Table 6.

Managing Health Category: Example Challenges and Quotes

Activity	Challenge code and participant quote
Exercising	Accessibility: “[At the gym] all of their machines are like electronic and digital. So if I get over there, I still can’t operate them. Even the treadmill, it’s digital, so nonaccessible to people who are blind or have low vision. I tried to go to a water aerobics class, and the instructor, is up there like ‘do this!’ and if you can’t see, or can’t see well, you have no idea what they’re doing.” Physical: “Just being able to do the whole routine. Let’s say the exercises in the class that I’m in, I will try them, and at one time, that would have been no problem for me. So, coming to terms to realize that I can do maybe eighty-five to ninety percent of them, but the rest I have to let go..” Transportation: “I would like to go to a gym and participate in some type of exercise. But because of transportation—because of income—I am not really able to do that.” Other challenge: “There is a gym in the next town that is specifically designed for disabled people. I really should go there and get involved in an exercise program, but it takes so much time to stick with it for 3 or 4 times a week, and it takes time away from other things.”
Managing diet and nutrition	Technology, tools, or devices: “I have a problem with reading the back of the box, like directions. [My reader] usually won’t read the back of a box, because of the fonts.” Cognitive or knowledge limitation: “The reading of food labels, understanding what to eat and what not to eat beyond basic things. I don’t understand like, for examples, carbs and all that kind of stuff. “
Accessing health information	Technology, tools, or devices: “They always want you to do it on the Internet, almost without exception. And that means I have to get somebody who has the patience to sit down and go through it with me. If you try to call any company you inevitably are faced with phone service, but none of these organizations keep people to keep up with the telephone anymore, so you inevitably end up waiting a long time. If you finally get somebody to talk to, [they] start wanting to know all kinds of answers to questions, and if you haven’t prepared yourself beforehand, you may be faced with hanging up and gathering up more information and calling back and going through it again.” Accessibility: “The challenge is the website, because the website is not user friendly for screen readers.”
Monitoring health	Technology, tools, or devices: “Blood glucose meters. They have made so much improvement and that glucose monitor can work by bluetooth into your cell phone and everything, [but] they have not taken in any consideration to make this [usable] for the visually impaired. Showing a picture of a scale is not going to help us.” Transportation: “It’s a huge problem, transportation. Instead of everything being within a few blocks, it’s all over the place. One’s on one side of town, the other one’s the other side of town, and you can’t walk from one to the other.” Financial: “I can get to the doctor, I can listen to what they say, but you know, financially, I can’t eat like they want me to eat because fresh vegetables and fruits are not cheap, and between paying mortgage, and utilities and getting back and forth to work, and paying people to assist me in this matter or that matter, it doesn’t leave too much to help me with my health problems.” Safety/pain: “I don’t cook in the residence I live in because I’m not comfortable - there’s no vent for the stove. There’s no window I can open to let smoke out when I burn something, or the doorways don’t have screens so I can’t open that. I don’t cook as often as I should.”
Managing medication	Visual limitation: “Making sure I’m taking the right medicine and the right dosages since I can’t read the label. I know that there are companies that provide audible labels that will verbally tell you what’s in the container, how many milligrams, and how frequently you’re supposed to take it, but mine doesn’t. I have to scan them with my scanner to read what they are. What I usually do is set them up for a 7-day supply in the little pill boxes.” Cognitive or knowledge limitation: “Taking it, trying not to forget.”
Going to healthcare appointments	Assistance from others: “Getting in and out of the building and moving around in the doctor’s office, you have to rely on someone. Some offices may have a security or someone that will help you up to your floor or suite that you’re going to, and some of them don’t.” Transportation: “Getting transportation. Other than that, no problem.”