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

## TL;DR

The ePOWER intervention is found to be acceptable for previvors in managing cancer-related uncertainty and supporting health decisions.

## Contribution

The study demonstrates the acceptability of the ePOWER intervention for BRCA1/2 previvors using mixed methods.

## Key findings

- 88% of participants exceeded the acceptability threshold on the TAPS.
- ePOWER was found to be visually appealing, understandable, and culturally appropriate.
- Themes of relatability and emotional support were identified as important aspects of the intervention.

## Abstract

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.

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.

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.

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

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

•Previvors are unaffected individuals who have increased risk of cancer due to a pathogenic variant in a gene.•The ePOWER intervention helps previvors manage uncertainty and make decisions.•The ePOWER intervention is an acceptable intervention.

Previvors are unaffected individuals who have increased risk of cancer due to a pathogenic variant in a gene.

The ePOWER intervention helps previvors manage uncertainty and make decisions.

The ePOWER intervention is an acceptable intervention.