{
  "file_id": "dr_SE0108",
  "total_codes": 137,
  "codes": [
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Oh, now you're asking a big question",
      "context": "Patient seems uncertain about their medication",
      "file_id": "dr_SE0108",
      "chunk_id": 1
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "So, , do you have diabetes?",
      "context": "Interviewer inquires about patient's diabetes, potentially indicating a health education opportunity",
      "file_id": "dr_SE0108",
      "chunk_id": 1
    },
    {
      "code": "Medication management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "Take medicine in the morning and take medicine at night and take a, a shot at night",
      "context": "Patient describes their daily medication routine",
      "file_id": "dr_SE0108",
      "chunk_id": 1
    },
    {
      "code": "Lack of health literacy",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "And I don't even have my list on me",
      "context": "Patient seems unsure about their medication",
      "file_id": "dr_SE0108",
      "chunk_id": 2
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "My doctor's gotten me on half-decent medicine now",
      "context": "Patient expresses satisfaction with their doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 2
    },
    {
      "code": "Access to effective treatment",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "My numbers have all come down",
      "context": "Patient has seen improvement in their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 2
    },
    {
      "code": "Lack of adherence",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "No perceived urgency",
      "quote": "Don't want to take medicine",
      "context": "Patient initially refused medication",
      "file_id": "dr_SE0108",
      "chunk_id": 3
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I wasn't taking medicine for probably a year or so",
      "context": "Patient avoided treatment due to fear",
      "file_id": "dr_SE0108",
      "chunk_id": 3
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "That's when I first started being old, hard-headed",
      "context": "Patient learned about importance of adherence",
      "file_id": "dr_SE0108",
      "chunk_id": 3
    },
    {
      "code": "Weight loss motivation",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "I lost 72 pounds- ... doing that",
      "context": "Patient motivated by health improvements",
      "file_id": "dr_SE0108",
      "chunk_id": 3
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I figured I better start doing something or I'm just gonna fade away",
      "context": "Patient's motivation to take medicine due to significant weight loss",
      "file_id": "dr_SE0108",
      "chunk_id": 4
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "everybody looked at me and thought I had AIDS because I lost that much weight",
      "context": "Patient's fear of being judged or misdiagnosed",
      "file_id": "dr_SE0108",
      "chunk_id": 4
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "what are some things that your doctor may have discussed, that you think may be important for people with diabetes to do?",
      "context": "Patient's awareness of importance of health education",
      "file_id": "dr_SE0108",
      "chunk_id": 4
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "did you feel you were able to express that with your doctor and you came to an agreement?",
      "context": "Patient's perception of provider's empathy and understanding",
      "file_id": "dr_SE0108",
      "chunk_id": 4
    },
    {
      "code": "Lack of health education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Well, no, I still have, what would you say? My DNA is one of-",
      "context": "Patient seems uncertain about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 5
    },
    {
      "code": "Poor diet awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "And I eat candy bars and candy and stuff that. They're in sweets that I shouldn't.",
      "context": "Patient acknowledges unhealthy eating habits",
      "file_id": "dr_SE0108",
      "chunk_id": 5
    },
    {
      "code": "Health education importance",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "People pay attention to what they're eating-",
      "context": "Patient emphasizes the need for awareness about diet",
      "file_id": "dr_SE0108",
      "chunk_id": 5
    },
    {
      "code": "Self management support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "People pay attention to what they're eating- ... and how it does react to your-",
      "context": "Patient highlights the importance of understanding food effects",
      "file_id": "dr_SE0108",
      "chunk_id": 5
    },
    {
      "code": "Lack of symptoms",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "No perceived urgency",
      "quote": "mine very seldom gives me any signals",
      "context": "Patient doesn't experience noticeable symptoms when sugar levels are high",
      "file_id": "dr_SE0108",
      "chunk_id": 6
    },
    {
      "code": "Emotional cues",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I get aggravated easier",
      "context": "Patient experiences emotional changes when sugar levels are high",
      "file_id": "dr_SE0108",
      "chunk_id": 6
    },
    {
      "code": "Lack of awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I, mine very seldom gives me any signals",
      "context": "Patient lacks awareness of diabetes symptoms",
      "file_id": "dr_SE0108",
      "chunk_id": 7
    },
    {
      "code": "Emotional cues",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Depression/anxiety",
      "quote": "I get aggravated easier- ... and mad easier",
      "context": "Patient experiences emotional changes when sugar is high",
