Table 2.

Themes From Focus Groups

Theme	Sub-Theme	Quotes	Example Of Subsequent Changes To Manual Based On Quote
Challenges of Living with Chronic Pain	Physical functioning	“I feel like a lot of fatigue comes with it… on good days where I feel like I don’t have a lot of pain, I’m still tired from compensating for when I had to do things with pain. Or maybe I’ll be functional but I’ll be afraid to overexert myself because then I might have to pay for it the next week.”	Include a specific emphasis on increasing activities and minding activity pacing while performing everyday function tasks (session 2)
	Social functioning	“It’s not only me that’s dealing with the chronic pain, it’s also my children, my wife, my coworkers, my friends.” “The problem is that chronic pain is not visual.” “People that don’t see something hurting don’t understand it. They don’t comprehend it.”	An increased focus devoted to social support and relationships in chronic pain (session 3)
Emotional functioning	“I’m still working through the panic attack that I had from the pain.”	Targeting emotional reactions to pain (sessions 3, 6, 7)
Perception of Mind-Body 3RP Specific Skills to Address Needs of Patients with Chronic Pain	Positively perceived mind-body skills	“I think as chronic pain sufferers, if we set a reward at the end of the goal … it makes you want to drive to get it.” “There are definitely times when I feel like I can power through some of my back pain and neck pain with mindfulness activities.” “We have pain, it’s hard enough. Put your efforts towards someone else. And your own self reward will come back to you and build you up higher, knowing that, ‘Yeah, I’m in pain, but I’m able to do something to help somebody else.’”	None
Negatively perceived mind-body skills	“[Deep breathing] is very difficult when you’re out in public. I’m able to use it at home, in private. But when I’m out in public … sometimes I forget because the pain just strikes so hard.” “For me, I don’t think [meditation/mindful awareness] would help because I associated mindfulness relaxation with relaxing, not moving… lying down on the floor, sitting on a chair with my eyes closed is not going to help me feel better.”	Emphasis on “Minis” and opportunities for short bouts of practice throughout the day (eg when waiting at a doctor’s office; session 2); cultivating mindfulness while being active or (session 4)
Perception of Additional Skills Targeting Emotional and Physical Functioning	Pain-specific skills	“I don’t have great body awareness… I had injuries first that I didn’t take care of right away because I wasn’t very good at figuring out body awareness. So, it was sort of things like… is this a good sort of pain? Did I overexert myself? And that’s something I still have trouble with… my own activity has sort of slowed down because I can’t really tell if I’m having like beneficial sort of sensations from it.” “I just want to get back to being somewhat normal, physically.” “It might not make the pain go away at all, but I feel like being able to work through it or walk through it and still be active without feeling like it’s going to come back and bite you, I feel like that’s what I would look for or expect.”	Emphasis on body awareness (session 2) and cultivating mindfulness of pain (session 3)
Physical activity skills	“The past year I’ve restricted myself so bad that I’m too scared to do anything, so … I just basically don’t.” “Maybe I’ll walk faster to the parking garage, and then I’ll have the worst joint pain when I get home. I don’t know how to even manage that.”	Providing more detail on activity pacing (session 2) and activity limitation due to misconceptions such as “hurt always means harm” (session 1)
Barriers and Facilitators	Using a Fitbit	“I have enough trouble charging everything else that has to be charged.” “Every time it reminds me, ‘Oh, you haven’t got enough steps, you have to do this,’ it’s always on the list of your every day schedule… and you always set it less priority. And it stays there for a long time, and you get really frustrated.”“The Fitbit is a reminder, it’s something in your face. We’re … creatures of habit, we need to see something that makes us go.”	Added detail of Fitbit, emphasis on making a specific plan to remember to wear, sync, and change Fitbits (Session 1)
Program participation	“I’m limited because I don’t drive now … and it’s difficult to get a ride.” “I would be interested in in-person … because it gives me an excuse to get out of the house.” “So to have to come here to attend a session—that would be tough … just ‘cause of the travel issues … whereas online you can just do it anywhere.”	Emphasis on motivation factors, link between attendance and potential benefit from program (session 1)