Table 3 Personas and top five barriers and generated solutions from the 1st, 2nd, and 3rd patients in the community co-development sessions developed with French-speaking and Mandarin-speaking individuals living with diabetes who have migrated from African-Caribbean countries and China
Patients in the Community Group | Workshop 1: Personas | Workshop 2: Barriers/Enablers | Workshop 3: Generated Solutions |
|---|---|---|---|
French-speaking individuals living with diabetes who have migrated from African-Caribbean countries | 1. Abu is a 50-year-old male who lives in Ottawa, has no knowledge about diabetic retinopathy, he finds appointments with his eye specialist very long, he has difficulty getting eye care 2. Clement is a 34-year-old male, he works at night and has diabetes. He has never heard of Diabetic Retinopathy; he is followed by a general practitioner and his doctor has never prescribed an appointment to see an eye specialist 3. Sylvie is 43 years old woman and does not speak English. She has had two diabetes tests and is taking diabetes medication. She is on a diet. She has no information on diabetic Retinopathy | Language | Provide interpreter services |
Not knowing what retinopathy screening is | Organize radio broadcasts, invite during these programs the participants to share their testimony, invitation of medical specialists | ||
Doctor haven’t told him/her about it | The community health team sends reminders (emails, SMS) about screening | ||
Doctor doesn’t help to make Appointment | The doctor must encourage patients to be tested and then make reminders by email (doctor's assistant) or via telephone messaging | ||
Hard to fit eye screening around work and other activities | The doctor or his assistant can send the reminder and include the screening in the periodic examinations | ||
Mandarin-speaking individuals living with diabetes who have migrated from China | 1. Cuihua is a 60-year-old female with type 2 diabetes. She has suffered from severe diabetic retinopathy. Her family doctor suggested to have routinely eye checks every 1-to-2 years. She feels that three issues exist impeding her to do the eye check. First, the language problem. All the hospitals or eye check places use English or French. She cannot speak these two languages. It makes it very difficult for her to communicate with doctors. Her daughter is very busy with her work, and it is difficult for her to take a leave every time to accompany her to eye checks. So Cuihua often delays the eye check or even seldom does the check anymore. Especially during current COVID situation, she cannot go to see the doctor directly, but have to make an appointment. She is unable to make an appointment using English. Secondly, she cannot find the right place to go for eye check. Is it the clinic or eye specialty hospital? Third, before September 2021, it was free to do the eye check. But now it seems that the eye check is not free anymore. She does not have income and have multimorbidity. It seems very expensive to do the eye check 2. Sun is a 67-year-old man who immigrated to Canada 15 years ago. He runs a pub and because of the nature of his work, he has irregular work hours. He smokes and drinks and has suffered from diabetes for 8 years. He does not control his blood sugar well and the main reason is he does not control what he eats. He would like to have an eye check. He does not know whether he suffers from diabetic retinopathy or not. He didn’t know that Ontarians could have free diabetic retinopathy check before this September. He never checked his eyes. His eyesight is ok, not very good. Since the elderly always have some eyesight problems, so he does not care about it a lot. He can speak the daily “pub” English, but medical English is a bit difficult for him. He thinks that it will be great if there are doctors that can speak Mandarin, but we all know there is very few 3. John is 58 years old and have suffered from diabetics for 15 years. He would like to get early screening, early identification, and early treatment. He knows nothing about diabetic retinopathy, its screening, and its severity. He has never heard of eye screening from the family doctor. Each time when he went to the family doctors for medication, the family doctor paid high attention on the diabetic foot and would knock his feet for checkup. But the family doctor never mentioned about the eye check or did any eye check to him. So, he does not have any information sources about diabetic retinopathy. He does not know how much the screening cost and how often he should go for the eye check. If it cost too much, then he has to consider whether it is worth it for him to spend so much money for eye check. He is concerned that he has to adjust his work schedule for the eye check and also concerned with the language for communication | Language | Support from interpreters |
Lack of knowledge | Diabetes patient WeChat group | ||
Lack of communication with the family doctor about screening | Brochures with audio recordings about diabetic eye screening (via a QR Code) | ||
Insufficient publicity about the screening | A patient guideline on diabetic eye screening, which encompasses different aspects of the screening, ranging from making appointment to screening and treatment | ||
Lack of specialized diabetic retinopathy screening facilities | Advocate for more specialized diabetes hospitals/facilities with the screening ability |