      "file_id": "dr_SE0108",
      "chunk_id": 7
    },
    {
      "code": "Spousal support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "And then she explains it to you-",
      "context": "Patient receives support from spouse",
      "file_id": "dr_SE0108",
      "chunk_id": 7
    },
    {
      "code": "Increased awareness",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "and you watch for it then, and then you notice- ... it's actually happening",
      "context": "Patient becomes more aware of diabetes symptoms with support",
      "file_id": "dr_SE0108",
      "chunk_id": 7
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "My eyes were probably better and 20/20 for almost my whole life. And then it started getting a little bit worse",
      "context": "Patient describes decline in vision without understanding the cause",
      "file_id": "dr_SE0108",
      "chunk_id": 8
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "She's my alarm clock. She keeps me awake.",
      "context": "Patient values provider's support and reminders",
      "file_id": "dr_SE0108",
      "chunk_id": 8
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "My visibility started going a little bit on it",
      "context": "Patient seems unsure about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 9
    },
    {
      "code": "Age related issues",
      "category": "BARRIER - Social Determinants of Health (SDOH)",
      "subcategory": "Education/health literacy barriers",
      "quote": "72 years old, you expect to do that",
      "context": "Patient attributes declining eyesight to age",
      "file_id": "dr_SE0108",
      "chunk_id": 9
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "They did, they said my num- my numbers were very high",
      "context": "Patient seems concerned about their test results",
      "file_id": "dr_SE0108",
      "chunk_id": 9
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "They did, they said my num- my numbers were very high",
      "context": "Provider clearly explained patient's test results",
      "file_id": "dr_SE0108",
      "chunk_id": 9
    },
    {
      "code": "Patient empowerment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I use readers and stuff that",
      "context": "Patient is taking steps to manage their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 9
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I have sugar with idiopathic or whatever the heck it's called",
      "context": "Patient shows lack of understanding about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 10
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?",
      "context": "Patient receives clear explanation from provider",
      "file_id": "dr_SE0108",
      "chunk_id": 10
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?",
      "context": "Patient receives health education from provider",
      "file_id": "dr_SE0108",
      "chunk_id": 10
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?",
      "context": "Patient has positive interaction with provider",
      "file_id": "dr_SE0108",
      "chunk_id": 10
    },
    {
      "code": "Access to healthcare",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "I've even been to Philadelphia",
      "context": "Patient had to travel far to see a specialist",
      "file_id": "dr_SE0108",
      "chunk_id": 11
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "seen the best eye doctor in the United States",
      "context": "Patient has access to high-quality care",
      "file_id": "dr_SE0108",
      "chunk_id": 11
    },
    {
      "code": "Regular scheduling",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "I get eye exams every six months",
      "context": "Patient is able to maintain regular follow-up appointments",
      "file_id": "dr_SE0108",
      "chunk_id": 11
    },
    {
      "code": "Access to healthcare",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "I've even been to Philadelphia",
      "context": "Patient had to travel far to see a specialist",
      "file_id": "dr_SE0108",
      "chunk_id": 12
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "seen the best eye doctor in the United States",
      "context": "Patient has access to high-quality care",
      "file_id": "dr_SE0108",
      "chunk_id": 12
    },
    {
      "code": "Provider Relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "my eye doctor, he sent me to go ahead and get all my moles checked",
      "context": "Patient trusts and follows provider's recommendations",
      "file_id": "dr_SE0108",
      "chunk_id": 12
    },
    {
      "code": "Resources Access",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "they removed one",
      "context": "Patient has access to necessary treatments",
      "file_id": "dr_SE0108",
      "chunk_id": 12
    },
    {
      "code": "Lack of awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "So if I wouldn't have had my eyes checked- ... he wouldn't have seen that and wouldn't have sent me.",
      "context": "Patient implies they didn't know the importance of eye checks",
      "file_id": "dr_SE0108",
      "chunk_id": 13
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "One of the best ones.",
      "context": "Patient expresses satisfaction with their eye doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 13
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "One of the best ones.",
      "context": "Patient has access to a good eye doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 13
    },
    {
      "code": "Regular health checks",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I get shots now in 'em every eight weeks",
      "context": "Patient is proactive about their eye health",
      "file_id": "dr_SE0108",
      "chunk_id": 13
