A Mixed-Method, Multi-Perspective Investigation of Barriers to Participation in Mindfulness-Based Cancer Recovery
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ORIGINAL PAPER
A Mixed-Method, Multi-Perspective Investigation of Barriers to Participation in Mindfulness-Based Cancer Recovery Kirsti Toivonen 1 & Madeline Hermann 1 & Jennifer White 2 & Michael Speca 3 & Linda E. Carlson 3,4,5 Published online: 4 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Mindfulness-based cancer recovery (MBCR) is a mindfulness-based intervention (MBI) evidenced to improve the psychosocial well-being of cancer survivors. Like many MBI group programs, there is typically attrition of 20–30% of participants who initially register for the program. Understanding the barriers to participation in and completion of MBCR may highlight potential avenues to improve uptake and adherence to MBIs, which would help more survivors benefit from MBCR. Methods The present study included: (1) quantitative analysis of barriers to practice; (2) qualitative analysis of survivors’ perceived barriers to participation, and; (3) qualitative analysis of MBCR instructors’ perceptions of barriers to participation. Results Most survivors reported relatively low levels of barriers and tended to report similar types of barriers, but those who dropped out were twice as likely to report experiencing barriers “daily” than those who did not drop out. In interviews, survivors’ reported barriers fell into four themes that were practical, person-related, cancer-related, and program-related. Instructors identified themes of practical barriers, there being a “right time”, participant attitudes, and the group setting as factors that influenced participation. Conclusions Barriers are ubiquitous and those who eventually dropped out did not appear to experience distinct barriers, just more of them. In light of this, broad strategies that might help facilitate the participation of all survivors in MBCR and other MBIs are discussed. Keywords Mindfulness-based intervention . Integrative oncology . Barriers . Mixed-methods . Qualitative . Cancer The increasing incidence of cancer diagnoses coupled with decreasing mortality due to advances in early detection and treatment has resulted in a growing number of cancer Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12671-020-01461-z) contains supplementary material, which is available to authorized users. * Linda E. Carlson [email protected] 1
Department of Psychology, University of Calgary, Calgary, AB, Canada
2
Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
3
Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB, Canada
4
Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
5
Cancer Control Alberta Holy Cross Site, 2202 2nd Street SW, Calgary, AB TN2 3C1, Canada
survivors (Canadian Cancer Statistics Advisory Committee 2018). Following completion of primary cancer treatments, cancer survivors can continue to experience late and longterm psychological and p
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