{ "file_id": "dr_HD0225", "total_codes": 247, "codes": [ { "code": "Physical limitations", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Transportation issues", "quote": "I got bad knees", "context": "Patient has physical limitation due to knee issue", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Exercise barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can't do a lot because I got bad knees", "context": "Patient's physical limitation affects exercise routine", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Proper food", "context": "Patient prioritizes healthy eating", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Try to exercise every day", "context": "Patient attempts regular physical activity", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Dietary control", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Eating right. Not eating-- control the amount", "context": "Patient understands importance of diet control", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Lack of discussion", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "", "context": "No mention of doctor discussing follow-up appointments", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Take your medications on a regular basis?", "context": "Patient understands importance of medication adherence", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And my wife prepares them every day", "context": "Patient has supportive family member helping with medication management", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "we have grandkids", "context": "Patient mentions family obligations", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "my wife tries to keep stuff that out of the house", "context": "Patient implies budgeting for snacks", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I had to-- my wife tries to keep stuff that out of the house", "context": "Patient lacks knowledge about healthy snacks", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife tries to keep stuff that out of the house", "context": "Patient has supportive family member", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I watch out for snacks", "context": "Patient is aware of healthy eating habits", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. No, the strawberries don't.", "context": "Patient seems unaware of how certain foods affect blood sugar", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm always trying to find stuff out.", "context": "Patient is proactive in learning about their condition", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm try-- , I'm always trying to find stuff out.", "context": "Patient is taking initiative to manage their diabetes", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Expensive food", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It's expensive too. Yeah. I-it's fi-- 4 or 5 dollars a piece.", "context": "Patient finds healthy food options to be costly", "file_id": "dr_HD0225", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know why, but they are", "context": "Patient shows lack of understanding about certain foods", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "The diet is a big part of it", "context": "Patient recognizes importance of diet in managing condition", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Provider guidance", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "both the doctors", "context": "Patient mentions receiving guidance from doctors", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "they'll do stuff for me", "context": "Patient receives help from family members", "file_id": "dr_HD0225", "chunk_id": 10 }, { "code": "Family Influence", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "I'm trying to get my wife on board with", "context": "Patient's family member may not understand health importance", "file_id": "dr_HD0225", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "it's hard to keep enough food in the house", "context": "Patient struggles with financial stability", "file_id": "dr_HD0225", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But it's tough. You got somebody in the house with diabetes.", "context": "Patient expresses difficulty managing diabetes", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Diabetes distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I've been struggling with it now for 10 years or more.", "context": "Patient expresses long-term struggle with diabetes", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They told me to take it in the evening or before I go to bed because your cholesterol-- on a normal person, cholesterol goes up when you're asleep, so.", "context": "Patient receives health education about medication timing", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "So I'm not worried about much of", "context": "Patient does not feel urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "they don't even come back for four months", "context": "Patient may be avoiding follow-up due to fear", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. C told me that", "context": "Patient receives clear information from provider", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "But my vision isn't that bad. But right now, it is because", "context": "Patient does not feel urgent need for follow-up due to current vision", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "And if she does the cataract surgery, it'll disturb that and make it worse", "context": "Patient is concerned about potential negative outcomes of treatment", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. C told me that", "context": "Patient mentions provider by name, implying a positive relationship", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know anything about that", "context": "Patient lacked knowledge about diabetes effects on eyes", "file_id": "dr_HD0225", "chunk_id": 15 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "And, , I can still see-- my left eye is never gonna be any better", "context": "Patient feels no urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know anything about that", "context": "Patient lacked knowledge about their condition", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "my vision wasn't quite as good", "context": "Patient didn't feel urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. C said, 'Yeah, they're not real bad yet, but it is there'", "context": "Provider clearly communicated diagnosis to patient", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They told me that", "context": "Patient had access to provider for diagnosis and discussion", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's not getting any worse", "context": "Patient seems to lack understanding of diabetes impact on retinas", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Positive provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He says it's about the same", "context": "Provider effectively communicates diagnosis to patient", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Getting it down-- helps all that", "context": "Patient understands the importance of managing diabetes for overall health", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He says it's about the same, so it's not getting any worse", "context": "Provider shows empathy by reassuring patient