Participants answered the following questions:

How was your experience during the mindfulness training?

The MBHP training took place during September and October 2021. The program was provided free of charge and lasted for two months, with a weekly commitment of two hours included within the participants' working hours. Following the protocol, eight sessions were conducted covering the following topics: 1) What is mindfulness? Breaking free from autopilot; 2) Mindfulness of breathing; 3) Mindfulness in daily life; 4) Mindfulness for challenging situations; 5) Mindfulness of the mind and thoughts; 6) Silence; 7) Mindfulness and compassion; and 8) Mindfulness for life. Each session incorporated active methodologies such as experiential activities, breathing exercises, mindful eating, group activities, conscious dialogues, mindful walking, and body scan. Additionally, each participant received a journal to record their weekly progress and experiences with assigned tasks in writing. Upon completion of the program, attendees received a participation certificate.

Table 1

Variable	Response Option	Frequency (n)	Percentage (%)
Marital Status	Single	7	44 %
	Married	1	6 %
	Common-law marriage	8	50 %
	Elementary school	1	6 %
	High School	1	6 %
Educational attainment	Technician/technologist	7	44 %
	Undergraduate	6	38 %
	Graduate	1	6 %
	Permanent	4	25 %
Type of contract	Indefinite	9	56 %
	Provision of services	2	13 %
	Work or Labor	1	6 %
Role	Assistant	6	38 %
	Administrative	10	63 %

Source: own elaboration.

The training was led by a psychologist certified as a Mindfulness na Promoção da Saude instructor by the Universidade Federal do Estado de São Paulo (UNIFESP) and the Centro Brasileiro Mente Aberta. In November 2022, one year after the training concluded, semi-structured audio-recorded interviews were conducted. These interviews were led by two psychologists, one of whom was a researcher in this project. The interviews took place in person at the hospital facilities. The interview comprised ten open-ended questions, including inquiries about participants' experience during mindfulness training, benefits they experienced from mindfulness practice, and changes they noticed after the training. These questions aimed to explore the perceived effects one year after participating in mindfulness training. Each interview lasted approximately 30 minutes and concluded when data saturation was achieved. No incentives were offered for participation.

A thematic analysis was applied, adopting a qualitative approach (Clarke & Braun, 2014). According to Braun and Clarke (2006) "thematic analysis is a method for identifying, analyzing and reporting patterns (themes) within data. It minimally organizes and describes your data set in (rich) detail" (p.79). Whereby the proposed themes were derived from an inductive paradigm, with data coding and theme development resulting from the data analysis process. The following steps were followed: a) familiarization with the data; b) generating initial codes; c) searching for themes; d) reviewing themes; e) defining and naming themes; and f) preparing the report with the final model (Braun & Clarke, 2006).

For this purpose, interviews were recorded and later transcribed verbatim. Transcription was initially made using Google Docs (Voice Typing); then, each recording was verified by the research team. For coding, the research team used Microsoft Excel and different colors were used to differentiate the proposed codes. Each researcher coded the data independently and systematically. Subsequently, in a joint session, codes were compared and discussed by the research team until a consensus was reached. After several review and theoretical discussion meetings, a final model of themes grouped into categories and subcategories was established.

This study adheres to the guidelines of the Declaration of Helsinki (WMA, 2024) and the Universal Declaration of Ethical Principles for Psychologist regulations (2008). Consent was obtained for both participation in the study and the recording of interviews. The research was approved by the Ethics Committee of the university that lead the research (Minutes n.° 05 of 2021). Participants' anonymity was maintained.

Participants (11/16) mentioned changes related to becoming more self-aware and acting accordingly. They mentioned creating space for themselves and engaging in self-care actions and activities. Thus, three subcategories identified in this topic were self-care, being aware, and self-knowledge.

Participants (9/16) reported two types of emotional benefits as a result of the intervention. On the one hand, they perceived an increase in positive emotions, including tranquility, joy, and gratification. On the other hand, they learned to better control negative emotions such as frustration, anger, or sadness due to mindfulness training.

Participants (12/16) noticed changes in their behavior within the workplace, describing improvements in patient/ client interactions, enhanced organizational climate in their areas, and better integration within work teams. They also mentioned transferring these changes to their socio-familial contexts by applying the learned skills, such as non-judgmental attitudes, constructive dialogue, and helping others.