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I couldn't see- ... the light in there probably",
      "context": "Patient seems uncertain about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 14
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "It's okay",
      "context": "Interviewer shows understanding and empathy",
      "file_id": "dr_SE0108",
      "chunk_id": 14
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Always had good vision, had no problems, what I mean?",
      "context": "Patient previously didn't see the need for regular eye checks due to good vision",
      "file_id": "dr_SE0108",
      "chunk_id": 15
    },
    {
      "code": "Perceived necessity",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I have to do it. I have to, every eight weeks they check my eyes",
      "context": "Patient now understands the importance of regular eye checks",
      "file_id": "dr_SE0108",
      "chunk_id": 15
    },
    {
      "code": "Regular scheduling",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "every eight weeks they check my eyes",
      "context": "Patient has a regular schedule for eye checks",
      "file_id": "dr_SE0108",
      "chunk_id": 15
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "they've all been excellent. I have no complaints about them at all.",
      "context": "Patient expresses satisfaction with healthcare providers",
      "file_id": "dr_SE0108",
      "chunk_id": 16
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "they've all been excellent. I have no complaints about them at all.",
      "context": "Patient implies effective communication with providers",
      "file_id": "dr_SE0108",
      "chunk_id": 16
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "they've all been excellent. I have no complaints about them at all.",
      "context": "Patient feels understood and supported by providers",
      "file_id": "dr_SE0108",
      "chunk_id": 16
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Well, I have no problem",
      "context": "Patient finds scheduling process easy",
      "file_id": "dr_SE0108",
      "chunk_id": 17
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "They ask us and then they ask us what time",
      "context": "Patient experiences clear communication with staff",
      "file_id": "dr_SE0108",
      "chunk_id": 17
    },
    {
      "code": "Patient navigation services",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Patient navigation services",
      "quote": "They say what day, what days are available",
      "context": "Staff assists patient with scheduling process",
      "file_id": "dr_SE0108",
      "chunk_id": 17
    },
    {
      "code": "Provider Response Time",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "they get back to us, i, I could say within an hour or so",
      "context": "Patient appreciates prompt response from provider",
      "file_id": "dr_SE0108",
      "chunk_id": 18
    },
    {
      "code": "Provider Availability",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Is your doctor's availability, , what does that look ? is there availability open?",
      "context": "Patient inquires about provider's schedule",
      "file_id": "dr_SE0108",
      "chunk_id": 18
    },
    {
      "code": "Effective Communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "they're really right up on-",
      "context": "Patient feels informed and supported by provider",
      "file_id": "dr_SE0108",
      "chunk_id": 18
    },
    {
      "code": "Provider System Issues",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "he's not asking nobody. He knows it already",
      "context": "Patient perceives provider as not communicative",
      "file_id": "dr_SE0108",
      "chunk_id": 19
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "the only place that I seen that really worked different was in Philadelphia",
      "context": "Patient praises healthcare system in Philadelphia",
      "file_id": "dr_SE0108",
      "chunk_id": 19
    },
    {
      "code": "Effective Communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Any question she's asked was answered right now by somebody standing right there",
      "context": "Patient describes effective communication in Philadelphia eye hospital",
      "file_id": "dr_SE0108",
      "chunk_id": 19
    },
    {
      "code": "Short wait times",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I sat today, I bet you a minute and a half",
      "context": "Patient experiences short waiting time at the clinic",
      "file_id": "dr_SE0108",
      "chunk_id": 20
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "Where for when you come in here, he's not asking nobody. He knows it already",
      "context": "Patient feels provider is knowledgeable and communicative",
      "file_id": "dr_SE0108",
      "chunk_id": 20
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "you come in, you stand here and tell 'em who you're seeing, you sit down and-",
      "context": "Patient finds the clinic process easy to navigate",
      "file_id": "dr_SE0108",
      "chunk_id": 20
    },
    {
      "code": "Short wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Wait times",
      "quote": "you end up sitting out there, so it's one after another. If you're on time, they're gonna be on time it seems",
      "context": "Patient experiences short wait times at the clinic",
      "file_id": "dr_SE0108",
      "chunk_id": 21
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "If you're on time, they're gonna be on time it seems",
      "context": "Patient perceives providers as accessible and punctual",
      "file_id": "dr_SE0108",
      "chunk_id": 21
    },
    {
      "code": "Effective self-care",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I always wear safety glasses- ... when I'm doing anything and , I have sunglasses in a car- ... I put on when I get out there. Then I put eyedrops in my eyes three day, three times a day.",
