{
  "file_id": "dr_KD0321",
  "total_codes": 74,
  "codes": [
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "maybe your diabetes is getting worse or maybe your sugar's messed up a little bit",
      "context": "Patient unsure about diabetes progression",
      "file_id": "dr_KD0321",
      "chunk_id": 1
    },
    {
      "code": "Symptom awareness",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "of course the blurry vision",
      "context": "Patient aware of symptoms indicating poor diabetes control",
      "file_id": "dr_KD0321",
      "chunk_id": 1
    },
    {
      "code": "Self monitoring",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "Anything... Any specific signs",
      "context": "Patient actively monitors diabetes symptoms",
      "file_id": "dr_KD0321",
      "chunk_id": 1
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't know if it had anything to do with this retinal tear or not",
      "context": "Patient unsure about diabetes impact on eyes",
      "file_id": "dr_KD0321",
      "chunk_id": 2
    },
    {
      "code": "Uncertainty about diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't know if it had anything to do with this retinal tear or not",
      "context": "Patient unsure about diabetes impact on eyes",
      "file_id": "dr_KD0321",
      "chunk_id": 2
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't know if it had anything to do with this retinal tear or not",
      "context": "Patient unsure about diabetes impact on eyes",
      "file_id": "dr_KD0321",
      "chunk_id": 3
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "It hasn't affected my acuity, my visual acuity",
      "context": "Patient feels no immediate need for follow-up",
      "file_id": "dr_KD0321",
      "chunk_id": 3
    },
    {
      "code": "Provider communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "They, they have? What have they told you- ... about that? Anything specific?",
      "context": "Patient receives information from doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 3
    },
    {
      "code": "Access to healthcare",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "Ophthalmologist. Local. Bridgeport. Local",
      "context": "Patient has local access to eye care",
      "file_id": "dr_KD0321",
      "chunk_id": 3
    },
    {
      "code": "Local access",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate resources",
      "quote": "Local. Bridgeport.",
      "context": "Patient has local access to eye exams",
      "file_id": "dr_KD0321",
      "chunk_id": 4
    },
    {
      "code": "Accessible provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Ophthalmologist. Local. Bridgeport.",
      "context": "Patient has accessible provider for eye exams",
      "file_id": "dr_KD0321",
      "chunk_id": 4
    },
    {
      "code": "Good doctor",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I had a very good doctor",
      "context": "Patient appreciates their doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 5
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "saw something, saw a red flag",
      "context": "Doctor effectively communicates concerns to patient",
      "file_id": "dr_KD0321",
      "chunk_id": 5
    },
    {
      "code": "Accessible provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "sent me here immediately, the same day",
      "context": "Patient received prompt referral to specialist",
      "file_id": "dr_KD0321",
      "chunk_id": 6
    },
    {
      "code": "Positive experience",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Uneventful. Just- Uneventful?",
      "context": "Patient had a smooth and uneventful experience with dilation",
      "file_id": "dr_KD0321",
      "chunk_id": 6
    },
    {
      "code": "Transportation assistance",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Transportation assistance",
      "quote": "And I had a driver",
      "context": "Patient has access to transportation",
      "file_id": "dr_KD0321",
      "chunk_id": 6
    },
    {
      "code": "Having a driver",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Transportation assistance",
      "quote": "And I had a driver",
      "context": "Patient has access to transportation",
      "file_id": "dr_KD0321",
      "chunk_id": 7
    },
    {
      "code": "Provider explanation",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Yeah. Which, , light. , bright light- Mm-hmm. ... and, , she provided the, , , darkening, , shield.",
      "context": "Provider explained process to patient",
      "file_id": "dr_KD0321",
      "chunk_id": 7
    },
    {
      "code": "Positive provider interaction",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "They were very good about that. , yeah.",
      "context": "Patient has positive experience with provider",
      "file_id": "dr_KD0321",
      "chunk_id": 7
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "They're very backed up",
      "context": "Patient experiences long wait times for appointments",
      "file_id": "dr_KD0321",
      "chunk_id": 8
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "They're very backed up",
      "context": "Patient has difficulty scheduling appointments due to provider's busy schedule",
      "file_id": "dr_KD0321",
      "chunk_id": 8
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "They're very backed up",
      "context": "Patient experiences long wait times due to high patient volume",
      "file_id": "dr_KD0321",
      "chunk_id": 9
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "They're very backed up now, even with- Yeah",
      "context": "Patient has trouble scheduling appointments due to clinic's busy schedule",
      "file_id": "dr_KD0321",
      "chunk_id": 9
    },
    {
      "code": "Provider availability",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "I think number of patients are- Mm.",
      "context": "Patient mentions issue with doctor's availability",
      "file_id": "dr_KD0321",
      "chunk_id": 10
    },
    {
      "code": "Lack of providers",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "No, dozens. There aren't?",