about their condition", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it just blurred vision", "context": "Patient lacks detailed understanding of diabetes effects on eyes", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my family doctor told me that years ago", "context": "Patient received health education from family doctor", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they said it-- , I knew from right from the beginning", "context": "Patient received clear information from healthcare provider", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I can still see real well", "context": "Patient perceives no immediate need for follow-up", "file_id": "dr_HD0225", "chunk_id": 19 }, { "code": "Limited understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it just blurred vision", "context": "Patient lacks comprehensive knowledge of DR effects", "file_id": "dr_HD0225", "chunk_id": 19 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know a whole lot", "context": "Patient lacks knowledge about diabetic retinopathy", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "that's why I got to keep my numbers down", "context": "Patient has some understanding of diabetes management", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he told me a while ago, two doctors did", "context": "Patient has trust in their healthcare providers", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if, if I hadn't taken care of the diabetes, they would be worse", "context": "Patient shows some understanding of disease progression", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's the one referred me to come over here", "context": "Patient has a referral from another provider", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I take care of the diabetes", "context": "Patient is taking care of their diabetes, implying some level of health knowledge", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's the one referred me to come over here", "context": "Patient has a referral from a trusted provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She's the one that told me I had beginnings of glaucoma and cataracts", "context": "Patient has a positive interaction with their provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She's the one that told me I had beginnings of glaucoma and cataracts", "context": "Patient receives clear information from their provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "what I'm saying? I mean, you still got to see", "context": "Patient implies difficulty accessing care", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "and then she got me hooked up with come over here", "context": "Patient has access to a provider", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "and then she got me hooked up with come over here", "context": "Patient has a positive interaction with provider", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what I'm saying? I mean, you still got to see", "context": "Patient is educated about importance of eye exams", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I-it's good. Easy.", "context": "Patient finds scheduling process easy", "file_id": "dr_HD0225", "chunk_id": 24 }, { "code": "Provider availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Always-- he's always available.", "context": "Patient's doctor is always available", "file_id": "dr_HD0225", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "he's always available", "context": "Patient finds doctor's availability convenient", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Flexible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "It fits my schedule", "context": "Patient appreciates flexible appointment scheduling", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he's always available", "context": "Patient has a positive experience with their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what do they tell you that you should be doing?", "context": "Patient receives clear guidance from their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just take care of my diabetes", "context": "Patient receives health advice from their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Lack of specific advice", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Just take care of my diabetes. That's the most important.", "context": "Patient receives general advice from doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "'Yep,' pat me on the shoulders, says, 'Keep it up. Keep going.'", "context": "Patient feels encouraged by doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to eat the right stuff. That's the main thing is my eating.", "context": "Patient receives dietary advice from doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Patient motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I love to eat. I mean, I, I love buffets", "context": "Patient is aware of their eating habits", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Food preferences", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I love to eat. I mean, I, I love buffets.", "context": "Patient prioritizes food enjoyment over health", "file_id": "dr_HD0225", "chunk_id": 27 }, { "code": "Family obligations", "category": "BARRIER - Social Determinants of Health", "subcategory": "Social support networks", "quote": "we-well, when I go-- we, we do go to buffets because look at those grandkids.", "context": "Patient's family responsibilities influence food choices", "file_id": "dr_HD0225", "chunk_id": 27 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It cost you fortune", "context": "Patient mentions high costs of food or potentially other expenses", "file_id": "dr_HD0225", "chunk_id": 29 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "It cost you fortune", "context": "Patient mentions high costs of treatment", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Out-of-pocket costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I come outta there 60 bucks for all four of us", "context": "Patient mentions high out-of-pocket expenses", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It cost you fortune", "context": "Patient implies financial burden of treatment", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know exactly--what to do", "context": "Patient unsure about diet soda's impact on health", "file_id": "dr_HD0225", "chunk_id": 31 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I've heard it's good. I've heard it's bad", "context": "Patient lacks clear information about diet soda", "file_id": "dr_HD0225", "chunk_id": 31 }, { "code": "No Transportation Issues", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "No, my wife drives. I don't even drive over here. She does.", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "No Wait Times Issues", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No", "context": "Patient does not experience long wait times", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "Positive Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my doctor, I need to talk to him, I guess.", "context": "Patient has a positive and trusting relationship with their provider", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "my wife drives", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "I expect-- when I come here, they, believe it, look they're having a