{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:49:04Z","timestamp":1791967744205,"version":"4.3.4"},"reference-count":39,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:00:00Z","timestamp":1783209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002653","name":"Yorkshire Cancer Research","doi-asserted-by":"publisher","award":["L389SS"],"award-info":[{"award-number":["L389SS"]}],"id":[{"id":"10.13039\/501100002653","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR","award":["RP-PG-1016-20005;NIHR134141;NIHR134257"],"award-info":[{"award-number":["RP-PG-1016-20005;NIHR134141;NIHR134257"]}]},{"name":"NIHR Senior Investigator","award":["NIHR305827"],"award-info":[{"award-number":["NIHR305827"]}]},{"name":"NIHR Undergraduate Internship Programme","award":["NIHR305976"],"award-info":[{"award-number":["NIHR305976"]}]},{"name":"NIHR Development and Skills Enhancement Award","award":["NIHR305132"],"award-info":[{"award-number":["NIHR305132"]}]},{"name":"NIHR Advanced Fellowship","award":["NIHR300588"],"award-info":[{"award-number":["NIHR300588"]}]}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns3:p>\n                    Background Complex factorial trials are increasingly employed to optimise complex behavioural interventions. However, acceptability of such designs to participants are unknown. In this qualitative process evaluation of a pilot optimisation randomised controlled trial (O-RCT) for a behavioural intervention to support medication adherence in women with breast cancer, we explored acceptability of trial participation, alongside barriers and facilitators to recruitment and retention. Methods We conducted a 2\n                    <ns3:sup>4\u20131<\/ns3:sup>\n                    fractional factorial pilot O-RCT evaluating the feasibility of four intervention components aiming to support adherence to adjuvant endocrine therapy in women with breast cancer. 52 women were randomised to one of eight conditions, comprising unique intervention component combinations. Four-months post-randomisation, 20 participants completed a semi-structured interview guided by the Theoretical Framework of Acceptability (TFA) and Theoretical Domains Framework (TDF). Data were analysed using rapid qualitative analysis and findings were mapped onto TFA and TDF constructs. Results Generally, participation in the trial was perceived positively (\n                    <ns3:italic>affective attitude<\/ns3:italic>\n                    ). Most women reported easy participation (\n                    <ns3:italic>burden<\/ns3:italic>\n                    ), confidence in capabilities (\n                    <ns3:italic>self-efficacy, beliefs about capabilities<\/ns3:italic>\n                    ), minimal opportunity costs (\n                    <ns3:italic>opportunity cost<\/ns3:italic>\n                    ), and personal benefit from participation (\n                    <ns3:italic>perceived effectiveness, knowledge, beliefs about consequences<\/ns3:italic>\n                    ). Randomisation process understanding (\n                    <ns3:italic>coherence<\/ns3:italic>\n                    ), and questionnaire retention experiences were mixed; women reported reduced motivation to complete questionnaires due to length, repetitiveness, and emotional impact (\n                    <ns3:italic>motivation and goals, memory, attention, and decision processes<\/ns3:italic>\n                    )\n                    <ns3:italic>.<\/ns3:italic>\n                    Participation decisions were shaped by contextual factors, (\n                    <ns3:italic>environmental context and resources<\/ns3:italic>\n                    ), altruism, personal benefit, and wanting to advance science (\n                    <ns3:italic>social\/professional role and identity, motivation and goals<\/ns3:italic>\n                    ). Conclusions This qualitative process evaluation suggests participation in an O-RCT was acceptable. Low randomisation coherence and questionnaire burden are notable areas for improvement. Future studies within trials should explore approaches to explaining factorial trials to participants. Barriers and facilitators to recruitment and retention were similar to parallel group randomised trials, suggesting interventions addressing these may be applicable regardless of trial design.\n                  <\/ns3:p>","DOI":"10.3310\/nihropenres.14321.1","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:44:08Z","timestamp":1788867848000},"page":"82","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring trial acceptability, recruitment, and retention in a pilot optimisation randomised controlled trial of a behavioural intervention to support medication adherence in women with breast cancer: A qualitative process evaluation"],"prefix":"10.3310","volume":"6","author":[{"given":"Jennifer F","family":"Ingram","sequence":"first","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Travis","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise H","family":"Hall","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Raine","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9251-492X","authenticated-orcid":false,"given":"Rachel","family":"Ellison","sequence":"additional","affiliation":[{"name":"York YO10 5DD York Trials Unit, University of York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"McNaught","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit Leeds