Participants (11/16) began acting with greater consciousness, being present in daily routines they used to perform automatically without much thought. These practices included hygiene habits like brushing teeth or bathing and healthy eating and exercise routines, like going for walks. They also started using body scanning to be mindful of their bodies. The intervention led them to internalize and practice various mindfulness techniques daily, bringing them satisfaction and tranquility. Some of these practices involve the experience of savoring and activating the senses, being attentive to sensations, breathing techniques, sleep reconciliation, and active pauses.

Participants (16/16) highlighted acquiring strategies for coping with work-related and personal stress. Two subcategories emerged: emotion-focused strategies involved changing emotions generated by stressful situations through relaxation, reframing, and self-control, while problem-focused strategies involved organization, problem reflection, and a proactive problem-solving approach.

Overall, all participants had a gratifying experience during the intervention and noticed positive changes in various aspects of their lives beyond the workplace setting. Most of them continue to practice some of the exercises learned during training; although not everyone performs them daily, they try to incorporate them into their lives.

In summary, Figure 1 presents the categories and subcategories. Table 2 provides the general categories and subcategories with examples of phrases from the interviewees.

Figure 1 Source: own elaboration.

In the second section of the interview, issues related to future intervention implementations were addressed. In this line of thought, 100% of the interviewees answered that it would be beneficial to have this type of training in the workplace. Their responses can be categorized into two types regarding the benefits it would bring. First, they mentioned that it would provide them with a space of containment and support; for example, one participant stated: "Some people have no one to talk to, they don't have a space to vent, we don't know how they live at home. For me, these actions help people to see life differently, to be able to find relief, release anger, complexes, and they are very helpful."

Second, most participants pointed out that another benefit is related to having tools to manage stress and preserve mental health. They associated this second benefit mainly with the type of work they do within the institution, as it involves a high workload and significant emotional impact due to it being a healthcare service. For example, one participant responded: "They benefit the staff because we are exposed to a lot of pressure at work, meeting goals, there are many demands, so it's good to have these kinds of spaces for that."

Regarding possible obstacles to implementing the practices in their workplaces, only four people mentioned potential barriers. The obstacles they referred to were related to a lack of financial resources and the institution's dynamics, as employees might argue that they don't have time for these activities. One interviewee even mentioned that some employees might refuse to participate due to disinterest or lack of motivation: "I think there could be obstacles because sometimes many people say, 'I don't like that,' and they don't take the time to get to know and check out the activity."

As for the possibility of conducting the intervention virtually, only three people stated that they would prefer that modality. The rest argued that they find it more effective to do it in person as it avoids interruptions, prioritizes contact with others, and provides time and space to connect with oneself. Regarding conducting the intervention in a self-managed way, although many considered it viable, they believed it was necessary to first go through the inperson experience guided by an instructor. Furthermore, they commented that, even if it is done autonomously, they believe having external guidance and orientation is essential.

This study aims to explore the perceived effects of a Mindfulness-Based Health Promotion (MBHP) program among workers in a Colombian hospital one year after its implementation. Findings indicate that the intervention's main effects are self-awareness, emotions, social interaction, healthy habits, and coping with stress.

One year after mindfulness training, participants reported positive effects related to self-awareness. This advance enabled them to embrace self-care practices, be mindful of everyday situations, and enhance self-knowledge. These findings align with the state of consciousness cultivated through mindfulness (Kabat-Zinn, 2017), which leads to attentional self-regulation and a focus on personal experiences observed with openness, curiosity, and acceptance (Bishop et al., 2004), fostering reflection and receptiveness (Evans et al., 2023). In this sense, MBHP aims to develop awareness and recognize internal phenomena like sensations and thoughts and external phenomena like sounds and smells (Demarzo, 2018; Duran et al., 2022).

Other studies also identified positive changes in participants following mindfulness interventions. For instance, Alves Peixoto et al. (2022) reported changes in self-awareness, leading to improved self-relationships (Neate et al., 2022). The observed changes in self-awareness may be associated with formal and informal mindfulness practices proposed in MBHP training. Particularly, informal practices in daily life offer opportunities to activate awareness and break free from automatic patterns (Trombka et al., 2018).

