Journal of Contextual Behavioral Science (JCBS)
Volume 40, April 2026
Authors
Rosco Kasujja, Khamisi Musanje, Ross McIntosh, Hilary Mugabo Mukula, Anisah Jagwe, Ivan Diaz Asiimwe, Sarah Mirembe Byamukama, Paul E. Flaxman
Key Findings
- Ugandan healthcare staff rated the ACT Matrix as acceptable and satisfying
- Well-being and psychological flexibility measures showed response sensitivity to ACT Matrix training
- It is feasible to progress to larger trials of ACT Matrix training for staff in this context
Abstract
Similar to other low- and middle-income countries (LMICs) in Africa, workers in Uganda have limited access to evidence-based workplace mental health promotion programs. This pilot trial assesses the feasibility, acceptability, and cultural suitability of implementing and evaluating training derived from acceptance and commitment therapy (ACT) among Ugandan healthcare staff. A sample of 16 staff (primarily nurses and midwives) employed at a hospital in Kampala participated in four group sessions of training using the ACT Matrix, and completed pre- and post-intervention measures. The program’s acceptability was assessed via the multidimensional Theoretical Framework of Acceptability. In addition, a subgroup of 7 participants provided qualitative data during a focus group immediately after completing the training. Despite reported challenges surrounding the timing of sessions, the ACT Matrix was rated as an acceptable, culturally relevant, and satisfying training approach in this context. Qualitative reports further suggested that participating staff experienced benefits across different life areas. Participants revealed no issues with English language psychometric instruments commonly used to evaluate ACT interventions, including prominent markers of perceived stress, well-being, and psychological flexibility/ inflexibility. Positively framed measures of well-being and psychological flexibility exhibited promising signs of short-term change sensitivity in response to the ACT Matrix. Taken together, these quantitative and qualitative data signal that it is feasible and appropriate to progress to a next stage of intervention research, aimed at examining the effectiveness of workplace ACT Matrix training with similar groups of healthcare staff in Uganda.