title: Barriers to and Suggestions on Improving Utilization of Eye Care in High-Risk Individuals: Focus Group Results.
abstract: 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, NUD(*)IST 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.
authors.affiliation: Duke University Eye Center, Duke University School of Medicine, Durham, NC 27710, USA; Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Elam
authors.affiliation: Duke University Eye Center, Duke University School of Medicine, Durham, NC 27710, USA; Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee