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Objective Diabetic retinopathy remains the leading cause of blindness among working-age U.S. adults largely due to low screening rates. Rural populations face particularly greater challenges to screening because they are older, poorer, less insured, and less likely to receive guidelineconcordant care than those in urban areas. Current patient education efforts may not fully address multiple barriers to screening faced by rural patients. We sought to characterize contextual factors affectingdoi:10.1371/journal.pone.0206742 fatcat:i4ueouwaq5bwhjzvdngvm5snpi