BACKGROUND Health coaching (HC) and mindfulness (MFN) are proven interventions for mobilizing patients' inner resources and are slowly being integrated into public primary care. Since 2015 the medical community in Gibsons BC has integrated physician-led HC and MFN-based programs into team-based care. This exploratory study aimed to understand the mechanisms by which these rural programs helped both patients and clinicians, and to elicit priorities for future study in these fields. METHODS Using a qualitative participant-engaged constructivist approach in focus groups and large-group graphic facilitation, we elicited perspectives from patients and their physicians during a 1-day event held in September 2018. Thematic analysis of transcripts using Nvivo identified emergent themes that were regularly reviewed with coresearchers, and member checked with participants via online videoconferences held at 6 weeks and 4 months postevent. RESULTS We identified six main themes relating to the successful implementation of these programs: (i) accessibility and affordability, (ii) offering a toolbox of practical skills, (iii) providing attuned and openhearted care, (iv) generating hope and self-efficacy, (v) experiencing a shared humanity and connection, and (vi) addressing the health of the whole person. CONCLUSION These themes highlight critical qualities of HC and MFN programs when implemented in a Medicare system. Key features include reducing stigma around mental health through making programs physician-led and a natural part of primary care, enriching accessibility through public funding, and enhancing patient agency through cultivating embodied awareness, self-compassion, and interpersonal skills. These themes inform the next steps to support upscaling these programs to other communities.

中文翻译：

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探索健康指导和正念作为健康转型的杠杆：利益相关者的观点。

背景 健康指导 (HC) 和正念 (MFN) 已被证明是调动患者内在资源的干预措施，并且正在慢慢融入公共初级保健。自 2015 年以来，不列颠哥伦比亚省吉布森斯的医学界已将医生主导的 HC 和 MFN 计划整合到基于团队的护理中。这项探索性研究旨在了解这些农村项目帮助患者和临床医生的机制，并为这些领域的未来研究提出优先事项。方法 在 2018 年 9 月举行的为期 1 天的活动中，我们在焦点小组和大型群体图形引导中使用定性参与者参与的建构主义方法，从患者及其医生那里获得了观点。使用 Nvivo 对成绩单的主题分析确定了经常出现的紧急主题与核心研究人员一起审查，成员通过在活动后 6 周和 4 个月举行的在线视频会议与参与者进行了核对。结果 我们确定了与这些计划的成功实施相关的六个主题：(i) 可及性和可负担性，(ii) 提供实用技能工具箱，(iii) 提供协调和开放的护理，(iv) 产生希望和自我效能，（v）体验共同的人性和联系，以及（vi）解决整个人的健康问题。结论 这些主题突出了在医疗保险系统中实施 HC 和 MFN 计划的关键品质。主要特点包括通过使计划由医生主导并成为初级保健的自然组成部分来减少对心理健康的污名，通过公共资金丰富可及性，并通过培养具身意识、自我同情心、和人际交往能力。这些主题为支持将这些计划升级到其他社区的后续步骤提供了信息。