A Mixed-Method, Multi-Perspective Investigation of Barriers to Participation in Mindfulness-Based Cancer Recovery

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. 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. 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. 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.