Patients attending selected Federally Qualified Health Centers in several Alabamian counties are eligible to participate a telemedicine eye health study if they have ?1 of these risk factors: (1) African American of Hispanic aged 40 years or older; (2) white aged 50 years or older; (3) anyone aged 18 years or older with diabetes, (4) anyone aged 18 years or older with glaucoma-associated diagnosis (glaucoma suspect), ocular hypertension, and primary open-angle glaucoma; (5) anyone aged 18 years or older with a family history of glaucoma. There is no cost to the participants, and they receive compensation for study enrollment in the form of a secure, preloaded participant payment cared used as a debit or a credit card.This study aims to assess the efficacy of a community-based telemedicine program in identifying glaucoma and other eye diseases. Study protocol: Once written informed consent is obtained, the study protocol is completed in 1 session. The research coordinator administers a series of surveys to collect demographic data such as age, race, gender, marital status, education level, employment status, insurance status, and contact information. Three questions are asked about cost being a potential barrier to eye care (Table 1.) Seven questions are asked in an effort to understand the participant's knowledge, attitudes, and beliefs about eye health (Table 1.) The study coordinator also collects the family history of glaucoma or blindness, medical history including smoking history, and ocular history. The Abbreviated National Eye Institute Visual Function Questionnaire is administered. Questions regarding the participant's education level, employment, and reason for not having an eye examination in the past 2 years represent social determinants of health. The eye health education program is then administered to the participant by the research coordinator. A telemedicine remote ocular assessment protocol (among other eye assessments) is implemented providing the severity results of the eye disease in terms of Intraocular Pressure (IPO). If IOP is > 30mmHg, participants are given a referral with a provider within 2 weeks. If the IOP > 35mmHg, a referral is made within 1 week. If the IOP is > 40mmHg, the participant is given an urgent referral within 1 day. Findings from this study will help form actionable public health programs of early detection and timely interventions for eye diseases, particularly for rural dwellers.You are the Health Economics co-investigator for this study. Your principal investigator (PI) has been wondering what if the patient had to pay to participate in this telemedicine eye health study to earn the early detection for the potential eye diseases as well as referrals for timely interventions. Were the patients willing to pay to participate? At what amount? Are there any common specific financial and socioeconomic factors that affect the patients' intention to participate the study. The PI turns into you demanding 3-5 queries for a random sample of the participants who have been recruited to the study (approximately 400 by now). These queries must satisfy to be part of a short survey that will be conducted by a either a phone survey or by a mail survey. These queries must not overlap with the questions that are already planned for the study (see Study Protocol). You are thinking about queries for a cost-benefit analysis. What are the 3-5 queries you come up with?

TABLE 1. Questions of Cost Barriers, Knowledge, Attitudes, and Beliefs about Eye Care Domain Item Synopsis Cost Is the cost of an eye examination a problem for you? Is the cost of buying eyeglasses a problem for you? If the doctor prescribed eye drops for you to treat an eye problem you have, would the cost of prescription eye drops be a problem for you? (Problem Scale)* Knowledge about A person can have glaucoma and not know glaucoma it. Glaucoma can be controlled. Vision lost from glaucoma can be restored. A complete glaucoma examination consists only of measuring eye pressure. People at risk for glaucoma should have an eye examination through dilated pupils. (True/false) Attitudes and beliefs It is important to go to the eye doctor at about eye care least once every 2 years. There is no need to go to the eye doctor if you're not having a problem with your eyes. (Agree/disagree scale)+ *Problem scale response options: not a problem at all, a little bit of a problem, somewhat of a problem, a big problem. Agree/disagree scale response options: strongly agree, somewhat agree, somewhat disagree, strongly disagree