convention or something", "context": "Patient expects long wait times at clinic", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They cover all the basics and--", "context": "Patient perceives clinic as having accessible providers", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They cover all the basics", "context": "Patient feels informed about eye care", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They cover all the basics and--", "context": "Patient has positive experience with providers", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Wanna protect my eyes in the sun because the sun's harder in your eyes", "context": "Patient demonstrates understanding of eye protection", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Lack of mention", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because it shades your eyes", "context": "Patient discusses coping mechanism without mentioning follow-up", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So that's, that's one thing I do", "context": "Patient shares self-care strategy, implying some health knowledge", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Supplement use", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take vitamin C every day", "context": "Patient takes supplements, indicating proactive approach to health", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I take that every day. That and C, and that's it.", "context": "Patient seems unsure about medications", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take that every day. That and C, and that's it.", "context": "Patient is aware of daily supplements", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm on it maybe an hour or so a day.", "context": "Patient has access to TV and possibly other resources", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, no, no, no.", "context": "Patient does not express concern for eye health", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Self care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I give my eyes a rest when I'm working on the computer for a long time or watching TV", "context": "Patient takes breaks to rest eyes", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Resource access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I use, -- what's it called? Artificial Tears, or?", "context": "Patient has access to eye drops", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "You got to keep the sugar down", "context": "Patient's limited understanding of diabetes management", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff'", "context": "Patient receives clear guidance from healthcare providers", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to keep the sugar down", "context": "Patient receives health education on diabetes management", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff'", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Lack of cure", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's no money in the cures. There's money in treatment.", "context": "Patient believes there is no financial incentive for a cure", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Resignation", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it's just something I live with.", "context": "Patient feels resigned to their condition", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Acceptance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm not mad about it. Not angry about it.", "context": "Patient has accepted their condition and is empowered to manage it", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Provider advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff.'", "context": "Patient receives guidance from healthcare providers", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Family History Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my grandfather had it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Personal Experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "it's just something I do", "context": "Patient has personal experience with diabetes management", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Health Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "you have to-- it's, it's on your mind", "context": "Patient is aware of the importance of diabetes management", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "You have to be", "context": "Patient has a positive outlook on managing their condition", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "No issues with provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "It's fine. It don't bother me that", "context": "Patient feels comfortable discussing their concerns with their doctor", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "Limited treatment options", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "when they tell you, there's only certain things they can do", "context": "Patient feels limited by the treatments available for their condition", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "It's fine. It don't bother me that--", "context": "Patient feels comfortable talking to their doctor", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They know that I'm working with it.", "context": "Patient feels heard and understood by their doctor", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what you eat and all this other stuff. It's still up to me, most of it.", "context": "Patient takes responsibility for their health", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "But it's a two way street.", "context": "Patient feels involved in their care decisions", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I never tell", "context": "Patient does not express concerns to doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I never tell", "context": "Patient does not communicate effectively with doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just give me lists of stuff to do", "context": "Patient seeks guidance on self-management", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "you wanna know if it's progressing-- getting better, staying the same", "context": "Patient asks questions and seeks information from doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "They were happy with it", "context": "Doctor shows positive attitude towards patient's progress", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I don't-- never-- I never tell.", "context": "Patient hesitant to share information with doctor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "Just give me lists of stuff to do. Give me lists of stuff to eat.", "context": "Patient desires clear instructions from doctor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "She gave me this whole big, long thing of food on it.", "context": "Patient finds health education from counselor helpful", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Patient-provider trust", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "My other doctor, the woman in there, she's a counselor.", "context": "Patient has positive relationship with counselor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Understanding of DR progression", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Beliefs & Perceptions", "quote": "It's very serious. Because I only have the one eye--", "context": "Patient understands severity