Table 4.

Topics, examples, and quotes from in-depth interviews with LHR in the CALMS-D study

Topic	Content	Representative quotes
LHR training	Written protocols were helpful; keep instructions simple; training helped LHR anticipate problems; very good quality training; in-person with live models; protocols were explained clearly; LHR were trained how to motivate participants	“…they [investigators] made sure everything was there and they explained you” “[the study] gives me everything I need.” “they give you different training to make you confident in your job” “they do excellent, they give you the practice”
Supervision of LHR fieldwork	Quick and supportive supervision was available to LHRs; support was always available; feel very secure contacting the supervisor; supervisor’s disposition was helpful; supervisors want LHR to feel well and be safe	“ [my supervisor] is very good…she would get in contact with the right person [to fix a problem].’” “…if you have a question they look for an answer quickly.” “she is always asking to see my point of view”
Technical aspects of devices and equipment	Tools/Equipment were easy to clean and maintain; have all equipment clean and ready to go; understand key specific challenges for each device and problem-solving strategies	“A kink here and there but we always solved it.” “Know what to do if you get an error [message on the device].” “clean, disinfect everything” “put them [sharps] in the red container”
New skill acquisition	First time; new experience; involved in a different experience; learned how to take blood pressure; learning about research; knowledge previously, new learning; learning to listen; how to organize and deal with people	“…lot’s of training…I learned something new.” “it is excellent what you learn in that field”
LHR comfort and safety during home visits	Go in pairs; go in a car; park in a good place; wear gloves; be respectful	“…always aware of surroundings for safety.” “safety is always first for me” “I always check my surroundings”
Facilitators of LHR success	LHRs are motivated; LHRs are satisfied with their job; well trained; detail-oriented; focused; patient and understanding; empathic; good communicator; calm, patient, reliable, not anxious	“You need to like what you do. My job is busy but not boring.” “You need to pay attention to what you do.” “Once you have everything ready you go with the flow…you need to make it happen.”
Would you recommend this LHR position? Why/why not?	Yes. To know about research and the community; giving service and getting experience; learn something new; contact and interaction with people	“learning. [the study] helped me grow” “It’s a way to experience something new, to learn about research.”
Importance of trust with participants	Talk calmly; provide encouragement; explain why it’s important for the community; ask how they’re feeling; be friendly; be respectful	“…once you build that trust they feel comfortable around you.” “I call them ahead to let them know I’m coming over so that they can prepare mentally…Give them the time.” “Need to check up on them…I think it’s the contact, the communication.” “We have open communication and we call back and forth.”
Participant training and understanding	Participants understood protocols; need to verify their understanding; they followed protocols; cheat sheet and wallet card for devices; instruction in their language; frequent communication; equipment ready for them to use	“Always communicate, explain to them [participants] what we are doing. It’s very important.” “I leave them everything they need to follow the protocol. I highlight things, explain them everything.” “Always give a cheat sheet to participants…to remind them.” “Sometimes they say they understand but in reality they didn't. Break it down for them.” “Always have to explain…you have to do the recap”
Participant challenges	Hard for participant to follow protocol when out of the house or in an emergency; not being able to shower for 24 hours and itchy skin from the Holter; tired; home not always conducive to data collection	“Very compliant unless they are not feeling well that day.” “They may miss a day because of their work schedules”
Participant motivation	Proper informed consent; appropriate incentives; incentives calibrated to compliance; LHR understand the challenges of the protocol; LHR understand the health status of the participants;	“I let them practice until they felt comfortable and could do it on their own.” “they want to know their blood pressure”
Participant satisfaction	Satisfied to be included in the study; glad for incentives; grateful for the financial incentive; feel important to be part of the research; want to know their results	“They’re thankful to participate.” “Doing it [the study] shows the power they have.” “They like someone coming to the house…they like that.”