      "context": "Patient engages in effective self-care practices for eye health",
      "file_id": "dr_SE0108",
      "chunk_id": 21
    },
    {
      "code": "Fear of treatment",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I didn't put nothing in my eyeballs after that",
      "context": "Patient had a bad experience with eyedrops",
      "file_id": "dr_SE0108",
      "chunk_id": 22
    },
    {
      "code": "Poor adherence due to past experience",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I didn't put nothing in my eyeballs after that",
      "context": "Patient's past experience influences current behavior",
      "file_id": "dr_SE0108",
      "chunk_id": 22
    },
    {
      "code": "Accessible treatment",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I got it in my pocket right now",
      "context": "Patient has easy access to artificial tears",
      "file_id": "dr_SE0108",
      "chunk_id": 22
    },
    {
      "code": "Fear of treatment",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "it hurt so bad in the one eye that the other eye blacked out too",
      "context": "Patient had a bad experience with eyedrops",
      "file_id": "dr_SE0108",
      "chunk_id": 23
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I didn't pay no attention",
      "context": "Patient lacked knowledge about proper use of eyedrops",
      "file_id": "dr_SE0108",
      "chunk_id": 23
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "She come over and she put a drop in my eye and I shoved her all the way across the room",
      "context": "Patient had a bad experience due to lack of clear instructions",
      "file_id": "dr_SE0108",
      "chunk_id": 23
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "it was running an ice pick through your eye, is what it felt",
      "context": "Patient expresses fear of painful treatment",
      "file_id": "dr_SE0108",
      "chunk_id": 24
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I would not put anything in my eye until my eyes got bad",
      "context": "Patient lacks understanding of disease progression",
      "file_id": "dr_SE0108",
      "chunk_id": 24
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Chloe Hatfield: Mm. Okay.",
      "context": "Interviewer shows empathy and understanding",
      "file_id": "dr_SE0108",
      "chunk_id": 24
    },
    {
      "code": "Patient empowerment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I had to start putting eye drops in",
      "context": "Patient takes initiative to manage condition",
      "file_id": "dr_SE0108",
      "chunk_id": 24
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "black out the other eye because it hurts so bad",
      "context": "Patient expresses fear of vision loss",
      "file_id": "dr_SE0108",
      "chunk_id": 25
    },
    {
      "code": "Lack of understanding about DR progression",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "if I didn't stay on my stuff, I'll lose my eyes",
      "context": "Patient lacks understanding of diabetes complications",
      "file_id": "dr_SE0108",
      "chunk_id": 25
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "If I got a problem I'm gonna call him",
      "context": "Patient feels comfortable contacting doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 25
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Your doctor only can fix what you explain is wrong",
      "context": "Patient values open communication with doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 25
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "That's why he gets paid",
      "context": "Patient feels doctor is invested in their care",
      "file_id": "dr_SE0108",
      "chunk_id": 25
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "You feel he's listening to you",
      "context": "Patient feels heard by their doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 26
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Your doctor only can fix what you explain is wrong",
      "context": "Patient understands importance of clear communication with doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 26
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "You feel he's listening to you",
      "context": "Patient has a positive relationship with their doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 26
    },
    {
      "code": "Lack of patient engagement",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No. And they always, I know at least two to three times ask me during the sessions- ... Do you have any questions to ask?",
      "context": "Patient does not ask questions or engage with their doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 26
    },
    {
      "code": "Poor patient-provider communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "No. I don't",
      "context": "Patient does not express preferences or concerns to their doctor",
      "file_id": "dr_SE0108",
      "chunk_id": 26
    },
    {
      "code": "Lack of patient-provider trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "I don't tell them what I would prefer or what I think would be better for you when discussing care",
      "context": "Patient does not express preferences to provider",
      "file_id": "dr_SE0108",
      "chunk_id": 27
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "he paid his way through school and knows more about anything that's wrong than I did",
      "context": "Patient perceives provider as knowledgeable",
      "file_id": "dr_SE0108",
      "chunk_id": 27
    },
    {
      "code": "Patient beliefs about healthcare",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Cultural beliefs about healthcare",
