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

Table 2

Examples of suggested changes to current eye care system.

Category of change (% of total comments, = 104)	Example
Education (33.6%)	“Social Services Agency can be used as focal points to make educational presentations. You can do that by contacting the workers there first, so that, with the customer’s permission, the social worker can present the names of people who really need the information.” (Focus group 2, participant 3)
	“You know how they have Fire Prevention Week? Is there an Eye Disease Prevention Week? Maybe we need something like that for the eye. Maybe something though the mail. Or maybe they could send something every month…Stress the importance of eye care.” (Focus group 2, participant 4)
	“I think if you start with children, there won’t be a problem. By the time they’re adults, they’re so used to going to the eye doctor, it’s nothing to them.” (Focus group 4, participant 5)
Cost/insurance (19.2%)	“…you’re supposed to have a yearly physical right? Why can’t they combine that? Why can’t your eye exam be a part of your yearly exam?…as far as insurance or paying goes?” (Focus group 1, participant 5)
	“Well if we had a clinic, funded by the government or whoever, and we had to pay, you know $5 or $10, even $25 or $30. Just something so low-income people could afford to not go blind.” (Focus group 1, participant 1)
Distance to doctor/transportation (11.2%)	“It goes back to incentives to get doctors to come to this area…are any programs for eye doctors that give incentives, whether they’re financial or tuition repayment or whatever, to work in these underserved areas for number of years once you’ve finished? And who knows, while working there, they might get attached and want to stay. So I think the way to get more doctors here won’t come from anything the communities themselves can do. It has to come from outside…there are some people…from communities like this who feel invested enough to come back and help us, but they are few and far between.” (Focus group 2, participant 3)
	“We need more doctors in our community. Or maybe some sort of satellite clinic that brings good doctors to the area. So if Duke is mass-producing good doctors, send some of them our way! Attach themselves to other facilities, put themselves in the community. So that people won’t have the barrier or distance or transportation.” (Focus group 3, participant 4)
	“Well maybe we could have a volunteer service…we’ll volunteer to take people to get their eyes examined. Then more people would volunteer for another month and just do it like that. Through our churches would work. The church has to take care of its people. A lot of people are retired and would love to get out and do something to help others…” (Focus group 2, participant 4)
Social support (10.2%)	“I think we’re aware of preventive eye care and we just don’t do what we need to do. Maybe those who are aware or familiar can get a buddy, a senior citizen that’s your buddy, a person that you could look out for. If you have to take them to the eye doctor, help them keep up with their appointments, and so forth…A buddy system is my suggestion.” (Focus group 2, participant 2)
Communication (9.1%)	“I want them to ask me questions, about how I’m doing. And then about my eyes. Explain things well. And then go on and tell me what we’re going to do. Answer my questions with honest answers. If they do that, we’ll have no problems.” (Focus group 2, participant 4)
	“Talk to me! Sit down and talk to me. Explain what you’re gonna do. The last doctor, he told me what he was gonna do, what he was gonna check…and that’s exactly what he did. So I felt real comfortable with him.” (Focus group 3, participant 6)
Doctor-patient relationship (8.1%)	“…If people are made to feel like they are apart of what you’re doing to them and for them, you’ll get cooperation.” (Focus group 3, participant 4)
	“I think it’s their attitude. They should be a little nicer and be concerned more about the patient.” (Focus group 1, participant 6)
	“…don’t talk down to me. Make sure the doctor is patient and willing to explain any terms that are unfamiliar.” (Focus group 2, participant 3)
Government (5.1%)	“With all the money the government has, why not have an eye care card? Something where people could go to and access that…have a listing of programs that would serve for that plan. It would at least give people a window to get what they need for the eye.” (Focus group 3, participant 4)
Service at clinic (4.0%)	“I mean, they do need a different way to schedule patients. They schedule everyone to come in at 8 am knowing they’re not gonna see them until 3 in the afternoon!…my father…he’s old, sitting around for 5 or 6 hours, that’s hard. So regardless of whether the eye doctor’s good or not, you’re already angry!” (Focus group 3, participant 3)
	“Well I’m looking at it not just from the doctor, but the entire office. When I walk in the door, do the receptionists and nurses greet me with a smile? Are they polite to me? You know, telling me what’s going to happen. If the doctor is running late, you know they acknowledge it and apologize…It would be a perfect visit.” (Focus group 2, participant 3)