{
  "file_id": "dr_SR0511",
  "total_codes": 104,
  "codes": [
    {
      "code": "Lack of self-monitoring",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't check myself, because I use my A1C",
      "context": "Patient does not regularly monitor blood sugar levels",
      "file_id": "dr_SR0511",
      "chunk_id": 0
    },
    {
      "code": "Provider guidance",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I've discussed this with my doctor, I don't check",
      "context": "Patient follows provider's advice on self-monitoring",
      "file_id": "dr_SR0511",
      "chunk_id": 0
    },
    {
      "code": "Medication adherence",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I take medication",
      "context": "Patient is taking prescribed medication for diabetes",
      "file_id": "dr_SR0511",
      "chunk_id": 0
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I use my A1C",
      "context": "Patient understands and uses A1C results to guide care",
      "file_id": "dr_SR0511",
      "chunk_id": 0
    },
    {
      "code": "Lack of perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "I can see fine now",
      "quote": "So, but as of right now, I don't check weekly or even daily because my A1C is good",
      "context": "Patient doesn't feel the need to monitor closely due to good A1C levels",
      "file_id": "dr_SR0511",
      "chunk_id": 1
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I watch how I'm feeling, if I get lightheaded, I will go check it.",
      "context": "Patient relies on physical symptoms to manage diabetes",
      "file_id": "dr_SR0511",
      "chunk_id": 2
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "Making sure I take my medication.",
      "context": "Patient prioritizes medication adherence",
      "file_id": "dr_SR0511",
      "chunk_id": 2
    },
    {
      "code": "Self management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "I watch how I'm feeling, if I get lightheaded, I will go check it.",
      "context": "Patient actively monitors physical symptoms",
      "file_id": "dr_SR0511",
      "chunk_id": 2
    },
    {
      "code": "Lack of awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Because usually I don't crave it all the time.",
      "context": "Patient may not fully understand diabetes management",
      "file_id": "dr_SR0511",
      "chunk_id": 2
    },
    {
      "code": "Physical signs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "If I feel at all that I'm lightheaded or I'm really craving sugar, it makes me go check my",
      "context": "Patient recognizes physical signs of potential issues",
      "file_id": "dr_SR0511",
      "chunk_id": 2
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't think the torn retina is because of the, of, of my diabetes",
      "context": "Patient unsure about relationship between diabetes and eye condition",
      "file_id": "dr_SR0511",
      "chunk_id": 3
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I know that I don't, , I know that the glaucoma is, and I don't know if there's a name for what I have right now",
      "context": "Patient uncertain about diagnosis and treatment",
      "file_id": "dr_SR0511",
      "chunk_id": 3
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "now, it's only affected one eye. So my doctor wasn't sure if it was diabetes, diabetic related, but when I went to the, another, , I think it was my ENT, they were , yeah, it's definitely diabetic related, so...",
      "context": "Patient has trust in provider's diagnosis",
      "file_id": "dr_SR0511",
      "chunk_id": 3
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I know that I don't, , I know that the glaucoma is, and I don't know if there's a name for what I have right now",
      "context": "Patient lacks knowledge about condition, needs health education",
      "file_id": "dr_SR0511",
      "chunk_id": 3
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "now, it's only affected one eye. So my doctor wasn't sure if it was diabetes, diabetic related, but when I went to the, another, , I think it was my ENT, they were , yeah, it's definitely diabetic related, so...",
      "context": "Patient has access to multiple providers for diagnosis",
      "file_id": "dr_SR0511",
      "chunk_id": 3
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I had a bleed. I think they called it a stroke, which is just an eye stroke, not a heart stroke, but an eye stroke",
      "context": "Patient shows limited knowledge of diabetic retinopathy and its effects",
      "file_id": "dr_SR0511",
      "chunk_id": 4
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I had a bleed. I think they called it a stroke, which is just an eye stroke, not a heart stroke, but an eye stroke",
      "context": "Patient's experience with a bleed and subsequent diagnosis may indicate fear",
      "file_id": "dr_SR0511",
      "chunk_id": 4
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "And while I was with Dr. G, we found that I had, a torn retina",
      "context": "Patient received care from Dr. G, indicating access to healthcare",
      "file_id": "dr_SR0511",
      "chunk_id": 4
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "And while I was with Dr. G, we found that I had, a torn retina",
      "context": "Patient's interaction with Dr. G suggests a positive relationship",
      "file_id": "dr_SR0511",
      "chunk_id": 4
    },
    {
      "code": "Lack of passion",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Patient beliefs about condition",
