{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:04:25Z","timestamp":1790172265231,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Research suggests that some adults with visible differences may experience challenges related to romantic relationships, sex and physical intimacy. Loving\n                      <jats:styled-content style=\"fixed-case\">ACTion<\/jats:styled-content>\n                      is a self\u2010guided Acceptance and Commitment Therapy (\n                      <jats:styled-content style=\"fixed-case\">ACT<\/jats:styled-content>\n                      )\u2010based intervention delivered as an audio podcast series, co\u2010produced with adults with visible differences and designed as a supportive intervention for adults with any kind of visible difference seeking help to navigate challenges related to intimacy and romantic relationships. The present study aimed to evaluate the effectiveness of Loving\n                      <jats:styled-content style=\"fixed-case\">ACTion<\/jats:styled-content>\n                      using a mixed methods design.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010one adults with a range of visible differences completed an online mixed methods survey at three time points: (1) baseline, (2) post\u2010intervention and (3) 2\u2010month follow\u2010up. Changes in psychosocial outcomes were examined using paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and open\u2010ended responses were analysed using content analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between baseline and post\u2010intervention, there were significant improvements in appearance\u2010related distress in romantic relationships, body image life disengagement, fear of negative appearance evaluation and internal shame as well as significant improvements in body esteem, psychological flexibility and self\u2010compassion. These improvements were maintained at follow\u2010up, with additional improvements observed in valued living. Content analysis suggested that engaging with Loving\n                      <jats:styled-content style=\"fixed-case\">ACTion<\/jats:styled-content>\n                      positively impacted wellbeing and made a difference to participants' lives.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      These findings provide preliminary support for the potential value of this novel, accessible intervention for adults with visible differences navigating romantic and intimate relationships. Loving\n                      <jats:styled-content style=\"fixed-case\">ACTion<\/jats:styled-content>\n                      is now freely available at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.visibledifferencesupporthub.com\">www.VisibleDifferenceSupportHub.com<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.70096","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:13:59Z","timestamp":1785251639000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Loving\n                    <scp>ACTion<\/scp>\n                    : An evaluation of an\n                    <scp>ACT<\/scp>\n                    \u2010based audio podcast intervention focussed on romantic and intimate relationships for adults with visible differences"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-8840","authenticated-orcid":false,"given":"Maia","family":"Thornton","sequence":"first","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9148-2617","authenticated-orcid":false,"given":"Emma","family":"Waite","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"White","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Zarola","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yara","family":"Vizinho","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Clarke","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4285-5678","authenticated-orcid":false,"given":"Diana","family":"Harcourt","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences University of the West of England  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u20103514.95.2.352"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620987109"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2021.01.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2014.04.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897\u2010016\u20109939\u20108"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2023.04.009"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmen.0000272"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2004.07.008"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2024.101840"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11195\u2010014\u20109360\u2010x"},{"key":"e_1_2_12_12_1","unstructured":"Costa B.(2022).The experiences of young Somali adults with visible facial differences: findings from a UK qualitative study[Unpublished Doctoral thesis the University of the West of England]. 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