Sabherwal Shalinder, Chinnakaran Anand, Sood Ishaana, Garg Gaurav K, Singh Birendra P, Shukla Rajan, Reddy Priya A, Gilbert Suzanne, Bassett Ken, Murthy Gudlavalleti V S
Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India.
Department of Projects and Marketing, Dr Shroff's Charity Eye Hospital, New Delhi, India.
JMIR Res Protoc. 2021 Nov 4;10(11):e31951. doi: 10.2196/31951.
A vision center (VC) is a significant eye care service model to strengthen primary eye care services. VCs have been set up at the block level, covering a population of 150,000-250,000 in rural areas in North India. Inadequate use by rural communities is a major challenge to sustainability of these VCs. This not only reduces the community's vision improvement potential but also impacts self-sustainability and limits expansion of services in rural areas. The current literature reports a lack of awareness regarding eye diseases and the need for care, social stigmas, low priority being given to eye problems, prevailing gender discrimination, cost, and dependence on caregivers as factors preventing the use of primary eye care.
Our organization is planning an awareness-cum-engagement intervention-door-to-door basic eye checkup and visual acuity screening in VCs coverage areas-to connect with the community and improve the rational use of VCs.
In this randomized, parallel-group experimental study, we will select 2 VCs each for the intervention arm and the control arm from among poor, low-performing VCs (ie, walk-in of ≤10 patients/day) in our 2 operational regions (Vrindavan, Mathura District, and Mohammadi, Kheri District) of Uttar Pradesh. Intervention will include door-to-door screening and awareness generation in 8-12 villages surrounding the VCs, and control VCs will follow existing practices of awareness generation through community activities and health talks. Data will be collected from each VC for 4 months of intervention. Primary outcomes will be an increase in the number of walk-in patients, spectacle advise and uptake, referral and uptake for cataract and specialty surgery, and operational expenses. Secondary outcomes will be uptake of refraction correction and referrals for cataract and other eye conditions. Differences in the number of walk-in patients, referrals, uptake of services, and cost involved will be analyzed.
Background work involved planning of interventions and selection of VCs has been completed. Participant recruitment has begun and is currently in progress.
Through this study, we will analyze whether our door-to-door intervention is effective in increasing the number of visits to a VC and, thus, overall sustainability. We will also study the cost-effectiveness of this intervention to recommend its scalability.
ClinicalTrials.gov NCT04800718; https://clinicaltrials.gov/ct2/show/NCT04800718.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31951.
视力中心（VC）是加强初级眼保健服务的重要眼保健服务模式。在印度北部农村地区，已在街区一级设立了视力中心，覆盖人口15万至25万。农村社区对视力中心的利用不足是这些视力中心可持续发展的主要挑战。这不仅降低了社区改善视力的潜力，还影响了自我可持续性，并限制了农村地区服务的扩展。当前文献报道，对眼病的认识不足、对眼保健需求的认识不足、社会耻辱感、对眼问题的低优先级、普遍存在的性别歧视、成本以及对护理人员的依赖等因素阻碍了初级眼保健的利用。
我们的组织计划在视力中心覆盖地区开展一项兼具提高认识和促进参与的干预措施——挨家挨户进行基本眼部检查和视力筛查，以与社区建立联系并改善视力中心的合理利用情况。
在这项随机平行组实验研究中，我们将从印度北方邦两个业务地区（温达文、马图拉区和穆罕默迪、凯里区）贫困、运营不佳的视力中心（即每日就诊患者≤10人）中，为干预组和对照组各选择2个视力中心。干预措施将包括在视力中心周边8 - 12个村庄进行挨家挨户的筛查和提高认识活动，对照视力中心将通过社区活动和健康讲座遵循现有的提高认识做法。将在4个月的干预期间从每个视力中心收集数据。主要结局指标将是就诊患者数量的增加、眼镜建议及使用情况、白内障和专科手术的转诊及接受情况，以及运营费用。次要结局指标将是屈光矫正的接受情况以及白内障和其他眼部疾病的转诊情况。将分析就诊患者数量、转诊情况、服务接受情况以及所涉及成本方面的差异。
涉及干预措施规划和视力中心选择的前期工作已经完成。参与者招募工作已经开始且目前正在进行中。
通过这项研究，我们将分析我们的挨家挨户干预措施在增加视力中心就诊人数从而提高整体可持续性方面是否有效。我们还将研究该干预措施的成本效益，以推荐其可扩展性。
ClinicalTrials.gov NCT04800718；https://clinicaltrials.gov/ct2/show/NCT04800718。
国际注册报告识别码（IRRID）：DERR1 - 10.2196/31951。
