Gibson Diane M
Marxe School of Public and International Affairs, Baruch College, City University of New York, 135 East 22nd Street, Box D-901, New York, NY 10010, United States of America.
Prev Med Rep. 2018 Oct 18;12:233-240. doi: 10.1016/j.pmedr.2018.10.005. eCollection 2018 Dec.
This paper examines adaptive device use among two samples of U.S. adults aged 40 years and older with age-related macular degeneration, diabetic retinopathy, glaucoma or cataracts from the 2008 and 2016 waves of the nationally-representative cross-sectional National Health Interview Survey (n = 2875 and n = 6233 respectively). Individuals who replied affirmatively to the question, "do you use any adaptive devices such as telescopic or other prescriptive lenses, magnifiers, large print or talking materials, CCTV, white cane or guide dogs?" were defined as adaptive device users. Descriptive statistics and logistic regression models of adaptive device use were estimated. The main regression models used 2008 data and included explanatory variables for vision-related limitations, other functional limitations, sociodemographic characteristics and the local availability of ophthalmologists and optometrists. 6.1% of the 2008 sample and 4.2% of the 2016 sample used adaptive devices, these percentages were significantly different. 31.4% of the 2008 sample and 24.0% of 2016 sample with multiple vision-related limitations used adaptive devices, these percentages were not significantly different. Based on previous research, adaptive device use among the subgroups with multiple vision-related limitations would be expected to improve functional ability. In the regression models, the likelihood of adaptive device use increased significantly with the number of vision-related limitations, family income and local ophthalmologist availability. The regression results provide evidence of socioeconomic and geographic disparities in adaptive device use in the U.S. Together the descriptive statistics and regression results suggest that public health strategies to increase access to adaptive devices are needed.
本文考察了来自2008年和2016年具有全国代表性的横断面国民健康访谈调查（样本量分别为2875人和6233人）中年龄在40岁及以上、患有年龄相关性黄斑变性、糖尿病性视网膜病变、青光眼或白内障的美国成年人两个样本中自适应设备的使用情况。对“您是否使用任何自适应设备，如望远镜或其他处方镜片、放大镜、大字印刷品或有声材料、闭路电视、白色手杖或导盲犬？”这一问题回答为肯定的个体被定义为自适应设备使用者。估计了自适应设备使用情况的描述性统计和逻辑回归模型。主要回归模型使用2008年的数据，包括与视力相关的限制、其他功能限制、社会人口统计学特征以及眼科医生和验光师的当地可及性等解释变量。2008年样本中有6.1%的人使用自适应设备，2016年样本中有4.2%的人使用，这些百分比有显著差异。2008年样本中31.4%有多种视力相关限制的人和2016年样本中24.0%有多种视力相关限制的人使用自适应设备，这些百分比没有显著差异。根据以往研究，预计在有多种视力相关限制的亚组中，自适应设备的使用会提高功能能力。在回归模型中，使用自适应设备的可能性随着视力相关限制的数量、家庭收入和当地眼科医生的可及性显著增加。回归结果提供了美国在自适应设备使用方面存在社会经济和地理差异的证据。描述性统计和回归结果共同表明，需要采取公共卫生策略来增加自适应设备的可及性。
