TABLE.

Themes and supporting quotes from interviews with clinic personnel and facilitators and parent focus group

Individual interviews
Themes	Supporting quotes
1. Establish the Relevance of the Intervention to the Setting and Population	1.1 “…I think that it’s excellent implementing Familias Unidas in the primary care setting because pediatricians, doctors, they are familiar with the problems that the kids might have…. They are very good reference…to refer families, to benefit from this information.”
	1.2 “I think any time…you try to open various communication with parents with children…it’s definitely a positive thing. So that from a parent as a parent, I think sometimes you don’t know how to talk to a kid. I don’t talk to the mas friend but to be honest with them, and, and let them know we’re not going to hurt them. You know their friends know nothing, most of them. So I always tell my kids, honestly I tell them I said, I’m going to tell you the truth. I think anytime you open up that door to communication it’s a positive experience.”
	1.3 “…the experience has been great. I think Familias Unidas is a great program. I have very good opinions of the family, about the benefit that they obtain, um, when they enroll in the program. So, to me, it’s magnificent, excellent…. It helps so much to the parents, to improving communication. Um, to talk about things as important as prevention of STDs, HIV, and drugs, and, uh, talk also about peer pressure. The importance of the parents to be involved in those aspects of the children’s life, and to know how to communicate with them. So, and the program has been so well prepared, so well organized, that to me, it’s excellent.”
	1.4 “The population’s the best…because they are…coming from countries where there is not the education…. They don’t know about the importance of taking care of themselves. Of preventing, um, drugs, alcohol, um being in sexual relationships without any prevention, without any protection…. So, if there is a population who needs this type of program, it’s this one.”
2. Engage Clinic Personnel	2.1 “…You have to have complete buy-in by the providers. Period. They’ve got to be, um, passionate you know, totally engaged. If they’re not, they’re going, they’re going to say no, we don’t want to do that. So you have to prove the value that you’re offering to the patient, um, and the benefits and once you sign them in, you know, once get them engaged, that I think is the biggest hurdle.”
	2.2 “…I think, as I said before, to me, it’s, you know, I find it excellent. And all the people I have spoken to about it, have given me high remarks, or high, um, comments. The comments were great about how good it is, and how well done it is.”
	2.3 “Enjoyed working with all the staff, you know, all the people, and, uh, I believe in the program and what it stands for.”
3. Minimize Disruption to Clinic Flow	3.1 “The initial engagement with the families in the clinic…was a little difficult. Because at the beginning we didn’t know…the routine of the clinic…I think that once time passes and we were able to know the people at the clinic, we were able to get more help from them…, know the flow,…and understand that we’re not interrupting the flow of the clinic and when to ask, when not ask.”
	3.2 “I don’t think its negative to the actual study but I would say that there was definitely, um, a few instances where we…we and or the staff felt okay there’s a time, you know, something was kind a road blocked, um, or things were taking a lot longer than what we had anticipated…. I think that the particular thing was the number of people that was there at a time was a little bit overwhelming for our facility.”
	3.3 “Yeah, I think that for sure that the physicians felt that it worked well and…it seemed, you know, from start to finish, meaning recruitment, it was definitely one of the quickest. I think that was a testament to the fact that you guys were organized, um, so I think from a physician stand point we didn’t really feel that impeded.”
4. Improve Collaboration and Training of Clinic Personnel and Research Team	4.1 “My only recommendation is…for the staff…that will have direct contact with the recruitment to maybe be trained, and to understand what are we doing, what we’re going to need, what is expected. And I think that that will make everything smoother, easier, and like I said before, we can be on the same page for the families.”
	4.2 “I think an orientation, not too long, just so they understand what’s happening, but then having brief check ins…where they can express concerns, and then also maybe having an anonymous system of competence, competency, or concerns. You know, where they, um, can just say, this has been a problem and if there’s something we can do about it…. Brief check ins how things are going, what are some things we can do, sometimes they are the best source of ideas, how to make it flow better.”
	4.3 “…My only frustration, if, if there was any frustration, would be that…I would like to be involved or at least kept up to date, as to, as to the progress. Even if I receive a progress note once a month or something, saying okay this is what’s happening with your patient. You know, they’ve completed X, Y, and Z, or something for the provider, so that…we know hey, this is a patient that is receiving intervention….We need to know, we need to be informed and in the loop of how things are progressing.”
	4.4 “.It can benefit, yes, to have an orientation and how to really understand the setting. Understand how to approach the families in that setting. Because it’s so fast, the setting is very fast. You cannot be shy…. But I think that for a facilitator in the future that comes to the primary care, I think that, yes, they might need training on the population, how to approach people in the setting. How to engage people in that fast paced setting and also how to work with the staff, that they’re busy and they’re doing their things.”
	4.5 “…In the future, I think that if the doctor really is explaining the program and really recommending the program and saying, ‘Hey, do it. I think that because this and this is happening to you or that you are going to benefit.’ Then, I would say that it would be good for me to go after because now she opened a door for me to go through.”
5. Secure Administrative Support and Funding	5.1 “You know, again, it’s the logistics, it’s you know, having someone who is a coordinator, who’s gonna be kind of overseeing it from our end, ‘cause we can’t add any more responsibilities to our plate, other than that one minute elevator speech, but …the actual… coordinating and so forth, uh takes resources.”
	5.2 “…Just kind of getting a sense of what’s entailed and how long it’s going to take you know how the room is going to be used for and not just necessarily communicating with us because obviously the nurses need to know what’s going on as well so, I think yes I would go back to that point person maybe and just having that one person in the clinic who’s kind of aware what is going on who’s being seen and that kind of thing.”
