not eliminate every source of response bias.
Acceptability assessment should be designed to support candid participation.
What If Participants Find an Intervention Acceptable but Ineffective?
This is entirely possible.
Participants may enjoy an intervention, consider it convenient, or appreciate its intended purpose without experiencing the desired outcome.
For example, students may prefer AI-generated feedback while demonstrating no measurable improvement in achievement.
Acceptability and effectiveness should therefore be evaluated separately.
A feasibility study may support a conclusion that the intervention is acceptable under the tested conditions, but it cannot establish effectiveness solely from favorable participant evaluations.
What If an Intervention Is Effective but Poorly Accepted?
An intervention may demonstrate beneficial effects under controlled conditions while imposing burdens that make routine implementation difficult.
For example, an intensive instructional strategy may improve performance but require more teacher time than participating institutions can sustain.
Acceptability findings can help identify whether the intervention needs adaptation.
However, modifying essential components may change the intervention and potentially affect its effectiveness.
Researchers should distinguish adaptations that improve implementation from changes that alter the intervention's intended mechanism.
Should Acceptability Be a Primary Feasibility Outcome?
It may be primary when uncertainty about participants' experiences is the central reason for conducting the feasibility study.
For example, a study involving sensitive learning analytics or unfamiliar AI-assisted assessment procedures may need to establish whether the proposed practices are acceptable before proceeding.
However, acceptability need not be primary when recruitment, intervention delivery, or outcome completeness presents a more consequential uncertainty.
The designation should follow the feasibility objectives.
Researchers should avoid assigning primary status to an outcome merely because it is convenient to measure.
What Is an Acceptable Acceptability Score?
There is no universal score or percentage that establishes acceptable intervention acceptability.
Interpretation depends on the instrument, construct, population, and consequences of unfavorable experiences.
For example, a favorable average rating may coexist with serious privacy concerns among a smaller group of participants.
Such concerns should not be dismissed merely because the overall mean exceeds a predetermined threshold.
Researchers should justify any numerical criteria and consider whether particular problems warrant attention regardless of the aggregate score.
How Should Acceptability Progression Criteria Be Established?
Progression criteria should identify which acceptability findings would support proceeding, require modification, or justify reconsidering the definitive study.
For example, a study may specify that substantial unresolved concerns about participant burden or privacy require redesign before progression.
Where quantitative thresholds are used, they should be grounded in the intervention and measurement approach.
Qualitative evidence may also identify critical concerns that cannot be reduced meaningfully to a percentage.
A green-amber-red progression system can support decisions, but it should not obscure ethical or methodological problems.
How Large Should an Acceptability Feasibility Study Be?
There is no universal sample size.
Quantitative assessment may require sufficient observations to estimate relevant acceptability outcomes with useful precision.
Qualitative assessment may prioritize participants who can illuminate different experiences and implementation conditions.
The sample should reflect the feasibility questions, the diversity of relevant stakeholders, and the intended interpretation.
A small study may identify important concerns without establishing how common those concerns are in the definitive population.
What If Acceptability Findings Are Mixed?
Mixed findings should be examined rather than averaged away.
For example, students may value an intervention's educational benefits while finding its assessment schedule burdensome.
Teachers may support its purpose but question the workload associated with implementation.
Researchers should identify which concerns are remediable and which relate to essential intervention components.
Progression may be justified after appropriate modifications, but substantial changes may require additional testing.
Disagreement among participants can provide useful evidence about the conditions under which the intervention may be feasible.
How Should Acceptability Findings Be Reported?
The report should define acceptability, identify the conceptual framework or operational dimensions used, and describe the assessment methods.
Researchers should specify whose perspectives were collected and when assessments occurred.
Quantitative results should be reported with appropriate measures of variation and uncertainty. Qualitative findings should preserve relevant differences and contextual explanations.
The discussion should distinguish anticipated from experienced acceptability and explain how findings inform progression decisions.
Researchers should avoid claiming universal acceptability based on a small or highly selected feasibility sample.
Watch Out
Do not equate favorable satisfaction ratings or high intervention completion with comprehensive acceptability. Participants may comply with demanding procedures despite substantial reservations, and important ethical or accessibility concerns may be concealed by an encouraging average score.
