| Facilitator | Barrier |
|---|---|
| Taking responsibility for health "But if you know that this is the test you need, then you can go and pressure the doctor. 'This is the test I need. This is my right' ." (Woman, group 2) | Fear "So many of my friends won't get tests done because they think they'll be taken to the hospital. Some people live so many years without knowing about their illness and they are fine. As soon as they find out about it they begin to panic." (Woman, group 2) "Some people think that if we go for the test … we may get cancer." (Woman, group 7) "He comes from Asia. … We eat a lot of clarified butter, sweets; that's all fat. If he has knowledge - these are the benefits, these are the risks of taking, then he thinks he'll have to stop it, and then I don't know, he's scared that doctor would say - like, if it's there - then my sweets and everything will be stopped." (Man, group 8) |
| Knowledge "Unless he doesn't know about his benefits or non-benefits, he won't accept it. Our people who come from India are new immigrants, they never used to bother. They would think 'I'm fine, I don't need this' ." (Man, group 8) "And examples. When somebody does it he was fine, and somebody didn't do it, what are the losses he had. If you give an example then it's more beneficial." (Man, group 8) | Low utility/risk "Like, maybe I don't need one [the pneumococcal vaccine]. In India nobody is bothered about pneumonia. Older people, they don't give much importance to this." (Man, group 8) "There are so many injections like flu and for other things and so if you are healthy, then you don't care. 'I don't need those injections.' And sometimes there is information like those companies who make the medicine, they are ruining the economy." (Man, group 5) |
| Trusting relationship "If the doctor establishes a good relationship with the patient and encourages him, then it's better for the patient." (Man, group 4) | Broken trust "If you will tell the doctor to check, only then they will check, otherwise they don't. The family doctor should check in routine the blood pressure, blood sugar. But they don't actually check the patient. They just prescribe the medicine, and they just ask verbally and write down the medicine and send the patient home." (Woman, group 7) |
| Unhurried pace "But now my doctor, he is really good. I've had the same doctor for the last seven, eight years and he's really good. He's a good doctor. I'm happy with the doctor now. So if I have any other problems, they should listen to each and every problem. Whatever problem you have, the doctor should listen to you." (Woman, group 2) | Rushing/not listening "The doctor always will not talk to me, and then she will just write down the medicine for me. They don't have time to discuss with the patient. I show the list of my questions to the doctor and the doctor just gives me the medicine … she didn't have time to discuss or ask about that." (Woman, group 6) "In India when we go to the doctor, they attend them properly. They listen to the patient in detail, but here they don't. They just write down the medicine. Send the patients home. Whenever I went to the clinic, doctor has never checked my diabetes sugar level. I just test myself. They don't. The family doctor does not do that. He should do, it's his duty, but he does not listen. So what is the use of the family doctor?" (Woman, group 7) |
| Integrated processes "Every driver will go do the medical test … he will have to go to this one [to maintain his class 4 driver's license]." (Man, group 4) | Lack of reminders"You are advising us that after 50, we should go for the colon screening test. Why the doctors are not referring our cases to the specialist for all these tests? It's the doctor's duty. If you say that after 50 years of age every lady should go for colon test, so why the doctors are not … referring their cases?" (Woman, group 7) |
| Availability of services"At the Indo-Canadian senior centre, the nurse used to come and then they came to know about blood pressure. They should be in that kind of facility and when seniors can go and check their blood pressure, they can get all the information." (Woman, group 6) | Short visit duration "But the doctor should also take care of the patients. There should be more clinics, and they should listen to the patients. The doctor should give sufficient time to each and every patient. The family doctor does not have this much of time to attend sufficient time." (Woman, group 7) "If I'm talking about stomach illnesses, flu, then he said, 'No, you come tomorrow. Come tomorrow, the day after too.' They don't want to listen to the other things, and they'll write down afterwards they just talked about one thing. One to 2 more topics, nothing more than. … [Over the course of multiple visits] my interest to get some knowledge will go away." (Man, group 8) |