      "quote": "the passion I used to feel for reading a book, I don't have it",
      "context": "Patient expresses decreased motivation due to health changes",
      "file_id": "dr_SR0511",
      "chunk_id": 5
    },
    {
      "code": "Brain fog",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I'll miss a whole chapter of a book because I just went brain fog",
      "context": "Patient experiences cognitive difficulties",
      "file_id": "dr_SR0511",
      "chunk_id": 5
    },
    {
      "code": "Loss of interest",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I don't actually have the feel of the book in my hand",
      "context": "Patient expresses loss of enjoyment in activities due to health changes",
      "file_id": "dr_SR0511",
      "chunk_id": 5
    },
    {
      "code": "Lack of awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Probably a year ago when I, when I scheduled a regular eye appointment to get new glasses",
      "context": "Patient was unaware of potential vision problems until incidentally discovered during routine appointment",
      "file_id": "dr_SR0511",
      "chunk_id": 6
    },
    {
      "code": "Incidental discovery",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "They found the stroke and sent me here",
      "context": "Patient received timely referral to specialist after unexpected diagnosis",
      "file_id": "dr_SR0511",
      "chunk_id": 6
    },
    {
      "code": "Lack of awareness",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I think that was a, a, a really sweet find",
      "context": "Patient seems unaware of the severity of their condition",
      "file_id": "dr_SR0511",
      "chunk_id": 7
    },
    {
      "code": "Previous healthcare experience",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Dr. Pagali had done the laser surgery",
      "context": "Patient has had positive experiences with healthcare providers in the past",
      "file_id": "dr_SR0511",
      "chunk_id": 7
    },
    {
      "code": "Existing health condition",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "the glaucoma, I knew about the glaucoma",
      "context": "Patient has existing health conditions that may impact their perception of DR",
      "file_id": "dr_SR0511",
      "chunk_id": 7
    },
    {
      "code": "Healthcare provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "Dr. Pagali had done the laser surgery",
      "context": "Patient has a established relationship with their healthcare provider",
      "file_id": "dr_SR0511",
      "chunk_id": 7
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "I haven't spoken, , in depth",
      "context": "Patient lacks understanding about diabetes and eye health",
      "file_id": "dr_SR0511",
      "chunk_id": 8
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I mean, I feel that this place is very, very good",
      "context": "Patient has positive experience with healthcare provider",
      "file_id": "dr_SR0511",
      "chunk_id": 8
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I mean, I feel that this place is very, very good",
      "context": "Patient has access to healthcare services",
      "file_id": "dr_SR0511",
      "chunk_id": 8
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I haven't spoken, , in depth",
      "context": "Patient lacks in-depth knowledge about diabetes impact on eyes",
      "file_id": "dr_SR0511",
      "chunk_id": 9
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I think Dr. G is very, very, , , he'll ask me questions",
      "context": "Patient appreciates engaging and inquiring provider",
      "file_id": "dr_SR0511",
      "chunk_id": 9
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "if I had questions, they would be answered",
      "context": "Patient feels confident in provider's ability to address concerns",
      "file_id": "dr_SR0511",
      "chunk_id": 9
    },
    {
      "code": "Healthcare system support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I mean, I feel that this place is very, very good",
      "context": "Patient has positive impression of healthcare facility",
      "file_id": "dr_SR0511",
      "chunk_id": 9
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "Dr. McNair, , does a really good job of keeping my diabetic, betes under control",
      "context": "Patient appreciates provider's efforts in managing diabetes",
      "file_id": "dr_SR0511",
      "chunk_id": 9
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "since I've went to Dr. McNair, I've got it under control",
      "context": "Patient feels comfortable with current provider",
      "file_id": "dr_SR0511",
      "chunk_id": 10
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "If I needed to, I could",
      "context": "Patient feels able to ask questions",
      "file_id": "dr_SR0511",
      "chunk_id": 10
    },
    {
      "code": "Patient empowerment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "And I'm, I'm okay with what, I mean, what I know I'm, I'm fine",
      "context": "Patient feels informed and in control",
      "file_id": "dr_SR0511",
      "chunk_id": 10
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "there are no longer any eye doctors in Preston County",
      "context": "Patient mentions lack of local eye care providers",
      "file_id": "dr_SR0511",
      "chunk_id": 11
    },
    {
      "code": "Accessible provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I went to the eye doctor at the Walmart, on 219, right off the interstate",
      "context": "Patient found an accessible alternative for eye care",
