Fig 4. Recommendations for a comprehensive approach to improving access to care for CD in the US.

The first column proposes actions, and the second column indicates barrier dimensions most impacted by each action. In the second column, the icons each represent a barrier dimension (see Fig 2). The first icon listed is the dimension primarily targeted by the action. For example, the first action, “Incorporate routine screening, diagnosis and treatment of CD into primary healthcare programs, including those serving vulnerable populations regardless of insurance and/or immigration status,” focuses on the systemic dimension yet ameliorates structural barriers (by providing services more easily accessed by vulnerable communities), psychosocial barriers (by integrating services at the community level, potentially mitigating stigma and fear), and can even improve the clinical dimension by assuring a larger patient population is available for involvement in clinical studies. CD, Chagas disease.