Ellish Nancy J, Royak-Schaler Renee, Higginbotham Eve J
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W Redwood St, Ste 100, Baltimore, MD 21201, USA.
Arch Ophthalmol. 2011 Dec;129(12):1592-8. doi: 10.1001/archophthalmol.2011.190.
To compare the effects of a tailored (individualized) and targeted (designed for a subgroup) print intervention in promoting dilated fundus examinations (DFEs) in older African Americans and to determine whether other factors (eg, demographics, preventive health practices, health literacy score, behavioral intentions, and DFE rates) are associated with getting a DFE.
African Americans aged 65 years or older who had not had a DFE in at least 2 years were recruited from community settings. Participants were randomized to receive either a tailored or targeted newsletter. Telephone follow-up was conducted at 1, 3, and 6 months to ascertain eye examination status. All participant-reported DFEs were confirmed by contacting their eye doctor (optometrist or ophthalmologist) by telephone. Main Outcome Measure Eye doctor-confirmed DFE at 6 months.
Of the 329 participants enrolled, 128 (38.9%) had an eye doctor-confirmed DFE. No significant difference was noted in this measure by intervention group (relative risk, 1.07; 95% confidence interval, 0.82-1.40), with 66 participants in the tailored group (40.2%) and 62 participants in the targeted group (37.6%) having an eye doctor-confirmed DFE. Based on logistic regression analysis, reading the newsletter (odds ratio, 1.76; 95% confidence interval, 1.08-2.87) and planning to make an appointment for a DFE (odds ratio, 2.46; 95% confidence interval, 1.42-4.26) were significant predictors for DFE.
The tailored and targeted interventions were equally effective in promoting eye doctor-confirmed DFEs at 6 months. Given the increased cost and effort associated with tailoring, our results suggest that well-designed targeted print messages can motivate older African Americans to get DFEs. Trial Registration clinicaltrials.gov Identifier: NCT00649766.
比较定制化（个性化）和针对性（针对亚组设计）的印刷品干预措施在促进老年非裔美国人进行散瞳眼底检查（DFE）方面的效果，并确定其他因素（如人口统计学特征、预防性健康行为、健康素养得分、行为意向和DFE率）是否与接受DFE相关。
从社区环境中招募至少两年未进行过DFE的65岁及以上非裔美国人。参与者被随机分配接受定制化或针对性的时事通讯。在1、3和6个月时进行电话随访，以确定眼部检查状况。所有参与者报告的DFE均通过电话联系他们的眼科医生（验光师或眼科医生）进行确认。主要结局指标为6个月时眼科医生确认的DFE。
在329名登记参与者中，128名（38.9%）有眼科医生确认的DFE。干预组在该指标上未观察到显著差异（相对风险，1.07；95%置信区间，0.82 - 1.40），定制化组有66名参与者（40.2%），针对性组有62名参与者（37.6%）有眼科医生确认的DFE。基于逻辑回归分析，阅读时事通讯（优势比，1.76；95%置信区间，1.08 - 2.87）和计划预约进行DFE（优势比，2.46；95%置信区间，1.42 - 4.26）是DFE的显著预测因素。
定制化和针对性干预措施在6个月时促进眼科医生确认的DFE方面同样有效。鉴于定制化相关的成本和工作量增加，我们的结果表明，精心设计的针对性印刷信息可以促使老年非裔美国人接受DFE。试验注册 clinicaltrials.gov标识符：NCT00649766。