Table 2

General Categories	Subcategories and quote examples from the Interviewees
Self-awareness	Self-care: "I learned to care for myself, to think about myself... I was not used to thinking about taking care of myself, but now I try to tell myself: look, take care of yourself; you also get tired, you can get sick, or you can be emotionally affected."
	Being aware: "I also discovered that there were situations where I wasn't fully present, like not paying attention to the people around me."
	Self-knowledge: "The experience was very satisfying, like when you meet yourself, and there were moments of questioning." Increase in positive emotions = Gratification: "It was very good, very gratifying, I learned many things I didn't know before, or things I didn't realize I was doing at the time." Tranquility: "It allowed me to accept changes calmly." Joy: "I used to come with negativity, sadness, but mindfulness always brought joy and happiness into my life."
Emotions	Managing negative emotions = Frustration: "I was laid off, and it was tough because I thought, what mistake did I make? When I started practicing mindfulness, I could... realize many things, think about what I'm doing wrong." Anger: "Managing anger or, for example, irritation, I breathe, I talk, and I don't blurt things out rudely, I take the time to think about how to say things." Sadness: "These are spaces that help a lot, for people to see life differently, or to be able to vent out all those situations of sadness."
	Work environment = Attention to patients and users: "Regarding patients and users of the hospital, there was a positive change in how we treated them." Organizational climate: "The work environment improved a lot, with colleagues, and it's noticeable in how we address each other, it was very enriching for everyone's life." Integration: "I have seen a lot of change because we have settled in, there's more collaboration, we work together in all areas."
Social Interaction	Family and social environment = Non-judgment: "Trying to understand, perhaps, the other person's situation and not judging them for doing things wrong, or because I don't like it. Trying to understand what they are going through, in other words, not judging, it's wrong, and giving them a wake-up call." Helping: "Doing things with love, giving the best to others, helping them." Dialogue: "When there are problems in relationships, then I try to calm down, I try to talk because things have a solution." Acting with awareness = Brushing one's teeth: "Brushing one's teeth, even if it takes time, consciously." Eating: "I feel when I'm eating, I give myself time, I enjoy it." Bathing: "While bathing, I feel the water on my skin, the soap sliding, I enjoy that moment more." Walking: "Walking mindfully, getting into a mental state, thinking." Body scanning: "For stress, I really like body scanning. I've tried practicing it during exercise, feeling the strength, the muscle contraction."
Healthy habits	Learnings = Savoring: "Savoring, feeling the taste of each thing." Active breaks: "For me, the greatest benefit is feeling that we need an active break, and we have to give ourselves that... because the daily obligations require it, otherwise, we get overwhelmed and sick." Sleeping: "The main benefit that I tell everyone is sleeping, because I had trouble falling asleep, and with the techniques we learned in the training, I fall asleep in about five deep breaths, I relax, and I can sleep." Breathing: "When we started the mindfulness process, I said, I have to be more patient, calmer. Let's breathe and try to improve." Attention to sensations: "The experience was outstanding; you learn to discover things you weren't aware of, like, for example, identifying smells, the space around you."
	Emotion-focused = Relaxation: "I try to relax, I feel it helps a lot when there's too much fatigue or work-related stress due to obligations." Resignification: "For me, these spaces help a lot for people to see life differently." Self-control: "Now I think before speaking, I take time to respond."
Coping with stress	Problem-focused = Organization: “It helped me get organized and make more time for myself, which I had never done before.” Reflection: “Having the ability to reflect, to look for other ways out without reaching a point of stress.” Problem-solving: “It helped me a lot to relax when there’s a problem and see that there’s always a solution.”

Source: own elaboration.

Furthermore, mindfulness practice positively impacts emotions. Particularly by increasing positive emotions such as gratification, tranquility, and joy. This result aligns with research by Fredrickson et al. (2017). It is also consistent with a previous study where participants reported having tools for emotional control, balance, and anxiety management after mindfulness intervention (Alves Peixoto et al., 2022). Thus, mindfulness fosters gratitude, peace (Neate et al., 2022), and tranquility (Banerjee et al., 2017).

Mindfulness also facilitates the management of negative emotions such as frustration, anger and sadness. Other studies have reported a reduction in negative affect following mindfulness interventions (Lindsay et al., 2018; Rodrigues de Oliveira et al., 2021, Schumer et al., 2018; Strege et al., 2018; Teixeira et al., 2024; Wilson et al., 2022), including those using technological devices (Victorson et al., 2020). Changes in emotions may be mainly linked to topics addressed in sessions 5 and 7 of MBHP training, which focus on mindfulness of the mind and thoughts and mindfulness and compassion, respectively, touching on gratitude and fears.

