Table 1.

Digital challenges and strategies used by community health workers to enhance attendance in virtual group visits among South Asian adults with limited English proficiency.

Digital challenge	Strategy or modification	Example or representative quote
Community health workers had limited experience with videoconferencing software	In-person sessions with the project coordinator and trial and error with the platform to learn to use features	“The project coordinator met with us [the CHWs] in the office and we created the initial set up and user experience for zoom.” “There was steady progress with features such as using the chat box, chatting, and muting participants as the CHWs became more familiar with interface [sic].”
Participants did not know how to download apps on their smartphone	Call the participant or involve a family member and walk them through the steps to download the app Provide in-language and empowerment to help participants address frustrations with new technology	“[We] encourage the participant that a challenge they experience is common (such as problems with the audio), and this encourages the participant to continue to work through the technical situation.”
Challenges with scanning consent forms or other survey documents	Provide real-time virtual or telephone assistance to troubleshoot issues with documents rather than waiting for weekly meetings or follow-up meetings or calls	“At the time that the CHW/participant needs to send a form, they call the coordinator/CHW to learn the skill. The person receiving the form then sometimes makes quick edits to the form to make it legible or printable.”
Participants did not have email addresses to receive study documents	Involve family members who can provide email addresses or support participants Choose a communication strategy that the participant might be familiar with, such as a text messaging platform	“It is often easier to send a link through text message or WhatsApp than email. In general, email proficiency of the participants has not change over time. It is not seen as an easy form of communication in the community.”
Participants did not know how to log in to Zoom	Involve family members in the meetings Schedule meetings on the basis of the availability of other family members	“We ask family members when they will be available and try to schedule sessions at those times.”
Internet connectivity challenges	Be flexible with scheduling and offer assistance at multiple times and days of the week, including weekends and evenings to attend sessions Change to audio only or telephone sessions if participants cannot connect	“Multiple family members may be using the same smartphone for internet; thus, we offer our sessions on the weekend and evenings and often have to reschedule to make sure participants can attend [sic].”