Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, 700 S 18th St, Ste 609, Birmingham, AL 35294-0009, USA.
J Natl Med Assoc. 2013 Spring;105(1):69-76. doi: 10.1016/s0027-9684(15)30087-0.
We examined the impact of an eye health education program for older African Americans on attitudes about eye care and utilization, using a randomized trial design in a community setting. Participants were older African Americans attending activities at senior centers: Ten centers were randomized to an eye health education (InCHARGE) or social-contact control presentation. InCHARGE addressed the importance of annual dilated comprehensive examination and strategies reducing barriers to care. The control presentation was on the importance of physical activity. Outcomes were attitudes about eye care 6 months post event through questionnaire and eye care utilization during 12 months post event through medical record abstraction. At baseline, more than 80% participants in both arms said transportation and finding, communicating, and trusting a doctor were not problematic and agreed that yearly care was important. One-fourth said eye examination cost was problematic; one-half said spectacle cost was problematic. There were no group differences 6 months post event. During the 12 months pre event, the dilated exam rate was similar in the groups (38.3% InCHARGE, 40.8% control) and unchanged during the 12 moiths post event. Results suggest fewer than half of older African Americans received annual dilated eye care. Group-administered eye health education did not increase this rate. Even before the program, they had positive attitudes about care, yet many cited examination and spectacle cost as problematic, which was not mitigated by health education. Evidence-based strategies in a community setting for increasing eye care utilization rate in older African Americans have yet to be identified. Policy changes may be more appropriate avenues for addressing cost.
NCT00591110, www.ClinicalTrials.gov
我们在社区环境中使用随机试验设计，研究了一项针对老年非裔美国人的眼部健康教育培训计划对眼部保健和利用态度的影响。参与者为参加老年人活动中心活动的老年非裔美国人：十个中心被随机分为眼部健康教育培训（InCHARGE）或社会接触对照组。InCHARGE 探讨了年度散瞳全面检查的重要性和降低护理障碍的策略。对照组介绍了体育活动的重要性。通过问卷调查评估事件后 6 个月的眼部保健态度，通过医疗记录摘要评估事件后 12 个月的眼部保健利用情况。在基线时，两组参与者中超过 80%的人表示交通和寻找、沟通和信任医生不是问题，并同意每年护理很重要。四分之一的人表示眼部检查费用是个问题；一半的人表示眼镜费用是个问题。事件后 6 个月时两组间没有差异。在事件前 12 个月，两组散瞳检查率相似（InCHARGE 组 38.3%，对照组 40.8%），事件后 12 个月内未发生变化。结果表明，不到一半的老年非裔美国人接受了年度散瞳眼部护理。小组管理的眼部健康教育并没有提高这个比率。甚至在项目之前，他们对护理有积极的态度，但许多人认为检查和眼镜费用是个问题，健康教育并没有减轻这种情况。在社区环境中，仍需确定增加老年非裔美国人眼部保健利用率的循证策略。政策变化可能是解决成本问题的更合适途径。
NCT00591110，www.ClinicalTrials.gov
