Table 2.

Barriers and facilitators experienced by participants during group, blended and individual, unguided online mindfulness-based cognitive therapy (eMBCT).

Themes and subthemes		Facilitators	Barriers
(1) Program: contenta
	Exercises	Multiple options: different exercises and different voices for the meditations Pleasant and clear voices that become familiar with time Good and short exercises	Too many exercises. No instructions explaining the goal of the meditation exercises
	Silent day	Pleasant silent day	Not feasible to do it independently at home without distractions Difficult to separate from daily disturbances and quotidian environment Too long silent day Lack of peer support and guidance from a therapist
	Diaries	Promotion of personal reflection Support personal processes	Too many different forms to fill out every week Confronting to fill out a diary every day
	Automatic feedback	Recognition with peer participants and normalization	Too impersonal Participants forced to choose an answer before being able to proceed
	Videos	Encouraging to see that the program is helpful for other people with cancer Explanations that clarify what is meant by the elements of the program Relate to other people with cancer experiences	Set too high standards Videos not inclusive enough
	Reminders	Helpful reminders	Too many reminders
(2) Program: formata
	Initial contact research team	Very helpful to have a personal introduction into the online program, makes it accessible	Business-like communication style Too impersonal
	Help desk	Supportive if you ran into problems Helpful to have the option of personal contact	Sometimes, it took too long to respond to participants.
	Structure	Logical structure: the sessions build on each other consistently. Lot of suggestions Clear structure of the platform	Unclear where to write notes or not write them at all Unclear structure, repetition; what do I need to do?
	Navigating through program	Easy to move forward in the program Possible to look back at own notes Did not get stuck Being able to fill things out yourself	Navigating the program was difficult. Not clear how to save entered information Unclear where to put notes in both daily and weekly forms Not being able to go back to the exercises to do them again or to the diaries to add information later on Getting stuck, not being able to move forward
	Time	Very relaxed, own time, own planning No travelling time Possibility to combine eMBCT with cancer treatment, rehabilitation, household chores Option to adapt the time invested in the program to the energy levels	Time-consuming program, took too much time
	Place	Pleasant to do it at home No traveling, does not cost energy	Interruptions for family members Difficult to find a room in the house where you will not be disturbed
	Infographics and avatar	Possibility to choose the coach and answers	The avatar was not of any added value for some participants. Getting stuck if an avatar was not selected
	Physical booklet	Having the choice of a physical booklet Being able to look back in the physical booklet to previous sessions, besides the online program Having an additional source for reading Future reference	Too many different things: online program, booklet; unsure where to go For some people, the app was very clear, and they used the app only. There was no added value from the booklet.
(3) Group, blended condition
	Group sessions	Connection with others Peer support Possibility to ask questions Synchronicity in communication Recognition that others struggle with the same things	Being stressed about not being able to log in in time Not being able to see people properly in the screen (Zaurus), no speaker perspective Prefer to meet people in person rather than on a screen Very tiring to sit behind a screen for a long time Intense, long, and tiring group sessions Too infrequent Confrontation with other participants’ cancer
	Feedback from mindfulness teacher	Good quality, elaborated, and personalized feedback Trustworthy, accessible, and supportive	Even though people got written feedback, this was less stimulating to some. Asynchronous written feedback and not clear timing of receiving it
(4) Individual, unguided condition
	Lack of peer support	—b	Need for self-discipline Difficult to maintain engagement without appointments Lack of support from a community
	Lack of feedback therapist	—	Feels unsafe to share personal information with unknown recipient

^aThe themes for the program content and format and their respective subthemes applied to both intervention conditions.

^bNo response.