Patient and Neighborhood Factors Influencing Participation in a Personalized Glaucoma Coaching Program

To assess barriers and facilitators to program engagement for participants in the Support, Educate, Empower (SEE) Personalized Glaucoma Coaching Pilot Program and identify differences by demographics or neighborhood area deprivation.

This mixed-methods study analyzed SEE glaucoma coaching program participants. Patient characteristics included age, sex, race, and neighborhood socioeconomic status (area deprivation index [ADI]). Interview transcripts were coded using the adapted Penchansky and Thomas framework, which defines healthcare access through access dimensions: availability (supply of services), accessibility (location), accommodation (organization of services), affordability (cost), awareness (communication/information), and acceptability (attitudes and comfort), to categorize barriers and facilitators. Thematic frequencies were calculated and stratified by participant characteristics.

The 44 participants in the SEE pilot program were 52% ≥65 years old, 55% male, 46% White, and 34% lived in high ADI neighborhoods. Awareness (100%) and acceptability (66%) were the most cited themes. Low ADI participants experienced more acceptability (79% vs. 39% high ADI) and awareness barriers (79% vs. 43% mid ADI). Mid ADI participants had more accessibility barriers (71% vs 13% low ADI) and accommodation facilitators (43% vs 8% low ADI). High ADI participants reported more patient-level facilitators (44% vs 14% mid ADI). No differences emerged by other demographics.

Among SEE pilot program participants, acceptability barriers and awareness facilitators were the most frequently cited. There were ADI differences for barriers and facilitators. Neighborhood factors should be considered when implementing glaucoma coaching programs, as program interaction varies by these characteristics. The SEE pilot program facilitated glaucoma medication adherence through educational resources and adherence monitoring tools.