Table 3. Common themes and relevant quotes illustrating barriers and facilitators for opportunity.

TDF Domains	Common Themes noted in Interviews	Exemplary Quotes grouped as Barriers and Facilitators
Social Influences	SMBP is driven by evidence and not behavior of colleagues.	• If there was a study that showed that ambulatory blood pressure monitoring really doesn’t help in the long term then I would stop pushing… • If there was data, it would probably sway me. But I don’t know just on other people’s actions if I would change. • I guess it would depend on why they’re using it less and less and if they are aware of some evidence that came out that I’m not aware of… • Not unless there was some data that showed me that [SMBP] wasn’t doing any good.
Environmental Context and Resources	Obtaining SMBP data from some patients can be hard.	• …there’s talk about encouraging patients to use the MyChart for uploading blood pressures and how it can be a valuable tool.…if the median age is 82, they are going to have more challenges than a younger population to even get access to [MyChart], so that’s a big challenge. But I think once someone is on-board, once they have kids that maybe on-board for them, it’s a great tool, but it’s just giving them that access.…there’s a push for us to get all of our patients enrolled in MyChart but the older adults just, I get them enrolled and they can’t follow through on it.
	Lack of workflow support is a common barrier to SMBP.	• I’m a pretty good person from a patient standpoint to look at that data and act on it but I don’t have that support. . . . • I can always use more support but yeah, I feel like I’m kind of old fashioned. I like to look at things myself. Well, no, it might be nice to have more support in that. • Obviously if the pharmacist is doing it, it would take some of the burden off of the clinician from having to do it.
	Another barrier is the cost of BP cuffs.	• If their insurance pays for the blood pressure cuff, I will prescribe it so that they can get it paid for by the insurance company. • The cost is all on the patient…Insurance isn’t going to pay for a blood pressure cuff, and I don’t have a free blood pressure cuff that I can give the patient…
	Accuracy of home BP cuffs and method of measuring BP is a concern.	… there’s a fair amount of worry that the information may be inaccurate because the machines aren’t good, or they don’t know how to use them and I still have that problem.• We just had a patient come in. She was obese. She was using the cuff that was provided with the device and it was too small for her arm, so they were very inaccurate readings. That’s why I always have them bring it in, because that stuff happens…not being able to always trust what the home values are I guess whether it’s ‘I’m not sure about the device’ or ‘I’m not sure how the patient is doing it and that kind of thing’ are big barriers.
	Changes to guidelines influence use of SMBP.	• I would say the more recent guidelines emphasize home blood pressure monitoring, and that has changed my practice • Now I think if there was evidence behind [not doing home blood pressure monitoring] then that would sway me. • I think the new ones over the last year or two promote home blood pressure monitoring.

PCP; primary care physician, SMBP; self-measured blood pressure monitoring.