of diabetes on vision", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "You don't realize it until you don't have it anymore", "context": "Patient lacks full understanding of vision loss impact", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They've told me that, . You got to stay on top of it", "context": "Patient receives health education from providers", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Perceived importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "To me, vision is the most precious thing in the world", "context": "Patient understands importance of vision preservation", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I've noticed a difference", "context": "Patient is starting to see changes in vision but lacks full understanding", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "if it can change that much-- it can get worse", "context": "Patient is worried about vision getting worse", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient feels supported by provider", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They-- , my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient is receiving health education from provider", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "it's steady. Not getting any worse.", "context": "Patient feels their vision is stable", "file_id": "dr_HD0225", "chunk_id": 46 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not getting mu-much any better", "context": "Patient lacks awareness of potential vision decline", "file_id": "dr_HD0225", "chunk_id": 46 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "a lot of fine print or whatever", "context": "Patient struggles with reading small text", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can watch it without glasses", "context": "Patient may not fully understand vision limitations", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "read everything on it and everything else", "context": "Patient is able to read and understand information", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Now I can't do that much anymore", "context": "Patient's limited ability to perform tasks due to vision", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Because everything anymore is so tiny", "context": "Patient's difficulty understanding their condition", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I used to work on cars, car work, all that stuff. Now I can't do that much anymore", "context": "Patient's reduced income due to vision limitations", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It looks to me it is", "context": "Patient's uncertain understanding of their condition", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "So it's, I mean, it's restricted a little bit", "context": "Patient's emotional response to vision limitations", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have to get magnifying glass out", "context": "Patient's use of assistive devices, implying accessible care", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because everything anymore is so tiny", "context": "Patient's awareness of their vision limitations, implying some level of health education", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I actually thought I could see better", "context": "Patient believes their vision has improved", "file_id": "dr_HD0225", "chunk_id": 49 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know about that, but--", "context": "Patient shows uncertainty about age-related eyesight decline", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm not ready to give up", "context": "Patient shows determination and motivation", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "That attitude makes all the difference", "context": "Provider shows understanding and support", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know about that", "context": "Patient shows lack of knowledge about age-related eyesight decline", "file_id": "dr_HD0225", "chunk_id": 51 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My grandfather had, and I guess my dad had it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_HD0225", "chunk_id": 51 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it's scary", "context": "Patient expresses fear after being diagnosed with eye issues", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If I can do something to make something better--that's what you do", "context": "Patient shows proactive approach to managing health", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Lack of concern", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "It's fine", "context": "Patient seems unconcerned about follow-ups and treatment plans", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Accessible Transportation", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I always got transportation. I can either-- she can bring me or I can bring myself", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Positive Attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It's just-- it's just something I have to do", "context": "Patient is motivated to attend follow-ups", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Effective Healthcare System", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's fine. No issues at all?", "context": "Patient has positive experience with healthcare system", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Reminder Systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "MyChart helpful", "context": "Patient uses digital tools to stay on track with appointments", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Transportation access", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I always got transportation. I can either-- she can bring me or I can bring myself.", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 54 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Under $10,000", "context": "Patient is price-sensitive when making a purchase", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "Four-wheel drive", "context": "Patient is discussing vehicle features, potentially related to transportation needs", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "they got money in the bank", "context": "Patient has access to financial resources", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Anyway, she's got a car sitting in the yard", "context": "Patient mentions having a car, implying potential resolution to transportation issues", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Insurance coverage", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "they're getting insurance on it for me and my wife", "context": "Patient mentions insurance, which could be a barrier or facilitator to healthcare access", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Accessible transportation", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "4. Resources & Access", "quote": "Anyway, she's got a car sitting in the yard", "context": "Patient has access to a vehicle, facilitating transportation to appointments", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Lack of barriers", "category": "BARRIER - Social Determinants of Health", "subcategory": "None", "quote": "No, not really.", "context": "Patient reports no discouragement from using healthcare services", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Because