England LS2 9NL Leeds Institute of Clinical Trials Research, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollie","family":"Wilkes","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit Leeds England LS2 9NL Leeds Institute of Clinical Trials Research, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei Loo","family":"Ow","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit Leeds England LS2 9NL Leeds Institute of Clinical Trials Research, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences and Health Glasgow Scotland G1 1QE University of Strathclyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7663-7804","authenticated-orcid":false,"given":"David P","family":"French","sequence":"additional","affiliation":[{"name":"Manchester England M13 9PL Division of Psychology and Mental Health, University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8052-2893","authenticated-orcid":false,"given":"Daniel","family":"Howdon","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1882-666X","authenticated-orcid":false,"given":"Jane","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology Leeds England LS9 7TF Leeds Teaching Hospitals NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Waller","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health London England E13 8SP Queen Mary University of London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Buxton","sequence":"additional","affiliation":[{"name":"Leeds Independent"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally J L","family":"Moore","sequence":"additional","affiliation":[{"name":"Leeds Independent"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4047-0345","authenticated-orcid":false,"given":"Catherine","family":"Parbutt","sequence":"additional","affiliation":[{"name":"Medicines Management and Pharmacy Services Leeds England LS9 7TF Leeds Teaching Hospitals NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galina","family":"Velikova","sequence":"additional","affiliation":[{"name":"Leeds England LS9 7TF Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital"},{"name":"Leeds Cancer Centre Leeds England LS9 7TF Leeds Teaching Hospitals NHS Trust, St James's University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J","family":"Farrin","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit Leeds England LS2 9NL Leeds Institute of Clinical Trials Research, University of Leeds"},{"name":"Edinburgh Clinical Trials Unit Edinburgh Scotland EH16 4UX Usher Institute, University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Collinson","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit Leeds England LS2 9NL Leeds Institute of Clinical Trials Research, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel G","family":"Smith*","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-5377","authenticated-orcid":false,"given":"Sophie M C","family":"Green*","sequence":"additional","affiliation":[{"name":"Leeds England LS2 9NL Leeds Institute of Health Sciences, University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2026,7,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40814-016-0058-y","article-title":"Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used.","volume":"2","author":"S Levati","year":"2016","journal-title":"Pilot and feasibility studies."},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-72206-1","author":"L Collins","year":"2018","journal-title":"Optimization of behavioral, biobehavioral, and biomedical interventions: The multiphase optimization strategy (MOST)."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1998-2008","DOI":"10.1093\/tbm\/ibab087","article-title":"One view of the next decade of research on behavioral and biobehavioral approaches to cancer prevention and control: intervention optimization.","volume":"11","author":"L Collins","year":"2021","journal-title":"Translational Behavioral Medicine."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1-13","DOI":"10.1186\/s12913-017-2031-8","article-title":"Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework.","volume":"17","author":"M Sekhon","year":"2017","journal-title":"BMC Health Services Research."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12913-022-07577-3","article-title":"Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions.","volume":"22","author":"M Sekhon","year":"2022","journal-title":"BMC Health Services Research."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1186\/s13063-019-3444-y","article-title":"Trials need participants but not their feedback? A scoping review of published papers on the measurement of participant experience of taking part in clinical trials.","volume":"20","author":"C Planner","year":"2019","journal-title":"Trials."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e002889","DOI":"10.1136\/bmjopen-2013-002889","article-title":"What can qualitative research do for randomised controlled trials? A systematic mapping review.","volume":"3","author":"A O\u2019Cathain","year":"2013","journal-title":"BMJ Open."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"h1258","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance.","volume":"350","author":"G Moore","year":"2015","journal-title":"BMJ."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance.","volume":"374","author":"K Skivington","year":"2021","journal-title":"BMJ."