      "quote": "I believe that he paid his way through school and knows more about anything that's wrong than I did",
      "context": "Patient defers to provider due to perceived expertise",
      "file_id": "dr_SE0108",
      "chunk_id": 27
    },
    {
      "code": "Lack of understanding about DR progression",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "If you don't fix it, it's gonna break all the way",
      "context": "Patient has limited understanding of diabetes complications",
      "file_id": "dr_SE0108",
      "chunk_id": 27
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "If you don't fix it, it's gonna break all the way",
      "context": "Patient lacks understanding of diabetes complications",
      "file_id": "dr_SE0108",
      "chunk_id": 28
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "If I don't pay attention to what I'm supposed to be doing-",
      "context": "Patient fears consequences of not managing diabetes",
      "file_id": "dr_SE0108",
      "chunk_id": 28
    },
    {
      "code": "Patient empowerment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "If I don't pay attention to what I'm supposed to be doing-",
      "context": "Patient takes responsibility for managing diabetes",
      "file_id": "dr_SE0108",
      "chunk_id": 28
    },
    {
      "code": "Positive outlook",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I'm hoping not to",
      "context": "Patient has positive attitude towards managing diabetes",
      "file_id": "dr_SE0108",
      "chunk_id": 28
    },
    {
      "code": "Lack of perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "I think is very good for 72 years old",
      "context": "Patient feels their vision is good, implying no urgent need for follow-up",
      "file_id": "dr_SE0108",
      "chunk_id": 29
    },
    {
      "code": "Education/health literacy barriers",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "I can't see any writing, writing in it sometimes",
      "context": "Patient may not fully understand their condition or its implications",
      "file_id": "dr_SE0108",
      "chunk_id": 29
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "What, what is that?",
      "context": "Patient unsure about age-related eyesight decline",
      "file_id": "dr_SE0108",
      "chunk_id": 30
    },
    {
      "code": "Education barriers",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "What, what is that?",
      "context": "Patient lacks understanding of medical term",
      "file_id": "dr_SE0108",
      "chunk_id": 30
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "What, what is that?",
      "context": "Patient shows lack of knowledge about age-related eyesight decline",
      "file_id": "dr_SE0108",
      "chunk_id": 31
    },
    {
      "code": "Family history",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "My aunt's the only one in the family besides me that had it",
      "context": "Patient is aware of family history of diabetes",
      "file_id": "dr_SE0108",
      "chunk_id": 31
    },
    {
      "code": "Lack of health literacy",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "What, what is that?",
      "context": "Patient lacks understanding of medical terms",
      "file_id": "dr_SE0108",
      "chunk_id": 31
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "My doctors seem to be-",
      "context": "Patient has good experience with doctors",
      "file_id": "dr_SE0108",
      "chunk_id": 32
    },
    {
      "code": "Healthcare system support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I just luck out and get a lot of good ones",
      "context": "Patient has access to good healthcare providers",
      "file_id": "dr_SE0108",
      "chunk_id": 32
    },
    {
      "code": "Social support networks",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "my wife worked in the eye field too",
      "context": "Patient has supportive spouse with healthcare knowledge",
      "file_id": "dr_SE0108",
      "chunk_id": 32
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "No, I'm one of the type people that don't go to too many classes",
      "context": "Patient has not participated in diabetes education",
      "file_id": "dr_SE0108",
      "chunk_id": 33
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "she, she yells if I didn't take my medicine",
      "context": "Patient has a supportive family member",
      "file_id": "dr_SE0108",
      "chunk_id": 33
    },
    {
      "code": "Health literacy barriers",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "No, I'm one of the type people that don't go to too many classes",
      "context": "Patient lacks engagement with educational resources",
      "file_id": "dr_SE0108",
      "chunk_id": 33
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "No, I'm one of the type people that don't go to too many classes",
      "context": "Patient has not participated in diabetes education",
      "file_id": "dr_SE0108",
      "chunk_id": 34
    },
    {
      "code": "Unsupportive spouse",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Cultural beliefs about healthcare",
      "quote": "She explains that I'm being stupid by not doing this or taking that",
      "context": "Patient's spouse is not supportive of their health concerns",
      "file_id": "dr_SE0108",
      "chunk_id": 34
    },
    {
      "code": "Lack of emotional support",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "That's, that's aggravating to her",
      "context": "Patient feels frustrated with their spouse's response to health concerns",
      "file_id": "dr_SE0108",
      "chunk_id": 34
    },
    {
      "code": "Supportive partner",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "If I tell her I, I get, it seems a headache in my eye",
      "context": "Patient's spouse is somewhat responsive to their health concerns",