I love healthcare services.", "context": "Patient has a positive perception of healthcare services", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Emotional benefit", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because it makes me feel better.", "context": "Patient feels healthcare services have a positive impact on their well-being", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "They try to help me, and I try to cooperate", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If I come over here, it's always-- I always come out of here with a, a good attitude", "context": "Patient has easy access to healthcare services", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They try to help me, and I try to cooperate", "context": "Patient feels heard and understood by providers", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "it looked it had a convention out here in the hallway", "context": "Patient observes busy clinic environment", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "They try to help me, and I try to cooperate", "context": "Patient expresses cooperation with providers", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "I'm impressed with the whole deal", "context": "Patient praises clinic experience", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I'm impressed-- with the whole deal. S2: 29:32 Thank you. S1: 29:33 --with the doctors, you, everybody.", "context": "Patient expresses satisfaction with healthcare providers", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah. We-well, the kids, just they did this morning, she goes, 'They'll get checked of sugar.'", "context": "Patient receives help from family members with diabetes care", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Reminders and assistance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, they, they, they had-- they're on top of it, the grandkids, .", "context": "Patient's family members provide reminders and assistance with diabetes care", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm impressed-- with the whole deal. S2: 29:32 Thank you. S1: 29:33 --with the doctors, you, everybody.", "context": "Patient expresses satisfaction with accessibility of healthcare providers", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "she takes care of me in that regard", "context": "Patient receives help from family member", "file_id": "dr_HD0225", "chunk_id": 62 }, { "code": "Family Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "Sometimes it's already on the-- on the island ready", "context": "Patient receives practical help from family", "file_id": "dr_HD0225", "chunk_id": 62 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I doubt if I would, because it's just something else.", "context": "Patient shows lack of interest in diabetes education", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "No health education offered", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "No. S2: 30:53 No, it's never offered?", "context": "Patient reports not being offered diabetes education", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "If somebody cares enough.", "context": "Patient values caring providers", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "She's a counselor. S1: 31:09 She had-- , I used to look to her when I first got on diabetes stuff.", "context": "Patient has a supportive counselor", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "you got to read the stuff", "context": "Patient emphasizes importance of reading health information", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She really helped me a lot", "context": "Patient appreciates counselor's support", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "But you got to listen to her", "context": "Patient values listening to counselor's advice", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "Because she got enough on her plate-- with the grandkids and everything else", "context": "Patient feels unable to share worries with wife due to her responsibilities", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife", "context": "Patient has someone to share worries with, but limited due to her plate", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Family responsibilities", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Because she got enough on her plate-- with the grandkids and everything else", "context": "Patient's wife has family responsibilities limiting support", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Age-related concerns", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "She's 68", "context": "Patient's wife is older and may have limited ability to handle stress", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Limited emotional support", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "She no spring-- she's 68", "context": "Patient's wife has limited ability to handle patient's worries", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "everybody has chores to do", "context": "Patient has family help with daily tasks", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Family Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "Kids help her with that", "context": "Patient's children assist with household responsibilities", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think so. I really do. I think so", "context": "Patient feels supported by family members", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "No, not really", "context": "Patient lacks family or friends to ask for advice on health and eye problems", "file_id": "dr_HD0225", "chunk_id": 67 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah, i-if I have a problem, I call the doctor", "context": "Patient has easy access to their doctor for advice", "file_id": "dr_HD0225", "chunk_id": 67 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my mind is just as good probably as it ever was", "context": "Patient seems to downplay potential health issues", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "my mind is just as good probably as it ever was", "context": "Patient does not see the need for follow-up", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife questions this", "context": "Patient has a supportive family member", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "people gets, , dementia and all that other stuff, they don't know", "context": "Patient lacks knowledge about disease progression", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "No, you're nuts", "context": "Patient expresses fear of being told they have a problem", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm trying to keep an eye on that", "context": "Patient takes initiative to monitor their health", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm aware of things", "context": "Patient shows awareness and willingness to take control", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "keep a good attitude", "context": "Patient believes having a positive attitude helps", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Good attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "keep an att-- a good attitude, a positive attitude", "context": "Patient emphasizes the importance of attitude in management", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm aware of things", "context": "Patient is knowledgeable