Supplemental Table.

Interview Guide

Questions for All Participants What is your current position and how long have you been in this position? For which division do you work? I'd like to know about your experience recommending CAM therapies to patients with SCD for pain management? When I say CAM therapies, I am referring to acupuncture, massage, chiropractic, prayer and spiritual healing, yoga, guided imagery, distraction, Reiki, heat, herbs, and aromatherapy among other therapies. Have you recommended any of these in your practice? Which therapies have been most helpful for patients? What process was used initiate introduction of CAM therapies?If someone was interested, or if you thought they would benefit from CAM, how would they start using them? Are you the one who usually brings up the use of CAM therapies for SCD pain? Or is it more often the families who bring it up? For which patients have CAM therapies been most effective? Specifically, what age group, level of SCD severity, outpatient versus inpatient setting, and what family circumstances of patients? For which age group do you think routinely promoting CAM therapies would be beneficial (infant, school age, or adolescent)? Have you or anyone in your family personally tried any of these remedies, and if so, do you believe they have been effective? What barriers do you encounter with respect to recommending these therapies for patients? What types of training have you received with respect to CAM therapy? Would you be interested in more training to better inform your ability to use CAM for SCD patients? Do you have concerns about patient's ability to pay for CAM therapies? Do you think SCD patients and their families are interested in using CAM? What types of programs and/or interventions could best support the integration of CAM therapies into routine care for children with SCD?

Questions for medical professionals (medical doctors, nurse practitioners, registered nurses) With respect to relaxation, have you heard or been told that practice of deep breathing, relaxation, guided imagery during times of wellness is really important to being able to call on those strategies in times of crises? What resources do providers know of (both at CNMC and in the community) for families seeking CAM therapies? What types of programs and/or interventions could best support providers to integrate CAM therapies into routine care for children with SCD? Do you experience time constraints that limit your ability to discuss or administer CAM therapies with patients?

Questions for nonmedical professionals (psychologists, social workers) How do you typically become involved with pain management for SCD patients? Are you aware of other CAM providers in the area to refer patients to on an outpatient basis?