      "file_id": "dr_SE0108",
      "chunk_id": 34
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I could feel it start to drop, whole face dropped",
      "context": "Patient seems unsure about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 35
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "I said, 'For what?'",
      "context": "Patient was not informed about the reason for hospital visit",
      "file_id": "dr_SE0108",
      "chunk_id": 35
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I could feel it start to drop, whole face dropped",
      "context": "Patient seems unsure about their condition",
      "file_id": "dr_SE0108",
      "chunk_id": 36
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "It, it really doesn't right now",
      "context": "Patient does not feel their eyesight is currently limiting",
      "file_id": "dr_SE0108",
      "chunk_id": 36
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "I couldn't see to drive or anything for three months",
      "context": "Patient experienced vision loss affecting daily activities",
      "file_id": "dr_SE0108",
      "chunk_id": 37
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "No, my wife, I drove for a lot of years and I think she was forgetting how to drive",
      "context": "Patient has a supportive spouse",
      "file_id": "dr_SE0108",
      "chunk_id": 37
    },
    {
      "code": "Adaptation strategies",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "so I'm gonna put her back into condition to drive",
      "context": "Patient finds alternative solutions with spouse's help",
      "file_id": "dr_SE0108",
      "chunk_id": 37
    },
    {
      "code": "Fear of treatment",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I'm going home, my eyes are hurting.",
      "context": "Patient expresses fear or reluctance towards eye treatment",
      "file_id": "dr_SE0108",
      "chunk_id": 38
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Pain in my eyes",
      "context": "Patient seems to lack understanding of their condition, focusing on immediate symptoms",
      "file_id": "dr_SE0108",
      "chunk_id": 38
    },
    {
      "code": "Emotional distress",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I'm going home, my eyes are hurting.",
      "context": "Patient expresses emotional distress due to eye pain",
      "file_id": "dr_SE0108",
      "chunk_id": 38
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "There ain't a way in hell I'm going",
      "context": "Patient expresses fear or reluctance to attend follow-up appointment",
      "file_id": "dr_SE0108",
      "chunk_id": 39
    },
    {
      "code": "Lack of understanding about DR progression",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I can see a big black spot right about here",
      "context": "Patient lacks understanding of their condition and its progression",
      "file_id": "dr_SE0108",
      "chunk_id": 39
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "everybody that we've dealt with",
      "context": "Patient expresses satisfaction with healthcare providers",
      "file_id": "dr_SE0108",
      "chunk_id": 39
    },
    {
      "code": "Excellent providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "everybody that we've dealt with have been right on their toes, right on the mark and are, are excellent people",
      "context": "Patient praises healthcare providers",
      "file_id": "dr_SE0108",
      "chunk_id": 40
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "everybody that we've dealt with have been right on their toes, right on the mark and are, are excellent people",
      "context": "Patient has positive experience with providers",
      "file_id": "dr_SE0108",
      "chunk_id": 40
    },
    {
      "code": "Excellent staff",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "The people there were excellent",
      "context": "Patient praises hospital staff",
      "file_id": "dr_SE0108",
      "chunk_id": 41
    },
    {
      "code": "Positive experience",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "Everybody in the hospital was excellent",
      "context": "Patient has good luck with hospitals",
      "file_id": "dr_SE0108",
      "chunk_id": 41
    },
    {
      "code": "Lack of continuity of care",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "everybody looked and says, 'Hey, it's pretty good.' The person who was gonna gimme the drugs come in and says, 'No, we're not having that today.'",
      "context": "Patient experiences inconsistent care from different providers",
      "file_id": "dr_SE0108",
      "chunk_id": 42
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider Relationship",
      "quote": "That's somebody looking out for me",
      "context": "Patient feels cared for by provider",
      "file_id": "dr_SE0108",
      "chunk_id": 42
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider Relationship",
      "quote": "She says, 'We don't know the reaction to your bell palsy and what's going on with your system right now'",
      "context": "Patient receives clear explanation from provider",
      "file_id": "dr_SE0108",
      "chunk_id": 42
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "That's somebody looking out for me.",
      "context": "Patient feels supported by healthcare provider",
      "file_id": "dr_SE0108",
      "chunk_id": 43
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "So the people here have really been good.",
      "context": "Patient appreciates clear communication from providers",
      "file_id": "dr_SE0108",
      "chunk_id": 43
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "I don't wanna make you worse.",
      "context": "Patient feels understood and cared for by provider",
      "file_id": "dr_SE0108",
      "chunk_id": 43
    }
  ]
}