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"190-198","DOI":"10.1016\/j.socscimed.2018.07.040","article-title":"Six dimensions of research trial acceptability: how much, what, when, in what circumstances, to whom and why?","volume":"213","author":"K Gooding","year":"2018","journal-title":"Social Science & Medicine."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e059230","DOI":"10.1136\/bmjopen-2021-059230","article-title":"Recruitment, consent and retention of participants in randomised controlled trials: a review of trials published in the National Institute for Health Research (NIHR) Journals Library (1997\u20132020).","volume":"12","author":"R Jacques","year":"2022","journal-title":"BMJ Open."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"100698","DOI":"10.1016\/j.conctc.2021.100698","article-title":"Does prospective acceptability of an intervention influence refusal to participate in a randomised controlled trial? An interview study.","volume":"21","author":"M Sekhon","year":"2021","journal-title":"Contemporary Clinical Trials Communications."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"95-103","DOI":"10.1097\/MLR.0000000000001664","article-title":"Guidelines for designing and evaluating feasibility pilot studies.","volume":"60","author":"J Teresi","year":"2022","journal-title":"Medical Care."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"382-392","DOI":"10.1016\/S1470-2045(21)00758-0","article-title":"Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials.","volume":"23","author":"R Bradley","year":"2022","journal-title":"The Lancet Oncology."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"771-784","DOI":"10.1016\/S0140-6736(11)60993-8","article-title":"Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials.","volume":"378","year":"2011","journal-title":"Lancet."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"4120-4128","DOI":"10.1200\/JCO.2009.25.9655","article-title":"Early Discontinuation and Nonadherence to Adjuvant Hormonal Therapy in a Cohort of 8,769 Early-Stage Breast Cancer Patients.","volume":"28","author":"D Hershman","year":"2010","journal-title":"Journal of Clinical Oncology."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"459-478","DOI":"10.1007\/s10549-012-2114-5","article-title":"Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.","volume":"134","author":"C Murphy","year":"2012","journal-title":"Breast Cancer Research and Treatment."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1515-1524","DOI":"10.1038\/bjc.2013.116","article-title":"Cohort study of adherence to adjuvant endocrine therapy, breast cancer recurrence and mortality.","volume":"108","author":"B Makubate","year":"2013","journal-title":"British Journal of Cancer."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1172-1180","DOI":"10.1038\/bjc.2013.464","article-title":"The value of high adherence to tamoxifen in women with breast cancer: a community-based cohort study.","volume":"109","author":"C McCowan","year":"2013","journal-title":"British Journal of Cancer."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"102264","DOI":"10.1016\/j.ctrv.2021.102264","article-title":"Systematic review of real-world studies evaluating the impact of medication non-adherence to endocrine therapies on hard clinical endpoints in patients with non-metastatic breast cancer.","volume":"100","author":"A Inotai","year":"2021","journal-title":"Cancer Treatment Reviews."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4548-4561","DOI":"10.1200\/JCO.23.00697","article-title":"A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors.","volume":"41","author":"E Bright","year":"2023","journal-title":"Journal of Clinical Oncology."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e069971","DOI":"10.1136\/bmjopen-2022-069971","article-title":"Refining and optimising a behavioural intervention to support endocrine therapy adherence (ROSETA) in UK women with breast cancer: protocol for a pilot fractional factorial trial.","volume":"13","author":"S Smith","year":"2023","journal-title":"BMJ Open."},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kaaf003","article-title":"Supporting endocrine therapy adherence in women with breast cancer: findings from the ROSETA pilot fractional factorial randomized trial.","volume":"59","author":"S Smith","year":"2025","journal-title":"Annals of Behavioral Medicine."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1186\/s12913-022-08243-4","article-title":"Supporting adjuvant endocrine therapy adherence in women with breast cancer: the development of a complex behavioural intervention using Intervention Mapping guided by the Multiphase Optimisation Strategy.","volume":"22","author":"S Green","year":"2022","journal-title":"BMC Health Services Research."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1065-1078","DOI":"10.1007\/s11121-024-01711-9","article-title":"Acceptability of Four Intervention Components Supporting Medication Adherence in Women with Breast Cancer: a Process Evaluation of a Fractional Factorial Pilot Optimization Trial.","volume":"25","author":"S Green","year":"2024","journal-title":"Prevention Science."},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibae066","article-title":"Assessing multidimensional fidelity in a pilot optimization trial: A process evaluation of four intervention components supporting medication adherence in women with breast cancer.","volume":"15","author":"S Green","year":"2024","journal-title":"Translational Behavioral Medicine."