      "context": "Patient notes scarcity of optometrists in the area",
      "file_id": "dr_KD0321",
      "chunk_id": 10
    },
    {
      "code": "Continuity of care",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of continuity of care",
      "quote": "when you've had a family doctor for years and an- Mm-hmm.",
      "context": "Patient values long-term relationships with healthcare providers",
      "file_id": "dr_KD0321",
      "chunk_id": 10
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Do you have any recommendations about, , regarding your eye care? , any suggestions to improve the experience?",
      "context": "Patient seeks improvement in provider accessibility",
      "file_id": "dr_KD0321",
      "chunk_id": 10
    },
    {
      "code": "Accessible facility",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate access to care",
      "quote": "access to the facility is fine",
      "context": "Patient finds the clinic easily accessible",
      "file_id": "dr_KD0321",
      "chunk_id": 11
    },
    {
      "code": "Helpful staff",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Patient navigation services",
      "quote": "helpful people",
      "context": "Patient receives support from clinic staff",
      "file_id": "dr_KD0321",
      "chunk_id": 11
    },
    {
      "code": "Lack of challenges",
      "category": "BARRIER - Social Determinants of Health",
      "subcategory": "None",
      "quote": "No. ... care? No?",
      "context": "Patient reports no challenges with receiving care",
      "file_id": "dr_KD0321",
      "chunk_id": 12
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "So for example, do you wear sunglasses to r-",
      "context": "Patient is asked about self-care practices",
      "file_id": "dr_KD0321",
      "chunk_id": 12
    },
    {
      "code": "Self care practices",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "So what are some ways that you specifically take care of your eyes?",
      "context": "Patient is asked about eye care habits",
      "file_id": "dr_KD0321",
      "chunk_id": 12
    },
    {
      "code": "Access to care",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate access",
      "quote": "None. That's good to hear.",
      "context": "Patient reports no issues with accessing care",
      "file_id": "dr_KD0321",
      "chunk_id": 12
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No",
      "context": "Patient does not express concern for vision loss with diabetes",
      "file_id": "dr_KD0321",
      "chunk_id": 13
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "So a multivitamin?",
      "context": "Patient is taking supplements, indicating some health awareness",
      "file_id": "dr_KD0321",
      "chunk_id": 13
    },
    {
      "code": "Accessible care",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Do you take any supplements for your eyes?",
      "context": "Interviewer is inquiring about patient's eye health, indicating accessible care",
      "file_id": "dr_KD0321",
      "chunk_id": 13
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "my PCP is very good about giving me a global",
      "context": "Patient has a positive relationship with their primary care physician",
      "file_id": "dr_KD0321",
      "chunk_id": 14
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "we discuss it every time",
      "context": "Patient and provider have open and regular discussions about diabetes management",
      "file_id": "dr_KD0321",
      "chunk_id": 14
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "my PCP is very good about giving me a global",
      "context": "Patient feels their provider is understanding and supportive",
      "file_id": "dr_KD0321",
      "chunk_id": 14
    },
    {
      "code": "Shared decision-making",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Shared decision-making",
      "quote": "we talk about all complications",
      "context": "Patient and provider work together to make informed decisions about diabetes management",
      "file_id": "dr_KD0321",
      "chunk_id": 14
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "availability of herself",
      "context": "Patient has easy access to their provider",
      "file_id": "dr_KD0321",
      "chunk_id": 14
    },
    {
      "code": "Transportation issues",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "Bringing him- Yeah. ... to Morgantown for laser-",
      "context": "Patient mentions bringing a family member to another location for treatment, implying potential transportation challenges",
      "file_id": "dr_KD0321",
      "chunk_id": 15
    },
    {
      "code": "Honest communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "To be honest with me",
      "context": "Patient values honesty from doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 16
    },
    {
      "code": "Trust in provider",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "give me the basic, honest truth",
      "context": "Patient wants trustworthy care from doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 16
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "It would terrify me",
      "context": "Patient expresses fear of losing eyesight due to diabetes",
      "file_id": "dr_KD0321",
      "chunk_id": 17
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "give me the basic, honest truth",
      "context": "Patient desires clear and accurate information about their condition",
      "file_id": "dr_KD0321",
      "chunk_id": 17
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "never fear telling me the truth",
      "context": "Patient values honest communication with their provider",
      "file_id": "dr_KD0321",
      "chunk_id": 17
    },
    {
      "code": "Lack of perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "I can see fine now",
      "quote": "I don't see it as threatening",
      "context": "Patient does not feel threatened by potential complications",
      "file_id": "dr_KD0321",
      "chunk_id": 18
    },
    {