about their condition", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "positive attitude. Positive influence. Everything.", "context": "Patient mentions importance of positive attitude", "file_id": "dr_HD0225", "chunk_id": 71 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know what was going on", "context": "Patient unsure about their condition", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was in the fog--because I didn't know what was going on", "context": "Patient anxious about unknown diagnosis", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You have to be positive", "context": "Patient emphasizes importance of positivity", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because I didn't know what was going on", "context": "Patient initially lacked knowledge about their condition", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they do-- , I ask them questions, they answer them", "context": "Patient experiences open communication with providers", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I feel great when I come here", "context": "Patient has a positive experience with their healthcare providers", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the woman over at Walmart, , ch-checks my eyes", "context": "Patient has access to convenient eye care services", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "Blood work alone can cost you $1,000", "context": "Patient mentions high cost of medical tests", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I know it's expensive to go to a doctor for blood tests, blood work", "context": "Patient highlights expense of healthcare", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Healthcare costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Healthcare is expensive", "context": "Patient and interviewer discuss high cost of healthcare", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "Healthcare is expensive. Yeah. Blood work alone can cost you $1,000.", "context": "Patient discusses high costs of healthcare", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But there aren't enough people that know about it--that have it.", "context": "Patient mentions lack of awareness about diabetes", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Of course, luckily, now I've got insurance--that pays for it.", "context": "Patient has insurance that covers healthcare costs", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "that's $100", "context": "Patient mentions cost as a concern for doctor visits", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "They ain't going to a damn doctor", "context": "Patient implies that some people do not visit the doctor", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "But you got to take care of yourself", "context": "Patient emphasizes self-care and personal responsibility", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But I don't see a lot of stuff on TV about it. Not enough. Awareness.", "context": "Patient mentions lack of public awareness about diabetic retinopathy", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Self care importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to take care of yourself. Nobody else is gonna do it for you.", "context": "Patient emphasizes personal responsibility for health", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Personal motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Number one comes first. And you got to take care of yourself.", "context": "Patient prioritizes self-care and health", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's not enough of it. People don't know about it.", "context": "Patient believes lack of awareness is a major issue", "file_id": "dr_HD0225", "chunk_id": 78 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Awareness. That's the key word right there.", "context": "Patient emphasizes importance of awareness and education", "file_id": "dr_HD0225", "chunk_id": 78 }, { "code": "Lack of self care", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "He's not taking care of it", "context": "Patient describes someone who doesn't take care of their health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Fatalistic beliefs", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "He thinks he's just making a fatal stab at it", "context": "Patient describes someone with fatalistic views on health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Lack of health motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Don't want it. I'll take care of himself", "context": "Patient describes someone who lacks motivation to manage their health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I spent $500", "context": "Patient mentions high initial cost of insulin", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "the one plan I had there a while back, it was free", "context": "Patient discusses variability in insurance coverage", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "it was free", "context": "Patient has access to free medication through insurance", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Financial assistance programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "I just go to the drug store, and then they-- whatever", "context": "Patient implies access to financial assistance for medication", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "I didn't have part B. Medicare-- for a long time.", "context": "Patient lacked necessary insurance coverage", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It's almost everything I get free-- 12, 13 prescriptions.", "context": "Patient implies reliance on free or low-cost services due to financial limitations", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I didn't have part B. Medicare-- for a long time. Didn't have it. Had Part A.", "context": "Patient eventually obtained necessary insurance coverage, facilitating access to care", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Cost me 300 something dollars a month", "context": "Patient mentions expensive insurance costs", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Had Part A", "context": "Patient had limited insurance coverage initially", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Cost me 300 something dollars a month", "context": "Patient mentions expensive monthly insurance costs", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "It's worth it", "context": "Patient considers insurance cost worthwhile, implying financial assistance is helpful", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "she don't wanna spend that money", "context": "Patient hesitant to spend money on healthcare", "file_id": "dr_HD0225", "chunk_id": 83 }, { "code": "Cost concerns", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "But we're not rich", "context": "Patient considers financial situation when deciding on healthcare spending", "file_id": "dr_HD0225", "chunk_id": 83 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She can't hear half the time", "context": "Patient experiences poor communication due to provider's hearing issues", "file_id": "dr_HD0225", "chunk_id": 84 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "That makes her nervous", "context": "Patient feels nervous, indicating potential lack of trust in provider", "file_id": "dr_HD0225", "chunk_id": 84 } ] }