Table 3 Focus group themes and sample quotes

Symptoms

“…I’ve definitely noticed a frequency in terms of how often I’m getting sick, and also how long my cough lasts.” (PA)

“I’m now very afraid to get up to that kind of high level. I would prefer to take the train. For a long time I have been reluctant to take a plane.” (M)

“My sister personally, she suffers from depression now because of 9/11. She was the only one that was in the house. We lived on the 30th floor in TriBeCa, so she says that she heard everything and saw everything, the plane and all that.” (NA)

“Generally, I am fearful when I go to a building, I’m always looking where the exit sign is.” (S)

Barriers to Care

“They’re pretty hard to contact. I had to call a good eight or ten times …” (NA)

“…That’s when I work I said, do you have another time? No, can you take off of work? I said, I can’t take off of work, I have to work so that I can get health care.” (NA)

“Yeah, the place where they refer me to was very far away.” (M)

“To get referred to someone and to go through more paperwork and then have to take extra steps, for me, is a drag.” (LM)

“I didn’t avail myself of them because I have my own doctor.”(LM)

“…you’re going to just be seeing some doctor who’s not going to give you the quality of care as a doctor you would have found on your own.” (LM)

“…you’d have to show me why this would benefit me. That [it] would be more advantageous to me than just going through my doctors…” (RR)

“…I didn’t know it’s an option or why you would specifically go to 9/11[program] versus your own doctor.” (PA)

“I feel like I’m not really legitimately crazy, so I shouldn’t be here.” (PA)

“I want to go to a small little office, I don’t want to go into a psycho ward.” (LM)

Not Connecting Symptoms to 9/11

“I have a time concern thing again. Generalized anxiety disorder, depression-we’re in the middle of a financial depression. A lot of these things have occurred to a lot of New Yorkers, a lot of people in the United States now. So how do you tease that out? If the cause is related to 9/11.” (PA)

“Every time I go, I feel like they would not connect it back to 9/11. I think they would quickly dismiss that.” (NA)

“Even without 9/11 I may still have the hypertension. So, I don’t even know whether it’s related. And when I ask them, they easily claim, oh no your health problem is not related to 9/11.” (M)

Program Knowledge and Utilization

“…they know we suffered that event. They will know, maybe they will focus more on helping us, knowing that…it’s a doctor specialized in the treatment of people who have lived a situation like this.” (S)

“They have to let us know what…would be considered 9/11-related. Don’t just waste our time…then you eventually just have a negative response that we are not qualified.” (M)