	5.3 “The funding would be for effort. The time, you know if it’s gonna take time—if I have to be involved with any type of planning or oversight then I have to have, you know I have to have our support for that, depending on how long much we think it’s going to take. If it’s going to take two hours a week, then that has to be built into funding, or if it’s going to take one of our schedulers, say, ten percent of their time.”
6. Provide Intervention Participants and Facilitators with Technical and Clinical Support	6.1 “The minor things…like being able to seeing both the parent and the child and ya know that would usually work that out, the parent would adjust the camera and step back if they needed to, we would be able to see them fine. Sometimes there was unanticipated technical difficulties that would happen and you would have a session scheduled and then it wouldn’t happen because you couldn’t get it done, get it fixed in time and that was just gonna happen sometimes with this format.”
	6.2 “…I had to work a little bit with the family, in the sense of, trying to see them if they were doing it on a tablet. I couldn’t really see them, and I had to be, ‘Okay, put it here, put it there.’ I couldn’t really appreciate seeing what the kid was doing or what mum was saying. I couldn’t hear what they were saying, but I couldn’t really get the gestures and the nonverbal. So, maybe for me to point back to each other. So, that was a little of a challenge, is doing it through the Internet.”
	6.3. “…Clinical supervision…you know, Maria’s great, and Lisa, and they have the experience…and you feel that support. Not only from Maria, and from everybody, from you guys, from Alexa. Everybody was very supporting. If you feel overwhelmed, you will know that there is, you know, a group that will support you. It will stand behind you, and help you, and it will give you a hand.”
	6.4 “…I enjoyed the program, I enjoyed doing, meeting with the families, working with them.”
Focus Group
7. Promote the Clinic as a Trusted Setting for Improving Children’s Behavioral Health	7.1 “…It’s a place where the majority of us, our children have been going there since [they were] young. So then it’s a place where we already have a trust with the doctors, a trust with the nurses. We’ve been there so many years that our kids, and we feel like we can trust them, that we’re uhm…that they talked to us there, and they approached us in that place, it was a place where…we feel good, safe, you know?…But what I’m telling you, it was a place where I feel like I can trust, I feel safe, in peace. That I know I’m going to go there and trust my doctor, the nurses, because I’ve been there for 12 years. So I know what they’re going to, what they’re going to come and tell me, or present to me, it’s something that will be good for my family. Good for my son; not something opposite to that, you know?”
	7.2 “…Because my kids, yeah it was something serious, because my kids have been going to that doctor for 12 years. So then I already have a relationship, trust in that place and I felt, well this is going to be something good for us.”
	7.3 “In my personal case, there wasn’t any influence…. They explained the topic to me, what it was, what we were going to learn, what we were going to learn to help our children and that. Very interesting. I think that the word influence doesn’t fit into what we’re looking at right now. Because influencing, influencing is saying, ‘Do it.’ No, no one influenced us. I think that word doesn’t fit within this context in this moment.”
8. Communicate the Perceived Benefits of the Intervention	8.1 “I had ear contact because I’m listening to him but I’m not looking at him, but it’s like I’m not taking it seriously and as important, so then I say ‘I need to have visual contact, I’m forgetting that.’… Now I look at him, I pay attention, we’re looking at each other. He knows I’m with him, and he’s with me; we’re both there.”
	8.2 “And she had great communication with us, with my daughter. The same with me, with Gretel too. She encouraged her to participate because she didn’t want to talk.”
	8.3 “It motivated me to know a little more about the world of drugs and sex at schools in this moment.”
	8.4 “Well for me, maybe the influence was that right now I have three boys who are a doles-cents. And for me, it’s not the first time I’m a mom and that I’m doing this, so it was very, for me it was very interesting to know how I can do things differently. Not with the son I’ min the program with, because with the son I’m in the program with things are different. But with my second one, uhm he’s a little…I would’ve liked it to be the second one the one to be in the program. But, but for that reason I knew that this was going to help me, not just with one but with the three of them. Especially with my second one, that I’ve been having a little bit of resistance with him.”
9. Highlight the Flexibility and Convenience of the eHealth Format	9.1 “Look, at least for the video you had a couple of weeks to watch it and you could watch it anytime. You could watch the video anytime. After work, at night, at midnight; whatever moment you could watch it, like, that wasn’t something…. The biggest problem were the visits. So then there I think the solution is the facilitator’s flexibility. Like, for that to always be open, to have time to adjust the times; because they also have their own life, personal problems, and so the fact that they can adjust to your needs, honestly that’s…”.
	9.2 “…Flexibility…. To be able to do it like the home visit…. I can imagine that was a success…because…for me, well in two or three occasions I had issues with the schedule, so then I would call Gladys and tell her: “Gladys look I have this problem,” I would send her a text, and then she would reply, “Ok no problem.”
	9.3 “I had many problems in the beginning also, until the third week I could not watch it because where I live…in the center…where they have computers, because I don’t have internet in my house, it was prepaid. Then it was limited, and I wanted to see the soap operas there. But they changed and blocked many things, then for the first three weeks I was trying to watch the videos and I could not. So for me but I resolved it all because I think the program that you have is very good, and I got a tablet.”
	9.4 “I think… when they’re recruiting the first thing that can be asked is ‘Do you have access to the internet? Do you have a computer at home? Do you have a tablet at home?’ Because they’re avoiding all the problems that she already went through, that she expressed for not being able to do it. Because also there can be access but not time.”
	9.5 “So for me, I believe, in my opinion, I think that if you guys talk and think I think it’d be good not only for the kids to be part of the part with the therapist which is difficult, but also watching the soap opera so that they can also see how it plays out.”