Vision is precious: a successful behavioral intervention to increase the rate of screening for diabetic retinopathy for inner-city adults.

PURPOSE

This purpose of this report is to describe a successful telephone intervention to increase the rate of diabetic retinopathy screening, its implementation with English and Spanish speakers, and the characteristics of those who benefited most from the intervention.

METHODS

Participants in the telephone group (N = 305) received a tailored intervention from trained health educators who were ethnically diverse and representative of the community. The main outcome for the randomized controlled study was documented receipt of a dilated fundus examination (DFE) within the 6-month study window. Exploratory analyses focused on examining the factors that contribute to receiving a DFE within 6 months for participants in the tailored telephone intervention using Pearson chi(2) and logistic regression analysis.

RESULTS

Participants in the telephone intervention who did not receive a DFE had significantly more documented steps in the behavioral process than those who did receive a DFE, and ethnic concordance of the health educator was not significantly associated with a positive outcome in the DFE group. There was a negative association between the time spent building rapport and receipt of DFE. As time spent engaging in educational activities by telephone increased, the likelihood of receiving a DFE increased.

CONCLUSIONS

Although the telephone intervention was highly successful compared with the print intervention, these process results demonstrate the difficulties and challenges of conducting a tailored telephone intervention to improve rates of screening in an underserved, diverse urban community.