Mindfulness has been shown to offer many psychological benefits to individuals, but it is less known whether these benefits extend to others. In the results of this study, we found that participation in the MBHP program led to improvements in social interaction. Participants emphasized implementing communication strategies such as non-judgment and dialogue, which can be linked to prior research showing that mindfulness, whether seen as a personality trait or a practice, is associated with higher levels of prosocial behavior, involving behaviors aimed at helping or benefiting others (Eisenberg et al., 2006). This strategy is reflected in emerging subcategories such as organizational climate, integration, and helping. Participants mentioned that the program helped them cultivate an altruistic and respectful attitude toward others.

Similarly, our findings align with the meta-analysis conducted by Donald et al. (2019), demonstrating evidence of a relationship between mindfulness and prosocial behavior. The authors explain this relationship, including mindfulness increasing attention levels and facilitating self-decentering, allow individuals to notice and respond more effectively to others' needs. This is also consistent with qualitative studies, such as that of Bonde (2023), who found that mindfulness practices positively impact social relationships at work. In line with this, Neate et al. (2022) identified that mindfulness fosters improved connections and relationships with others by developing skills like active listening.

Notably, while the MBHP program was conducted in a professional health context, participants mentioned that the benefits of social interaction extended beyond the workplace to their socio-familial sphere. This is fostered in the program through module 3: Mindfulness in daily life.

Furthermore, participants reported the effects of adopting healthy habits, especially those that enable conscious action and new ways of conducting daily practices. This could be related to mindfulness's focus on cultivating non-judgmental present-moment attention, leading to richer experiences (Alves Peixoto et al., 2022). In a study with healthcare workers who received mindfulness intervention, participants emphasized the importance of practicing mindful exercises like conscious breathing and walking. They argued that these should become habits due to their benefits (Banerjee et al., 2017).

Besides, changes in internal mechanisms for developing mindfulness and transferring these learnings to different life situations were observed in an online mindfulness intervention. Specifically, changes were identified in daily experiences approached with kindness and non-judgment (Neate et al., 2022).

These healthy habits are promoted in various MBHP program sessions, including practices such as body scan, mindful eating, and mindful walking. Additionally, they align with the informal practices proposed during training, such as mindful tooth brushing, eating, and bathing. According to Trombka et al. (2018), these informal practices promote awareness by bringing the learnings from formal sessions into everyday activities.

Numerous studies have shown the positive effects of mindfulness-based interventions in reducing stress among healthcare workers (Lomas et al., 2019), including the MBHP program analyzed in this study (Demarzo, 2020; Demarzo & García Campayo, 2015; Salvo et al., 2018; Trombka et al., 2021). However, fewer studies have explored the impact of these programs on strategies to cope with stress (Donald & Atkins, 2016; Finkelstein-Fox et al., 2019; Teixeira et al., 2024).

Thematic analysis revealed that participants in the MBHP program highlighted one of its main benefits as acquiring coping tools for handling both work-related and personal stress. This finding can be linked to Lazarus and Folkman's (1984) classification of coping strategies into problem-focused coping and emotion-focused coping. For instance, regarding emotion-focused strategies, participants reported that the intervention helped them gain better emotional self-control and avoid reactive responses.

As for problem-focused strategies, they began to value the importance of organization and planning for finding solutions. MBHP works to transmit these tools primarily through module 4: Mindfulness for challenging situations. This is a strength of this intervention, as several studies emphasize the need for interventions that not only reduce stress but also promote the health of healthcare workers (Janssen et al., 2020; Lemos et al., 2021). Our findings support the idea that mindfulness training promotes health, aligning with previous research results (Alves Peixoto et al., 2022; Banerjee et al., 2017; Demarzo & García-Campayo, 2015; Neate et al., 2022).

Promoting health has been a primary focus of positive psychology, a subdiscipline that has seen significant growth in the last two decades (Martín-del-Río et al., 2021; van Zyl and Salanova, 2022). Specifically, Positive organizational psychology emphasizes the importance of putting individuals at the center of work relationships and nurturing their strengths, virtues, and capacities (Salanova et al., 2019). Therefore, mindfulness training is an effective intervention to promote the health of those who care for others' health.

In this context, the MBHP approach used in this study has maintained its positive effects on participants one year after the intervention, possibly because, as suggested by Hugh-Jones et al. (2018), discrete and time-limited experiences provided by the training link together to generate multiple positive benefits through upward spirals. This potential explanatory mechanism aligns with the conservation of resources theory, especially with resource caravans and their capacity to sustain and enhance psychological resources (Hobfoll et al., 2018).