      "file_id": "dr_SR0511",
      "chunk_id": 11
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "she immediately found the problem I was having",
      "context": "Patient praises provider's effective diagnosis and communication",
      "file_id": "dr_SR0511",
      "chunk_id": 11
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "I feel very good, that she just immediately found the problem and took care of it",
      "context": "Patient feels positive about provider's care and attitude",
      "file_id": "dr_SR0511",
      "chunk_id": 11
    },
    {
      "code": "Lack of technology",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of access to healthcare",
      "quote": "the eye doctor I had in Preston County, he was no longer there, didn't have that technology",
      "context": "Patient's previous doctor lacked necessary technology",
      "file_id": "dr_SR0511",
      "chunk_id": 12
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "the doctor I'm going to now does have the newer technology",
      "context": "Patient's current doctor has necessary technology",
      "file_id": "dr_SR0511",
      "chunk_id": 12
    },
    {
      "code": "Expensive treatments",
      "category": "BARRIER - Cost-Related Barriers",
      "subcategory": "Expensive treatments/surgery",
      "quote": "But usually my glasses are pretty expensive",
      "context": "Patient mentions high cost of glasses due to bad vision",
      "file_id": "dr_SR0511",
      "chunk_id": 13
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I think, did they dilate me today? No, they didn't dilate me",
      "context": "Patient seems unsure about eye exam procedures",
      "file_id": "dr_SR0511",
      "chunk_id": 13
    },
    {
      "code": "Infrequent exams",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "No perceived urgency",
      "quote": "Probably two months ago",
      "context": "Patient had not had a dilated eye exam recently",
      "file_id": "dr_SR0511",
      "chunk_id": 13
    },
    {
      "code": "Healthcare access",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "I'll either go through, I think it's called Rennie, or I'll buy the glasses there",
      "context": "Patient mentions possible insurance coverage for glasses",
      "file_id": "dr_SR0511",
      "chunk_id": 13
    },
    {
      "code": "Regular check-ups",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "It, well, I've been monthly",
      "context": "Patient believes in regular eye check-ups",
      "file_id": "dr_SR0511",
      "chunk_id": 13
    },
    {
      "code": "Lack of self management",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I'm getting shots in my eyes and I definitely can't do that myself",
      "context": "Patient relies on healthcare providers for treatment",
      "file_id": "dr_SR0511",
      "chunk_id": 14
    },
    {
      "code": "Perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now' (no perceived urgency)",
      "quote": "once I get this problem under control, I think I should go yearly",
      "context": "Patient believes less frequent visits are needed when condition is controlled",
      "file_id": "dr_SR0511",
      "chunk_id": 14
    },
    {
      "code": "Provider Relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I'm getting shots in my eyes",
      "context": "Patient receives regular treatment from provider",
      "file_id": "dr_SR0511",
      "chunk_id": 14
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I've been monthly",
      "context": "Patient has access to regular appointments",
      "file_id": "dr_SR0511",
      "chunk_id": 14
    },
    {
      "code": "Scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "So sometimes that's difficult and it has to be done in a four-week time",
      "context": "Patient experiences difficulty scheduling appointments",
      "file_id": "dr_SR0511",
      "chunk_id": 15
    },
    {
      "code": "Limited appointment times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "because I'm a teacher, I can only do after school",
      "context": "Patient has limited availability for appointments",
      "file_id": "dr_SR0511",
      "chunk_id": 15
    },
    {
      "code": "Transportation issues",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "Just driving in Morgantown. (Laughs) I'm from rural Preston County, so... I gotta go to Morgantown",
      "context": "Patient experiences difficulty traveling to clinic due to rural location",
      "file_id": "dr_SR0511",
      "chunk_id": 16
    },
    {
      "code": "Accessible providers",
      "category": "B. FACILITATORS TO FOLLOW-UP",
      "subcategory": "1. Healthcare System Support",
      "quote": "They've, they've totally accommodated me.",
      "context": "Patient feels supported by healthcare providers",
      "file_id": "dr_SR0511",
      "chunk_id": 16
    },
    {
      "code": "Appointment scheduling flexibility",
      "category": "B. FACILITATORS TO FOLLOW-UP",
      "subcategory": "1. Healthcare System Support",
      "quote": "And they've always given me lots of options.",
      "context": "Patient appreciates flexible appointment scheduling",
      "file_id": "dr_SR0511",
      "chunk_id": 16
    },
    {
      "code": "Transportation issues",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "Just driving in Morgantown. (Laughs) I'm from rural Preston County, so... I gotta go to Morgantown.",
      "context": "Patient faces challenges due to rural location",
      "file_id": "dr_SR0511",
