Supplemental Table 2. Sample quotes from focus groups.

Theme / Sample Quotes
Experiences with The Reflux Improvement Monitoring (TRIM) program / Education
•“she sent me to a dietician who showed me how to eat foods that I eat normally, helped a lot.”
Follow-up
•“I think following up on what you eat is the most benefit.”
•“I think accountability is one of the major things for this research.”
Support
•“I like the support group aspect, like everyone in here has gone through the same thing, and kind of going through the same thing with medications, like a group like that.”
Positive Outcomes
•“Well and weight loss and exercise helps in many diseases, arthritis, high blood pressure, cholesterol, fibromyalgia, for just about anything—so I don’t think it’s one or the other, as long as you try to maintain your weight”
• “I’ve been on for 5 months, my doctor introduced me to the study. And I have to tell you it has made a difference. Although I have not been a good follower, I have made… mistakes, there IS a difference.”
•“I personally feel that if I lost more weight I can look in the future to eliminating my medication.”
•“It helps me change- make lifestyle changes.”
•“I love that they don’t make you feel guilty.”
•“It’s more personal, I like that.”
•“if you’re cheating, you’re cheating YOURSELF.”
Barriers with TRIM
•“[TRIM] pushes the weight loss, but they… [should] make it about the food and the choices that you’re making…Make it about that, not just about losing weight.”
Healthcare Team / Lack of understanding
•“[it’s] not just like your doctor telling you oh you have to lose weight- but actually talking about it, actually talking about the problems and barriers that you have when it comes to weight loss, and you don’t feel guilty talking about it”
•“I don’t think [doctors] understand what’s it’s like to have GERD. Here’s your plan, take it every other day, and then get off, and then everything will be right.”
Barriers
•“[I want] someone who could spend some time…and maybe more follow-up. Doctors don’t, I’m sorry, but…they just don’t have the time”
Living with GERD / Perceived Severity
•“Pain is just, such a…. it’s just uncomfortable… it’s hard to focus, or do anything, when you’re constantly feeling like something is wrong, constantly clearing your throat.”
•“it feels life threatening”
•“you can bend and you’ll get the reflux right away. If you go to bend, pick something up for a minute or whatever, you can feel it come up.”
•“If it gets you in the middle of the night. You can’t sleep, or you wake up.”
•“You get inflammation of the vocal cords; my voice changes all the time. And the coughing- sometimes a GERD attack will be nothing but coughing all night long.”
Socio-contextual Factors
•“It impacts the way I do my job. I’m constantly talking to patients, and clearing my throat constantly, and it makes me unable to do my job.”
•“I used to be a first soprano; this is not my regular speaking voice, because of several years of suffering from acid coming up.”
•“At work, people all around me eating bags all day, potato chips, I mean all day! I hear it, I smell it”
•“Being a mailmain, bringing lunch in the summer is fine, but in the winter you want something hot.”
•“I’m in construction, it’s the same thing. Once the cold hits, it’s what is the closest food, and it’s usually McDonald’s”
Psychosocial Factors
•“Yeah stress is a big one. Just the fact that you don’t know when it’s going to happen, just stresses you out also”
•“Yeah, people always think you’re sick, like what’s wrong with you, because you’re constantly clearing your throat”