Acceptability of the ePOWER intervention: Managing previvors' cancer-related uncertainty and supporting decision making

Abstract

Objective

Previvors—unaffected individuals who have increased risk of cancer due to a pathogenic or likely pathogenic variant in a gene—experience high levels of uncertainty, which is associated with negative outcomes. The ePOWER (empowering Preventive Options for Women Experiencing Risk) intervention is designed to help BRCA1/2 previvors manage their cancer-related uncertainty and make informed health decisions. In this study, we assessed the acceptability of ePOWER using a multiple methods approach.

Methods

Previvors (N = 24) completed individual, semi-structured interviews. Previvors first completed the Treatment Acceptability and Preference Scale (TAPS). Additionally, using a Learner Verification & Revision (LV&R) interviewing approach, we also elicited feedback on whether ePOWER was understandable, salient, and satisfactory to previvors. Acceptability was assessed by quantitative data (TAPS scores) and qualitative data (interviews). In analyzing the interview data and integrating the findings, deductive coding was utilized using LV&R categories and inductive thematic analysis was utilized to capture additional nuances from participants' evaluation.

Results

Adequate acceptability was demonstrated by TAPS scores. 88 % of participants exceeded the a priori acceptability threshold (TAPS ≥3). Deductive coding using LV&R categories also confirmed ePOWER was visually appealing, understandable, persuasive, cultural appropriate, and fostered self-efficacy. Inductive thematic analysis expanded on the LV&R categories and identified two additional themes: (1) relatability and emotional support and (2) useful resource.

Conclusion

ePOWER is an acceptable intervention to help previvors manage cancer-related uncertainty and support decision making.

Innovation

The ePOWER intervention can be shared during healthcare appointments and then utilized continuously by previvors to manage uncertainty and facilitate decisions.