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3310\/nihropenres.13337.1","article-title":"Acceptability, fidelity and trial experience of four intervention components to support medication adherence in women with breast cancer: A process evaluation protocol for a pilot fractional factorial trial.","volume":"3","author":"S Green","year":"2023","journal-title":"NIHR Open Research."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems.","volume":"12","author":"L Atkins","year":"2017","journal-title":"Implementation Science."},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.17605\/OSF.IO\/FP8ZW","article-title":"ROSETA Pilot Trial Process Evaluation.","author":"S Green","year":"2024"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1753-1760","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies.","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qualitative Health Research."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1596-1604","DOI":"10.1177\/1049732320921835","article-title":"Rapid Techniques in Qualitative Research: A Critical Review of the Literature.","volume":"30","author":"C Vindrola-Padros","year":"2020","journal-title":"Qualitative Health Research."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"13-27","DOI":"10.1177\/1098214019886914","article-title":"Rapid, Responsive, and Relevant?: A Systematic Review of Rapid Evaluations in Health Care.","volume":"42","author":"C Vindrola-Padros","year":"2021","journal-title":"American Journal of Evaluation."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"303-309","DOI":"10.1016\/j.pec.2011.06.002","article-title":"Personal experiences of taking part in clinical trials - a qualitative study.","volume":"84","author":"L Locock","year":"2011","journal-title":"Patient Education and Counseling."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"420-435","DOI":"10.1016\/j.amjsurg.2009.02.010","article-title":"Informed consent: how much and what do patients understand?","volume":"198","author":"M Falagas","year":"2009","journal-title":"American Journal of Surgery"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1-13","DOI":"10.1016\/j.jclinepi.2021.03.007","article-title":"Why trials lose participants: A multitrial investigation of participants\u2019 perspectives using the theoretical domains framework.","volume":"137","author":"R Newlands","year":"2021","journal-title":"Journal of Clinical Epidemiology."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1186\/s12885-024-12464-7","article-title":"Participants\u2019 perspectives of being recruited into a randomised trial of a weight loss intervention before colorectal cancer surgery: a qualitative interview study.","volume":"24","author":"A Talbot","year":"2024","journal-title":"BMC cancer."},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.MR000013.pub6","article-title":"Strategies to improve recruitment to randomised trials.","volume":"2018","author":"S Treweek","year":"2018","journal-title":"Cochrane Database of Systematic Reviews."},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.MR000032.pub3","article-title":"Strategies to improve retention in randomised trials.","volume":"2021","author":"K Gillies","year":"2021","journal-title":"Cochrane Database of Systematic Reviews."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e084889","DOI":"10.1136\/bmjopen-2024-084889","article-title":"Recruitment, retention and reporting of variables related to ethnic diversity in randomised controlled trials: an umbrella review.","volume":"14","author":"E Owusu-Addo","year":"2024","journal-title":"BMJ Open."}],"container-title":["NIHR Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:09:14Z","timestamp":1791965354000},"score":1,"resource":{"primary":{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,5]]},"references-count":39,"URL":"https:\/\/doi.org\/10.3310\/nihropenres.14321.1","relation":{"has-review":[{"id-type":"doi","id":"10.3310\/nihropenres.15604.r41191","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15604.r41517","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15604.r41517","asserted-by":"object"},{"id-type":"doi","id":"10.3310\/nihropenres.15604.r41191","asserted-by":"object"}]},"ISSN":["2633-4402"],"issn-type":[{"value":"2633-4402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,5]]},"assertion":[{"value":"Indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.15604.r41191, Alex Molassiotis, Aston University, Birmingham, England, 08 Sep 2026, version 1, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1#referee-response-41191","order":0,"name":"referee-response-41191","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15604.r41517, Brianna Leitzelar, University of Minnesota-Twin Cities, Minneapolis, 10 Sep 2026, version 1, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-82\/v1#referee-response-41517","order":1,"name":"referee-response-41517","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute for Health and Care Research (NIHR) under its [\u2018NIHR Advanced Fellowship\u2019 (Grant Reference Number NIHR300588)]. Additional funding was received from Yorkshire Cancer Research (Grant Reference Number L389SS), NIHR Development and Skills Enhancement Award (NIHR305132), NIHR Undergraduate Internship Programme Award (NIHR305976), and other NIHR programmes (Grant Reference Numbers RP-PG-1016-20005, NIHR134141, NIHR134257). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}