      "chunk_id": 17
    },
    {
      "code": "Accessible providers",
      "category": "B. FACILITATORS TO FOLLOW-UP",
      "subcategory": "1. Healthcare System Support",
      "quote": "This, , doc, the WVU eye care is very prompt. I mean, I literally sat down for one minute and they called my name",
      "context": "Patient praises promptness of healthcare providers",
      "file_id": "dr_SR0511",
      "chunk_id": 17
    },
    {
      "code": "Prompt service",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "the WVU eye care is very prompt",
      "context": "Patient appreciates the efficiency of the clinic",
      "file_id": "dr_SR0511",
      "chunk_id": 18
    },
    {
      "code": "Short wait times",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I literally sat down for one minute and they called my name",
      "context": "Patient experiences minimal waiting time",
      "file_id": "dr_SR0511",
      "chunk_id": 18
    },
    {
      "code": "Efficient appointments",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I'm in and I'm out",
      "context": "Patient values the quick appointment process",
      "file_id": "dr_SR0511",
      "chunk_id": 18
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Wait times",
      "quote": "Literally, when I go and say I'm here, for them to call my name and for me to get everything done and the shot in my eye is, is usually less than half an hour",
      "context": "Patient describes wait time as relatively short",
      "file_id": "dr_SR0511",
      "chunk_id": 19
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "they literally found it and they literally took care of it right there",
      "context": "Patient appreciates prompt care from provider",
      "file_id": "dr_SR0511",
      "chunk_id": 19
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "And they asked me if I wanted it done, I'm , 'Yes'",
      "context": "Patient engages in shared decision-making with provider",
      "file_id": "dr_SR0511",
      "chunk_id": 19
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "I was thankful for that",
      "context": "Patient expresses gratitude towards provider",
      "file_id": "dr_SR0511",
      "chunk_id": 19
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "And then they just took care of it",
      "context": "Patient received immediate care",
      "file_id": "dr_SR0511",
      "chunk_id": 20
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "And they asked me if I wanted it done, I'm , 'Yes'",
      "context": "Patient felt heard by provider",
      "file_id": "dr_SR0511",
      "chunk_id": 20
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "so what are some ways you take care of your eyes?",
      "context": "Patient is educated on eye care",
      "file_id": "dr_SR0511",
      "chunk_id": 20
    },
    {
      "code": "Light sensitivity",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I'm just really, really sensitive to the light",
      "context": "Patient experiences discomfort due to light sensitivity",
      "file_id": "dr_SR0511",
      "chunk_id": 20
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "I didn't know I could",
      "context": "Patient unaware of potential supplements for eye health",
      "file_id": "dr_SR0511",
      "chunk_id": 21
    },
    {
      "code": "Light sensitivity",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "None",
      "quote": "I'm just really, really sensitive to the light",
      "context": "Patient experiences discomfort due to light sensitivity after dilation",
      "file_id": "dr_SR0511",
      "chunk_id": 21
    },
    {
      "code": "Lack of knowledge",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I didn't know I could",
      "context": "Patient unaware of potential supplements for eye health",
      "file_id": "dr_SR0511",
      "chunk_id": 22
    },
    {
      "code": "Education barriers",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "I didn't even think about it",
      "context": "Patient lacks awareness of potential treatments or discussions with doctor",
      "file_id": "dr_SR0511",
      "chunk_id": 22
    },
    {
      "code": "Healthcare System Support",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "definitely something you could discuss with your doctor",
      "context": "Patient encouraged to discuss supplements with doctor",
      "file_id": "dr_SR0511",
      "chunk_id": 22
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "(laughs)",
      "context": "Interviewer shows understanding and empathy towards patient's lack of knowledge",
      "file_id": "dr_SR0511",
      "chunk_id": 22
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "they haven't replied",
      "context": "Patient requested better computer for work due to vision issues but was ignored",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - SDOH",
      "subcategory": "Financial constraints",
      "quote": "I've requested from my special-ed director, a better computer",
      "context": "Patient needs better computer for work due to vision issues but may not be able to afford it",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Education/health literacy barriers",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "Which I think affects the, the eyes",
      "context": "Patient lacks understanding of how diabetes medications affect their eyes",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Lack of understanding about DR progression",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Which I think affects the, the eyes",
      "context": "Patient lacks understanding of how diabetes medications affect their eyes",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Feeling overwhelmed",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "it's very hard to type on my computer and see the screen when I'm that close up",
      "context": "Patient struggles with daily activities due to vision issues",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I've requested from my special-ed director, a better computer",
      "context": "Patient receives support from special-ed director for work accommodations",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I take stuff for my diabetes",
      "context": "Patient is aware of their diabetes management and takes medications",
      "file_id": "dr_SR0511",
      "chunk_id": 23
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No, just the fact that having diabetes can be very bad for your eyes",
      "context": "Patient lacks detailed knowledge about diabetes effects on vision",
      "file_id": "dr_SR0511",
      "chunk_id": 24
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "They have told me, I am aware",
      "context": "Patient has received some health education from doctors",
      "file_id": "dr_SR0511",
      "chunk_id": 24
    },
    {
      "code": "Self management support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "I've done what I can to take care of the glaucoma",
      "context": "Patient takes initiative in managing their condition",
      "file_id": "dr_SR0511",
      "chunk_id": 24
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "No, just the fact that having diabetes can be very bad for your eyes",
      "context": "Patient lacks detailed knowledge about diabetes effects on eyes",
      "file_id": "dr_SR0511",
      "chunk_id": 25
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "if they say this needs to be done, I do it",
      "context": "Patient trusts provider's recommendations",
      "file_id": "dr_SR0511",
      "chunk_id": 25
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "They have told you? What are, do you remember anything specific that they said to you?",
      "context": "Patient receives health information from providers",
      "file_id": "dr_SR0511",
      "chunk_id": 25
    },
    {
      "code": "Adherence to treatment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I do do the drops in my eyes twice a day",
      "context": "Patient follows prescribed treatment regimen",
      "file_id": "dr_SR0511",
      "chunk_id": 25
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "if they say this needs to be done, I do it",
      "context": "Patient feels heard and understood by provider",
      "file_id": "dr_SR0511",
      "chunk_id": 25
    },
    {
      "code": "Lack of symptoms",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "No perceived urgency",
      "quote": "because it never hurt",
      "context": "Patient doesn't feel urgency due to lack of symptoms",
      "file_id": "dr_SR0511",
      "chunk_id": 26
    },
    {
      "code": "Provider awareness",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "they're aware of my issue and I haven't had to ask them",
      "context": "Patient feels provider is proactive in their care",
      "file_id": "dr_SR0511",
      "chunk_id": 26
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "I guess I would tell them any symptoms I had",
      "context": "Patient feels comfortable sharing information with provider",
      "file_id": "dr_SR0511",
      "chunk_id": 26
    },
    {
      "code": "Patient motivation",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I really wanna continue to drive. And, and live a fulfilled life",
      "context": "Patient is motivated to manage their condition",
      "file_id": "dr_SR0511",
      "chunk_id": 26
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I didn't even know I had it",
      "context": "Patient was unaware of their condition",
      "file_id": "dr_SR0511",
      "chunk_id": 27
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "I can see fine now",
      "quote": "it never hurt",
      "context": "Patient did not feel symptoms and therefore didn't perceive a need for follow-up",
      "file_id": "dr_SR0511",
      "chunk_id": 27
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "what supplements I could do",
      "context": "Patient is interested in learning about self-care and prevention",
      "file_id": "dr_SR0511",
      "chunk_id": 27
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "they become aware of it before I know if there's issues",
      "context": "Patient feels their provider is proactive and caring",
      "file_id": "dr_SR0511",
      "chunk_id": 27
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I didn't know about the fish oil",
      "context": "Patient is learning about new health information and seeking knowledge",
      "file_id": "dr_SR0511",
      "chunk_id": 27
    },
    {
      "code": "Lack of education",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Education/health literacy barriers",
      "quote": "I didn't know there were eye, eye supplements",
      "context": "Patient lacks knowledge about available treatments",
      "file_id": "dr_SR0511",
      "chunk_id": 28
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "how serious you think the vision loss is because of diabetes",
      "context": "Patient unsure about severity of vision loss due to diabetes",
      "file_id": "dr_SR0511",
      "chunk_id": 28
    }
  ]
}