@dgoulding48 Here is the settings you currently have selected…
The issue I see in your settings and why it appears to not be working is you have Challenge/Response Mode enabled in your settings. This is an advanced mode that requires authoring the checklist content in a different way. There is a separate post with information on that mode in this category…
Challenge / Response Information Topic
The Interrupt Mira also should only be enabled when utilizing a headset. As you are trying to get this to work I would initially turn that off as well.
To keep it simple for now I would also turn off Listens Aggressively and set the Background Noise slider between 3 and 3.5.
First do some testing with these settings in a quiet area with no bluetooth yet, just talking directly to the iPhone or iPad.