Understanding Patient Experience With Past Barriers to Eye Care and How Barriers Were Addressed in the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program.

Abstract

To use community engaged research to understand barriers to eye care utilization and explore participant experiences with free glaucoma screenings through the Michigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program. Qualitative study. Purposive sampling of 42 participants out of 254 total participants from 2 community clinics in Flint and Ypsilanti, Michigan enrolled between 10/29/21 and 12/22/21. We conducted semi-structured interviews that explored past barriers to eye care, motivations for attending and overall experience with the MI-SIGHT program. Interviews were transcribed then coded using Grounded Theory; and thematic analysis was completed. Themes were compared between (1) the 2 clinics; (2) those who did and did not screen positive for glaucoma; and (3) of those who screened positive for glaucoma, comparing between those randomized to standard care and those randomized to personalized coaching and education. The most common past barriers to eye care included cost, insurance status, and transportation. Motivations to attending glaucoma screenings with the MI-SIGHT program included affordability, location of community clinics, and having a trusted referral source endorse the program. Overall, participants most valued the rapport and communication received when interacting with the ophthalmic technicians who also acted as care navigators as part of MI-SIGHT. The MI-SIGHT program was able to address barriers such as cost and transportation through having free eye screenings located at the community clinic. Developing trust and rapport with the participants and the community clinics was critical to the program's high satisfaction rates.