Table of Contents
International Scholarly Research Notices
Volume 2014, Article ID 527831, 8 pages
Research Article

Barriers to and Suggestions on Improving Utilization of Eye Care in High-Risk Individuals: Focus Group Results

1Duke University Eye Center, Duke University School of Medicine, Durham, NC 27710, USA
2Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA

Received 1 May 2014; Revised 15 July 2014; Accepted 23 July 2014; Published 15 October 2014

Academic Editor: Lyne Racette

Copyright © 2014 Angela R. Elam and Paul P. Lee. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To understand barriers facing high-risk individuals and to solicit the suggestions of these individuals, especially nonusers, on how to change the eye care delivery system to better meet their needs. Methods. Four focus groups were conducted. All discussion was audiotaped and transcribed. Content analysis was performed by the authors and with the assistance of qualitative software, Vivo. Results. The most frequently cited barriers include (1) cost, (2) trust, (3) communication, (4) clinic accessibility (transportation/distance), and (5) doctor-patient relationship. In underutilizers, trust was the most identified barrier to care. Suggestions on increasing educational opportunities/awareness of eye care and addressing cost and insurance issues as a means of improving trust and communications were most frequently offered, including using the Department of Social Services as a focal point for eye care education and assessment. Discussion. Trust is a major barrier to eye care, especially among underutilizers of disadvantaged populations. Increasing trust and eye care education at the community and individual levels is essential to increasing eye care utilization.