Table 3.

High and Sublevel Codes and Highlighted Quotes

High level codes/domains	Sublevel codes/facilitators and barriers	Quotes
Patient–clinician communication	Two‐way communication; lack of communication; discussion of options, pros, and cons; able to ask questions	“His [clinician] willingness to discuss my blood pressure, the consequences. He doesn't hold back when he talks to me, and I'm able to discuss my views, and he listens to it, and we make the decision together. … It's something positive.” (Pt. 1041) “Well, it was easy when she was like “Well, you have the option to exercise, or change your eating habits to make your blood pressure more healthier.” So I felt as though that was a option that I was willing to take.” (Pt. 1215)
	Lack of information provision	“I think that I should've been giving a little more information than I do get. I don't know if I have an actual doctor or a practitioner, but sometimes I do feel like I'm not getting all the information that I would get if I had a black doctor.” (Pt. 4101)
	Clinicians’ accent	“I speak English … basically only English speaking person, and if they have a difficult accent to understand, then it's a very difficult conversation. So I don't care what color they are, or what their ethnic background is, if I can't understand them then it's difficult” (Pt. 0017)
Patient–clinician relationship	Trust and respect for the clinician; respect for clinician's education	“I think that is done with the trust you have in your doctor. The trust your doctors give you to treat him. It makes you get involved in the treatments and not to forget how the treatments were indicated.” (Pt. 5011)
	Hierarchy; patient feeling intimidated	“I think she thought that I didn't understand, and I'm coming from— I'm thinking “I'm the doctor, I know best, I've got the education, I've got the knowhow.” But still, no matter what you have, you can always listen to someone else. You can come to a person and talk to them like you would like to be spoken to if you was the patient, and that person was the doctor.” (Pt. 1238)
	Shared history and experiences; mutual understanding; no mutual understanding/different perspectives	[patient–clinician racial discordance] “She is a younger generation person and she's also Asian descent, so they understand stuff differently than how Caucasians understand.” (Pt. 0106)
	Different lifestyles	[patient–clinician racial discordance] “It could be. It could be because if we're from different ethnic groups, in the way we eat, and our lifestyle will be different. I think it is.” (Pt. 0076)
	Continuity of care	“They knew what we have tried, what's worked, why we are where we are with the meds. So, the fact that they know the background is reassuring to me and then we don't have to start from scratch each time. … a primary physician who has the context of my history and then he or she brings what's the latest in the research, in the medication. I bring how I'm feeling and together, we either affirm what we're doing or we modify it.” (Pt. 0010)
Patient factors	Understanding of hypertension and treatment; lack of knowledge and understanding	“Maybe there are other people who don't understand like me, at the beginning. I didn't understand what high blood pressure implied. If I don't understand, then I don't know how to correct it.” (Pt. 3039)
	Control over oneself	“It's easy for me [to participate in decision‐making] knowing that I am in control of myself. I'm still of my mind and I know what's right and what's wrong. I'm still in my mind to say I will do this, or I won't do this. Nobody has that privilege over me.” (Pt. 1238)
	Lack of regimen compliance	“The most difficult thing is that sometimes I don't take the medication and that has an impact on them not being able to help me like they want to help me.” (Pt. 5294)
Clinician factors	Time constraints	“Well, pressure on the provider to limit time with the patient, and I've seen that happen, when administration says you should see X number of patients in X number of time.” (Pt. 1171)
	Clinician takes time; clinician shows interest in the patient	“I have a physician that shows interest in me. And so when he sits and he looks at me in the face and we are communicating, it makes it easy for me— and I know he's listening to me. So it makes it easy for me to get involved and express myself regarding my health. And he works along with me. We're on the same page. And so that makes it easy.” (Pt. 1035)
	Clinician knowledgeable of health disparities	“I guess my provider understand that because I'm African‐American and, you know, the hypertension affect us more than any other race. And she's Caucasian so she has a very good understanding of what it is that I'm dealing with.” (Pt. 1108)
	Clinician's personality and attitudes	“Animosity between the two working together as a team. I mean, by “animosity” I mean him not listening to you or you're not listening to him or vice‐versa on the medical for your best interests. Like me, I catch an attitude when a doctor gives me an attitude. How's that? So that would be detrimental to my health and making decisions.” (Pt. 1041)
	Perceived lack of compassion	“She just rarely cares about what I have to say. You know what I mean? She always tells me what she thinks about what I said, and we never come up with decisions about my health. That's why I had to kind of like find another person that was more interested in my well‐being than she was.” (Pt. 1034)
Clinic or health system factors	Time constraints	“Well, pressure on the provider to limit time with the patient, and I've seen that happen, when administration says you should see X number of patients in X number of time.” (Pt. 1171)
	Having an interpreter	“It doesn't affect me [patient–clinician racial and ethnic discordance] because there's always an interpreter, and she treats everyone equally.” (Pt. 5294)
	Limited availability of clinicians	“In rural areas as well yeah. There aren't enough of them [clinicians] and two they're all rushed I mean … I'm always concerned because my provider is over 70 and I know that he's going to retire so. And I think, who's gonna be there when he does, I have no idea.” (Pt. 2013)
Influence of participants' race and ethnicity	Patient's race specific risks	“I'm African‐American and I know that we're at the top of the chart as far as having hypertension. So knowing that fact makes me very well aware of what's going on. And it really vastly impacts decision‐making.” (Pt. 1108)
	Family history of hypertension	“Well, it's important because my family— a lot of my family members have high blood pressure. So it's very important that I be— it's very important to me.” (Pt. 1193)
	Not taken seriously	“No, I will make a decision, but you do feel like maybe you are not being taken serious or understanded all the way through. But, no, because if the doctor is fine, I'm fine with whatever they are.” (Pt. 1025)

Pt. indicates participant.