Xuxi Zhang

Data collection Data will be collected from participants before the start of the first workshop (baseline, T0) and at 6 months (T1) with the use of a questionnaire. The instruments used for the outcome measures are described in measurements section. The instruments or items without validated translations are translated by translators. The study team discussed the translations and adapted the translation when needed. Measurements Our objective is to evaluate the effects of the SEFAC intervention on self ‐ management, healthy lifestyle behavior, social support, stress, depression, sleep and fatigue, adherence to medications and HRQoL. Self ‐ management is measured with General Self ‐ efficacy Scale (GES) 23 as well as the short 6 ‐ item version of the Chronic Disease Self ‐ Efficacy instrument (CDSE ‐ 6) 24 which measure the confidence in one’s ability to deal with health problems. The CDSE ‐ 6 covers domains that are common across many chronic conditions, such as symptom control, role function, emotional functioning and communicating with physicians. With respect to healthy lifestyle behavior, we will assess physical activity, healthy eating, sedentary behavior, smoking and alcohol use. Physical activity is measured with six items on physical exercise 24 and five items of The Physical Exercise Self ‐ Efficacy Scale (PESES) 25 . Healthy eating is measured with three items on the intake of fruits, vegetables and breakfast and five items of The Nutrition Self ‐ Efficacy Scale (NSES) 26 . Sedentary behavior is measured with one item from the International Physical Activity Questionnaire (IPAQ) 27 , current smoking is assessed with a single yes/no question and the frequency of alcohol use is determined with one item from the AUDIT ‐ C 28 . Social support is measured with the 3 ‐ item Oslo Social Support scale (OSS ‐ 3), regarding the primary support group, interest and concern shown by others and ease of obtaining practical help 29 . Stress is measured with the 10 ‐ item Perceived Stress Scale (PSS ‐ 10) 30 . Depression is measured with the 8 ‐ item Patient Health Questionnaire depression scale (PHQ ‐ 8) 31 . Sleep and fatigue are measured by visual analog scales, ranging from 0 (no sleeping problem/fatigue) to 10 (severe sleeping problem/fatigue). Adherence to medication is measured with six items from the Short Medication Adherence Questionnaire (SMAQ) 32 , a short tool based on questions posed directly to the participant regarding his/her medication ‐ taking habits. HRQoL is measured with the 12 ‐ item Short ‐ Form health survey (SF ‐ 12) 33 and the EuroQol ‐ 5 Dimensions ‐  5 level (EQ ‐ 5D ‐ 5L) 34 instrument. The SF ‐ 12 is a patient ‐ reported survey which includes both a physical dimension (physical functioning, role ‐ physical, pain and general health) and a mental dimension (vitality, social functioning, role ‐ emotional and mental health). SF ‐ 12 scores can be summarized in the Physical Component Summary (PCS) and the Mental Component Summary (MCS), ranging from 0 (worst) to 100 (best quality of life). 33 The EQ ‐ 5D ‐ 5L is often used in the Quality ‐ Adjusted Life Year calculation to determine the cost ‐ effectiveness of an intervention. It has five dimensions: mobility, self ‐ care, activity, pain 8 211 A mindfulness-based intervention among adults with chronic conditons