Table 4. Common themes and relevant quotes illustrating barriers and facilitators for capabilities.

TDF Domains	Common Themes noted in Interviews	Exemplary Quotes grouped as Barriers and Facilitators
Skills	A holistic approach with knowledge of guidelines, disease processes, medications and comorbidities are needed to manage hypertension.	• You’d have to have baseline knowledge of the disease and the therapeutic measures, and so you’d have to know the protocols. But you’d also have to be able to think critically, and problem solve, and recognize and understand the exceptions to the rules. • I think you have to have some background knowledge of all of those things—the physiology, the pathophysiology, the pharmacology—and then also be able to look at all of those things in the context of the patient and the patient lifestyle and the patient’s comorbid conditions so that you can come up with a treatment plan that’s going to work for that individual patient. • If there is a patient just has plain hypertension and nothing else is going on, that’s fine. But if they also have lupus, if they also have a history of a stroke, there are other things to take into account. • You would need knowledge of the medications, the guidelines, and yeah, side effects, interactions. There’s certainly a large knowledge that’s needed to be able to manage somebody’s blood pressure.
	Clinic staff other than physicians may not have all the skills needed for managing hypertension but can be trained to manage hypertension.	• I think that they all have adequate training. The pharmacist may know more about medications. We, in our clinic can now refer to a pharmacist to check in on blood pressure as well as other things, but then we also have the nurse protocol, and so all of them are adequately trained and you could say that a RN nurse can do it. • I don’t know if they have the skills right now but I think they could be trained. I’m pretty sure they could be trained. We’re using people who are PharmDs and some of them have done residencies.…I think if a nurse can be taught to change medication based on protocol, that the pharmacist shouldn’t have any problem at all. • Communication, I guess, is another skill… I think there’d have to be a period of training. • I think there are some things that are specific conditions that you learn in medical school and residency trainings that a pharmacist just doesn’t have the training in so I think there would need to be collaboration and oversight with a provider in certain cases… • My experience has been that [pharmacists] are knowledgeable about guidelines, medications, side effects. I think the only area that they would not excel in would maybe be looking at the whole picture and knowing the patient individually. • I don’t know that they could manage all the comorbidities and other things that complicate hypertension and all the other preventative things that need to be going along with it, because it’s not their training, but from a strictly medication-data management, side-effects management, they could probably do okay.
Behavioral Regulation	Strategies for SMBP vary among PCPs.	• I always ask the patient if they have a blood pressure cuff that they use at home, and we talk a little bit about what kind of cuff if they have one. If they have one, we talk about appropriate ways to take the blood pressure… • Some patients who do not have a cuff and I think are unlikely to purchase one, I either ask them to go to the drugstore and get it checked or come back to our clinic for a nurse visit to have it checked. • If my patients are more elderly, they’ll usually record them at home and then call my nurse with readings and she’ll just type them into a note so I can review them, but a lot of my younger patients are pretty technologically savvy and they’ll just use the one on MyChart. • But I’ve had multiple patients who have said that they can’t afford it. So, then I often will recommend that they go to a local CVS or Walgreens or a pharmacy and have their blood pressure monitoring.
Memory, Attention, and Decision Processes	PCPs rely on in-clinic BP for hypertension management.	• I follow the guidelines and everything, so in general 140/90, if it touches that then we start talking about medications and everything. • If they come in, though, and their blood pressure is already 180/100, then I’ll go straight to medication in addition to the lifestyle modifications.

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