Exploring health coaching and mindfulness as levers for transformation in health: stakeholder perspectives.

Health coaching (HC) and mindfulness (MFN) are proven patient-centered interventions for mobilizing patients' inner resources and changing the trajectories of many chronic physical and psychological conditions. However, though widely available in the private sector, they have been slow to find their way into public primary care in Canada. Since 2015 a rural medical community in BC Canada has integrated physician-led HC and MFN-based programs into primary care. This exploratory study aimed to understand how these programs are working to help both patients and clinicians, providing insights that other communities might use. We elicited perspectives from patient participants and their physicians through focus groups and large-group graphic facilitation during a 1-day event held in September 2018. We identified six themes contributing to successful implementation. Key features include reducing stigma around mental health through making programs publicly accessible and physician-led, and enhancing patient hope and empowerment through cultivating awareness, self-compassion, and interpersonal skills. It also mattered that the facilitators created psychological safety where participants could grow these skills in a nurturing environment, while addressing various dimensions of health. These themes refine our understanding of how these programs can work within public systems to support patient self-management.