Salivary cortisol is considered to be a safe and noninvasive measure of 
hypothalamic-pituitary-adrenal axis functioning, and is a commonly measured 
biomarker of the human stress response in pediatric research. However, cortisol 
is highly variable and sensitive to a wide range of factors, creating a 
challenge for reliable salivary cortisol collection in the community setting. 
Furthermore, the acceptability of salivary cortisol collection in community 
samples of children is largely unknown. The purpose of this integrative review 
was to investigate current evidence on the acceptability and feasibility of 
salivary cortisol collection in community samples of children. In an analysis 
framed by the Theory of Planned Behavior, data extracted from 31 studies 
revealed six categories of psychosocial influences on acceptability and 
feasibility: uncertainty and misconceptions, cultural and ethnic values, family 
rules and values, difficulty following protocols and procedures, burden of 
multiple samples, and child refusal or resistance. Further research is required 
to fully understand the factors that influence acceptability and feasibility of 
salivary cortisol collection in community samples of children. Understanding 
individual, family, and community perceptions of biobehavioral research will 
lead to more culturally sensitive and feasible community-based research methods. 
© 2016 Wiley Periodicals, Inc.