      "code": "Health awareness",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I am aware of what complications can occur",
      "context": "Patient has knowledge about potential complications",
      "file_id": "dr_KD0321",
      "chunk_id": 18
    },
    {
      "code": "Self management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "Watching my diet",
      "context": "Patient takes control of their diet to manage condition",
      "file_id": "dr_KD0321",
      "chunk_id": 18
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I didn't even know I had this tear. I had no clue.",
      "context": "Patient was unaware of their condition",
      "file_id": "dr_KD0321",
      "chunk_id": 19
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "I don't see it as threatening.",
      "context": "Patient does not feel their condition is a threat",
      "file_id": "dr_KD0321",
      "chunk_id": 19
    },
    {
      "code": "Accessible provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "So she was right on it. , right on- In- ... top of it",
      "context": "Provider was responsive and proactive",
      "file_id": "dr_KD0321",
      "chunk_id": 19
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "She says, 'Wait a minute.' , 'I need you to go to Morgantown to, , have a more extensive exam.'",
      "context": "Provider clearly communicated the need for further examination",
      "file_id": "dr_KD0321",
      "chunk_id": 19
    },
    {
      "code": "Accessible provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "So she was right on it.",
      "context": "Patient appreciates prompt provider action",
      "file_id": "dr_KD0321",
      "chunk_id": 20
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "She says, 'Wait a minute.'",
      "context": "Provider clearly communicates need for further exam",
      "file_id": "dr_KD0321",
      "chunk_id": 20
    },
    {
      "code": "Desire longevity",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I want to have longevity and a quality of life to enjoy that longevity",
      "context": "Patient motivated by desire for long and healthy life",
      "file_id": "dr_KD0321",
      "chunk_id": 21
    },
    {
      "code": "Receptive doctor",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "Very much so",
      "context": "Patient feels doctor is supportive of their goals",
      "file_id": "dr_KD0321",
      "chunk_id": 21
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "She's quite an advocate for that",
      "context": "Patient feels supported by their doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 22
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "She's quite an advocate for that",
      "context": "Patient feels heard and understood by their doctor",
      "file_id": "dr_KD0321",
      "chunk_id": 22
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "She's quite an advocate for that",
      "context": "Patient feels their doctor cares about their well-being",
      "file_id": "dr_KD0321",
      "chunk_id": 22
    },
    {
      "code": "Positive experience",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "you've had such a good experience",
      "context": "Patient had a positive experience with their provider",
      "file_id": "dr_KD0321",
      "chunk_id": 24
    },
    {
      "code": "Allergy season",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "It's allergy season",
      "context": "Patient mentions allergy season as a potential challenge",
      "file_id": "dr_KD0321",
      "chunk_id": 24
    },
    {
      "code": "Health Education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "More education",
      "context": "Patient appreciates educational content in waiting room",
      "file_id": "dr_KD0321",
      "chunk_id": 25
    },
    {
      "code": "Provider Education",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "they're reaching out, in that way",
      "context": "Patient values provider's effort to educate",
      "file_id": "dr_KD0321",
      "chunk_id": 25
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "Who's ever had enough education?",
      "context": "Patient expresses need for more education",
      "file_id": "dr_KD0321",
      "chunk_id": 26
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "Provide education",
      "context": "Patient suggests providing education as a facilitator",
      "file_id": "dr_KD0321",
      "chunk_id": 26
    },
    {
      "code": "Diabetes self-management support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "self-advocated",
      "context": "Patient mentions self-advocacy as a facilitator",
      "file_id": "dr_KD0321",
      "chunk_id": 26
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "Reading more about diabetes",
      "context": "Patient takes initiative to learn about diabetes",
      "file_id": "dr_KD0321",
      "chunk_id": 27
    },
    {
      "code": "Community resources",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Community health programs",
      "quote": "they do offer them in the community",
      "context": "Patient aware of community-based diabetes programs",
      "file_id": "dr_KD0321",
      "chunk_id": 27
    },
    {
      "code": "Positive staff",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "staff are very, patient-oriented",
      "context": "Patient praises clinic staff",
      "file_id": "dr_KD0321",
      "chunk_id": 28
    },
    {
      "code": "Smooth process",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "Bangsolutely. Start to finish",
      "context": "Patient describes efficient clinic experience",
      "file_id": "dr_KD0321",
      "chunk_id": 28
    },
    {
      "code": "Patient-oriented staff",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "staff are very, patient-oriented",
      "context": "Patient appreciates the clinic's patient-centered approach",
      "file_id": "dr_KD0321",
      "chunk_id": 29
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "staff are very, patient-oriented",
      "context": "Patient values the positive interaction with clinic staff",
      "file_id": "dr_KD0321",
      "chunk_id": 29
    }
  ]
}