Zhongshan Ophthalmic Center, State Key Laboratory and Division of Preventive Ophthalmology, Sun Yat-sen University, Guangzhou, China.
Ophthalmology. 2011 Dec;118(12):2343-50. doi: 10.1016/j.ophtha.2011.06.016. Epub 2011 Sep 1.
To test an educational intervention promoting the purchase of spectacles among Chinese children.
Randomized, controlled trial.
Children in years 1 and 2 of all 20 junior and senior high schools (ages 12-17 years) in 3 rural townships in Guangdong, China.
Children underwent visual acuity (VA) testing, and parents of participants with presenting VA worse than 6/12 in either eye improving by more than 2 lines with cycloplegic refraction were recommended to purchase glasses. Children at 10 randomly selected schools received a lecture, video, and classroom demonstration promoting spectacle purchase.
Self-reported purchase of spectacles (primary outcome) and observed wear or possession of newly purchased glasses (secondary outcome) at follow-up examinations (mean, 219 ± 87 days after the baseline visit).
Among 15 404 eligible children, examinations were completed for 6379 (74.6%) at intervention schools and 5044 (73.6%) at control schools. Spectacles were recommended for 2236 (35.1%) children at intervention schools and for 2212 (43.9%) at control schools. Of these, 417 (25.7%) intervention schools children and 537 (34.0%, P = 0.45) control schools children reported buying glasses. Predictors of purchase in regression models included female gender (P = 0.02), worse uncorrected VA (P < 0.001), and higher absolute value of refractive error (P = 0.001). Neither the rate of self-reported purchase of glasses or observed wear or possession of newly purchased glasses differed between control schools and intervention schools in mixed-effect logistic regression models. Among children not purchasing glasses, 21.7% had better-eye VA of worse than 6/18.
An intervention based on extensive pilot testing and focus groups in the area failed to promote spectacle purchase or wear. The high burden of remaining uncorrected poor vision underscores the need to develop better interventions.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
检验一项促进中国儿童配眼镜的教育干预措施。
随机对照试验。
广东 3 个农村乡镇所有 20 所初中和高中的 1、2 年级学生（年龄 12-17 岁）。
对儿童进行视力（VA）测试，对双眼未矫正视力低于 6/12 但经睫状肌麻痹验光后提高超过 2 行的患儿的家长建议购买眼镜。在 10 所随机选择的学校，儿童接受有关配眼镜的讲座、视频和课堂演示。
自我报告的配眼镜情况（主要结局）和随访检查时观察到的新配眼镜的佩戴或拥有情况（次要结局）（平均距离基线访视 219±87 天）。
在 15404 名符合条件的儿童中，干预学校的 6379 名（74.6%）和对照学校的 5044 名（73.6%）完成了检查。建议干预学校的 2236 名（35.1%）和对照学校的 2212 名（43.9%）儿童配眼镜。其中，干预学校的 417 名（25.7%）和对照学校的 537 名（34.0%，P=0.45）儿童报告购买了眼镜。回归模型中的购买预测因素包括女性性别（P=0.02）、未矫正视力较差（P<0.001）和屈光不正绝对值较高（P=0.001）。在混合效应逻辑回归模型中，控制学校和干预学校之间自我报告的眼镜购买率或新购买眼镜的佩戴或拥有率均无差异。在未购买眼镜的儿童中，21.7%的儿童最佳矫正视力差于 6/18。
一项基于该地区广泛试点测试和焦点小组的干预措施未能促进眼镜购买或佩戴。大量未矫正的视力不佳仍需开发更好的干预措施。
作者没有与本文讨论的任何材料有关的专有或商业利益。
