{
  "file_id": "dr_DA1010_Part1",
  "total_codes": 39,
  "codes": [
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "they said since I had so many eye surgeries",
      "context": "Patient has had multiple eye surgeries, implying potential lack of access to preventive care",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 0
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - SDOH",
      "subcategory": "Financial constraints",
      "quote": "they pre-treating it with drops",
      "context": "Patient is receiving pre-treatment, potentially implying cost concerns",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 0
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "what are some things that you do each day, regarding your diabetes",
      "context": "Patient is being asked about daily diabetes management, implying some level of health education",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 0
    },
    {
      "code": "Self-management support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "Take my blood sugar",
      "context": "Patient is actively managing their diabetes, implying some level of self-management support",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 0
    },
    {
      "code": "Lack of discussion",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "So they pre-treating it with drops.",
      "context": "Patient seems unclear about treatment",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 1
    },
    {
      "code": "Medication management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "Take my blood sugar.",
      "context": "Patient is managing diabetes through medication and monitoring",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 1
    },
    {
      "code": "Priority on health",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "Keep my A1C down as low as possible.",
      "context": "Patient prioritizes controlling diabetes through A1C management",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 1
    },
    {
      "code": "Self monitoring",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "Well, if I have a week of high blood sugars-",
      "context": "Patient is aware of the impact of high blood sugar on their health",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 1
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No, I don't think diabetes has affected my eyes",
      "context": "Patient shows lack of awareness about diabetes impact on eyes",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 2
    },
    {
      "code": "Provider education",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Health education programs",
      "quote": "Yes, my doctor explained how diabetes could affect my eyesight",
      "context": "Patient received education from provider about diabetes and eye health",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 2
    },
    {
      "code": "Access to care",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Accessible providers",
      "quote": "I get my eye exams here, 50/50",
      "context": "Patient has access to eye care services",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 2
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't know what you mean by procedure, because the, , the doctor determines that.",
      "context": "Patient unsure about procedures during eye exams",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 3
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "I don't know what you mean by procedure, because the, , the doctor determines that.",
      "context": "Patient unclear about procedures, possibly due to poor communication",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 3
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "For a normal eye exam? ... the doctor determines that.",
      "context": "Patient has access to a provider for regular exams",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 3
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't know what you mean by procedure",
      "context": "Patient unsure about medical procedures",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 4
    },
    {
      "code": "Familiarity with process",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I'm familiar with the process",
      "context": "Patient has knowledge of medical procedures",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 4
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "they cancel just as many times as I do",
      "context": "Patient experiences challenges with scheduling follow-up appointments due to cancellations",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 5
    },
    {
      "code": "Flexible scheduling",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "they're far enough apart from each other that pretty well pick your own time",
      "context": "Patient appreciates the flexibility in scheduling eye care visits",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 5
    },
    {
      "code": "Provider availability issues",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of continuity of care",
      "quote": "No, because- they cancel just as many times as I do",
      "context": "Patient experiences difficulties with provider availability",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 5
    },
    {
      "code": "Transportation issues",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "And there's nobody, there's nobody t- to push me around",
      "context": "Patient has mobility issues and lacks assistance with transportation",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 6
    },
    {
      "code": "Lack of accessibility",
      "category": "BARRIER - SDOH",
      "subcategory": "Transportation issues",
      "quote": "nobody to push me around",
      "context": "Patient has mobility issues and lacks assistance",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 7
    },
    {
      "code": "Inaccessible facilities",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "no place to sit",
      "context": "Clinic lacks seating for patients with mobility issues",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 7
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of continuity of care",
      "quote": "stand out there so long",
      "context": "Patient experiences prolonged waiting periods",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 7
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "When you're by yourself, yes",
      "context": "Patient implies difficulty accessing care alone",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 8
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I feel comfortable with him",
      "context": "Patient feels at ease with their doctor",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 8
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "I'm still working on him for a secret on fishing",
      "context": "Patient has casual conversation with doctor, indicating good rapport",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 8
    },
    {
      "code": "Understanding of DR progression",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I'd say it's about 100%",
      "context": "Patient shows awareness of diabetes-related vision loss risk",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 8
    },
    {
      "code": "Lack of trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "A doctor here that botched up a detached retina",
      "context": "Patient expresses distrust due to past negative experience",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 9
    },
    {
      "code": "Poor provider care",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Rude or dismissive providers",
      "quote": "A doctor here that botched up a detached retina",
      "context": "Patient had a negative experience with a provider",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 9
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I'm greatly disappointed in my vision",
      "context": "Patient expresses fear and disappointment about their vision loss",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 9
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "All my life I've had problems with my eyes",
      "context": "Patient lacks understanding of their condition and its progression",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 9
    },
    {
      "code": "Lack of family health history",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No, but keep in mind I grew up at a time where, , adults looked at kids should be seen and not heard",
      "context": "Patient lacks knowledge about family health history due to cultural upbringing",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 10
    },
    {
      "code": "Cultural beliefs about healthcare",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Cultural beliefs about healthcare",
      "quote": "And anytime the adults were talking, the kids left the room",
      "context": "Patient's cultural background may influence their perception of healthcare and communication with providers",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 10
    },
    {
      "code": "Lack of health education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "No way for you to know",
      "context": "Patient lacks knowledge about family medical history",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 11
    },
    {
      "code": "Cultural beliefs",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Cultural beliefs about healthcare",
      "quote": "adults looked at kids should be seen and not heard",
      "context": "Patient's cultural upbringing may impact health communication",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 11
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "I live with a woman",
      "context": "Patient has someone to help with daily care",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 11
    },
    {
      "code": "Acceptance of diagnosis",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Diabetes distress",
      "quote": "you just gotta accept that and go on",
      "context": "Patient's emotional response to diagnosis may impact adherence",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 11
    },
    {
      "code": "Social Support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "I live with a woman",
      "context": "Patient has a partner for potential support",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 12
    },
    {
      "code": "Lack of Clarity",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "that's a really gray area there",
      "context": "Patient expresses uncertainty about their care",
      "file_id": "dr_DA1010_Part1",
      "chunk_id": 12
    }
  ]
}