Acceptability refers to the degree to which an intervention is perceived as palatable or satisfactory. Acceptability in the context of chiropractic care has been measured using surveys to assess patient satisfaction after receiving care. 

Most published evidence surrounding the acceptability of chiropractic care has focused on patient perspectives of chiropractic care. Patients receiving chiropractic care generally report being highly satisfied with and accepting of the care received. Acceptance of complementary and integrative health approaches, including chiropractic care, by other healthcare professionals has been growing recently, particularly to fill gaps in mainstream medical practice and increase patient choices for treatment options. There is a need for further investigation into provider attitudes, organizational barriers and facilitators, and interventions to enhance chiropractic care acceptability. 

Appropriateness refers to the perceived relevance of the intervention to address a given need. Researchers have used expert panels to evaluate the appropriateness of chiropractic care approaches for treating lower back pain. Appropriateness can also be gauged from the perspective of care recipients.  

Efforts to increase the use of chiropractic care have highlighted several viewpoints of implementation appropriateness. A review article of scopes of practice for various health professions identified chiropractors as appropriate for assessing and triaging musculoskeletal pain. A retrospective chart review of chiropractic patients determined spinal manipulation was appropriate for low back and neck pain, based on consensus-generated appropriateness criteria. Additionally, developing quality indicators for chiropractic care has been a focus, aiming to standardize and measure the quality of appropriate care provided. However, challenges remain, such as the need for more robust evidence and methodologies to fully assess the appropriateness of chiropractic interventions. These findings underscore the importance of continued research of best practices to enhance the integration and effectiveness of appropriate chiropractic care in diverse healthcare environments. 

Adoption refers to the action of employing an intervention. Service penetration refers to the degree to which an intervention is utilized among an appropriate population. Both of these implementation measures can be measured by tracking utilization rates for chiropractic care. 

The evidence regarding the adoption of chiropractic care has focused on overall uptake and service penetration within integrated healthcare systems. Recent estimates of the annual utilization rates of chiropractic care range from 11-14% of the US adult population. The uptake of chiropractic care for low back pain increased following the introduction of clinical practice guidelines supporting spinal manipulation and other treatment approaches. Expanding access to evidence-based complementary and integrative health options, including chiropractic care, for Medicaid beneficiaries has led to an uptake of services by patients (0.3% to 11.1% in response to the Oregon Health Plan’s 2016 Back Pain Policy). Increasing adoption of chiropractic care over time is evident in the Veterans Health Administration, alongside efforts to expand service availability and penetration across the health system through the program's legislatively mandated expansion and organic growth. Increasing chiropractor occupational capacity within military treatment facilities was associated with the expanded use of services available at these facilities. Through community-purchased mechanisms, highlighting expanded service availability within a health system may increase demand that outweighs available supply. Formal studies evaluating implementation strategies of chiropractic care are needed to understand how to optimize uptake.