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通过远程医疗项目参与密歇根青光眼和眼健康筛查和干预:比较诊所与社区为基础的招募策略的效果。

Engagement in the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program: Comparing the Effect of Clinic versus Community-Based Recruitment Strategies.

机构信息

Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.

Morehouse School of Medicine, Atlanta, Georgia.

出版信息

Ophthalmol Glaucoma. 2023 May-Jun;6(3):266-276. doi: 10.1016/j.ogla.2022.10.006. Epub 2022 Nov 1.

Abstract

PURPOSE

To determine the effectiveness of adding community-based recruitment to clinic-based recruitment to engage participants in a glaucoma detection program.

DESIGN

Prospective cohort study.

SUBJECTS

Anyone ≥ 18 years of age who does not meet exclusion criteria.

METHODS

The Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program tests a novel way of improving glaucoma detection in communities with populations at high risk for disease, including people who identify as Black and Hispanic and those living with low socioeconomic status. The MI-SIGHT program is conducted in a free clinic (Ypsilanti, MI) and in a federally qualified health center (FQHC) (Flint, MI). Community engagement methods were used to identify outreach strategies to enhance recruitment. Participants were asked "How did you hear about the MI-SIGHT program?" and responses were summarized overall and by clinic and compared between clinic-based and community-based recruitment strategies.

MAIN OUTCOME MEASURES

Proportion recruited by location, within or outside of the clinic.

RESULTS

In total, 647 participants were recruited in the first 11 months of the study, 356 (55.0%) at the free clinic over 11 months and 291 (45.0%) at the FQHC over 6 months. Participants were on average 54.4 years old (standard deviation = 14.2); 60.9% identified as female, 45.6% identified as Black, 37.8% identified as White, 9.6% identified as Hispanic, and 10.9% had less than high school education. Participants reported hearing about the MI-SIGHT program from a clinic phone call (n = 168, 26.1%), a friend (n = 112, 17.4%), nonmedical clinic staff (n = 100, 15.5%), a clinic doctor (n = 77, 11.9%), an in-clinic brochure or flyer (n = 51, 7.9%), a community flyer (n = 44, 6.8%), the clinic website or social media (n = 28, 4.3%), or an "other" source (n = 65, 10.1%). Recruiting from the community outside the medical clinics increased participation by 265% at the free clinic and 46% at the FQHC.

CONCLUSIONS

The Community Advisory Board recommendation to use community-based recruitment strategies in addition to clinic-based strategies for recruitment resulted in increased program participation.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

摘要

目的

确定在诊所基础上增加社区基础招募以吸引参与者参与青光眼检测计划的有效性。

设计

前瞻性队列研究。

受试者

任何年龄在 18 岁及以上且不符合排除标准的人。

方法

密歇根州通过远程医疗进行青光眼筛查和眼部健康筛查和干预(MI-SIGHT)计划测试了一种在高危人群中提高青光眼检测的新方法,包括自认为是黑人和西班牙裔的人群,以及生活在社会经济地位较低的人群。MI-SIGHT 计划在一个免费诊所(密歇根州 Ypsilanti)和一个合格的联邦健康中心(密歇根州 Flint)进行。社区参与方法用于确定扩大招募的外展策略。参与者被问到“你是如何听说 MI-SIGHT 计划的?”,并对总体和按诊所的回答进行了总结,并将诊所内和社区内的招募策略进行了比较。

主要观察指标

按位置(诊所内或诊所外)招募的比例。

结果

在研究的前 11 个月内,共有 647 名参与者被招募,其中 356 名(55.0%)在 11 个月内在免费诊所,291 名(45.0%)在 6 个月内在合格的联邦健康中心。参与者平均年龄为 54.4 岁(标准差=14.2);60.9%为女性,45.6%为黑人,37.8%为白人,9.6%为西班牙裔,10.9%的人没有高中以上学历。参与者报告说,他们是从诊所电话(n=168,26.1%)、朋友(n=112,17.4%)、非医疗诊所工作人员(n=100,15.5%)、诊所医生(n=77,11.9%)、诊所小册子或传单(n=51,7.9%)、社区传单(n=44,6.8%)、诊所网站或社交媒体(n=28,4.3%)或其他来源(n=65,10.1%)听说过 MI-SIGHT 计划。从医疗诊所外的社区招募增加了免费诊所 265%的参与率,合格的联邦健康中心增加了 46%的参与率。

结论

社区咨询委员会建议在诊所基础上增加社区基础招募策略,以增加项目参与率。

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