Finally, it is important to highlight that qualitative research, by recognizing the social and human dimension (Lanka et al., 2021), provides interpretive richness, contextualization of the environment or surroundings, details and unique experiences (Hernández et al., 2014) hat have been valuable in enhancing the understanding of quantitative results in the field of mindfulness.

Qualitative findings raise new questions regarding the relationship between psychological and social variables involved in the effectiveness of mindfulness interventions. Likewise, they provide a deeper insight and understanding of participants' own perspectives on various aspects of the intervention and its short, medium and long-term effects (Nardy et al., 2020; Stjernswärd, 2020).

The main results obtained in this study are relevant to both qualitative and quantitative research findings. This research significantly contributes to scientific literature by documenting that the effects on MBHP participants persists one-year post-intervention, particularly, the sustained internalization of healthy practices and habits among participants. These findings are compelling as they illustrate that the program's effects transcend the workplace setting and influence diverse facets of participants' daily lives.

This study pioneered the use of this mindfulness program in a Latin American country from a qualitative perspective. We believe that qualitative research, specifically thematic analysis, allows us to understand the phenomenon studied from the experience, perceptions, and stories of participants by grouping patterns (themes) within a set of data, in this case obtained from interviews. The flexibility of thematic analysis allows it to be adapted to various disciplines, making it suitable for social and administrative sciences. In this study, this methodology allowed us to approach the effects of MBHP training one year after its implementation and find that these effects are grouped into five major themes. It is noteworthy that the perceived benefits resulting from the program not only brought about personal changes but also enhanced participants' interpersonal relationships and communication skills.

This study identified at least two limitations. The first is related to the small number of participants ( n =16). However, it is important to note that in qualitative studies, collecting data from large samples is not necessarily a crucial requirement, and it is common to work with small samples (Marks & Yardley, 2004).

The second limitation could be related to the specific characteristics of the institution and locality where the practice was conducted, as it was a small establishment where people often knew each other. This aspect may have led to a tendency to respond positively and not express criticism or objections to the intervention. While the interviewers tried to maintain a neutral stance that did not induce responses, it is possible that bias was not completely eliminated.

Regarding future lines of work, it would be interesting to study the online implementation of this type of intervention and analyze whether similar effects are obtained, especially in the long term. Although some participants expressed reluctance to the virtual implementation of the program, many argued that it would be more convenient and feasible, given the challenges of attending in-person sessions due to high work demands in healthcare settings like the one studied. Building upon these findings, future studies could investigate the effectiveness of shorter intervention programs and assess whether positive outcomes persist with a reduced number of sessions.

It would also be relevant to analyze the role of potential mediating variables, such as examining whether coping strategies acquired due to the program mediate stress reduction (Finkelstein-Fox et al., 2019; Lazarus & Folkman, 1984; Terry & Hines, 1998).

In terms of processing qualitative data, future studies could incorporate the support of software such as Atlas. ti, NVivo, Dedoose, or Taguette (Chandrasekar, et al., 2024) and could also make use of tools with artificial intelligence, which facilitates the analysis of large volumes of information. These programs facilitate research work, especially when it comes to big qualitative data analysis.

Finally, future studies could aim to conduct mixed-method research, combining qualitative and quantitative methodologies (Levitt et al., 2018) to increase the rigor of the findings. Among the strengths of this study, it stands out that it was conducted using a novel mindfulness program (MBHP) suitable for application among healthcare workers in the Latin American context. Additionally, it is noteworthy that there is a scarcity of research conducted in Latin American countries into the effects of such practices on healthcare workers (Juárez et al., 2022). Furthermore, few empirical studies have examined the impact of mindfulness on well-being in healthcare settings using a qualitative approach (Weisbaum & Chadi, 2022).

In Colombia, human resource management areas have been positioning themselves in a strategic field for achieving business objectives (Calderón-Hernández et al., 2023). In this sense, those who lead these areas must promote the implementation of intervention programs that have scientific evidence, such as the MBHP, especially in healthcare institutions.

Another strength of this research lies in the sustained effects observed one year after the intervention. Future studies can explore whether the effects of this program endure for even longer periods, as demonstrated by other research with different intervention modalities that have shown lasting results up to two and even four years after the intervention (e.g., Fuertes et al., 2019; Solhaug et al., 2019).