Department of Ophthalmology, Grossman School of Medicine, New York University.
Department of Ophthalmology, Howard University College of Medicine.
J Glaucoma. 2024 Apr 1;33(4):288-296. doi: 10.1097/IJG.0000000000002328. Epub 2023 Oct 20.
Residence in a middle-class neighborhood correlated with lower follow-up compared with residence in more affluent neighborhoods. The most common explanations for not following up were the process of making an appointment and lack of symptoms.
To explore which individual-level and neighborhood-level factors influence follow-up as recommended after positive ophthalmic and primary care screening in a vulnerable population using novel methodologies.
From 2017 to 2018, 957 participants were screened for ophthalmic disease and cardiovascular risk factors as part of the Real-Time Mobile Teleophthalmology study. Individuals who screened positive for either ophthalmic or cardiovascular risk factors were contacted to determine whether or not they followed up with a health care provider. Data from the Social Vulnerability Index, a novel virtual auditing system, and personal demographics were collected for each participant. A multivariate logistic regression was performed to determine which factors significantly differed between participants who followed up and those who did not.
As a whole, the study population was more socioeconomically vulnerable than the national average (mean summary Social Vulnerability Index score=0.81). Participants whose neighborhoods fell in the middle of the national per capita income distribution had a lower likelihood of follow-up compared with those who resided in the most affluent neighborhoods (relative risk ratio=0.21, P -value<0.01). Participants cited the complicated process of making an eye care appointment and lack of symptoms as the most common reasons for not following up as instructed within 4 months.
Residence in a middle-class neighborhood, difficulty accessing eye care appointments, and low health literacy may influence follow-up among vulnerable populations.
与居住在较富裕社区相比，居住在中产阶级社区与较低的随访率相关。未按要求进行随访的最常见原因是预约流程复杂和没有症状。
使用新方法探索哪些个体和社区因素会影响易受影响人群在眼科和初级保健筛查呈阳性后的推荐随访。
2017 年至 2018 年，957 名参与者接受了眼科疾病和心血管危险因素筛查，作为实时移动远程眼科研究的一部分。对眼科或心血管危险因素筛查阳性的个体进行联系，以确定他们是否接受了医疗服务提供者的随访。为每位参与者收集了社会脆弱性指数（一种新的虚拟审计系统）和个人人口统计学数据。对多变量逻辑回归进行了分析，以确定在遵循和不遵循建议的参与者之间存在显著差异的因素。
总的来说，研究人群比全国平均水平更易受到社会经济的影响（平均综合社会脆弱性指数评分为 0.81）。与居住在最富裕社区的参与者相比，居住在全国人均收入分布中位数社区的参与者的随访可能性较低（相对风险比=0.21，P 值<0.01）。参与者表示，预约眼科护理的过程复杂以及缺乏症状是未按要求在 4 个月内进行随访的最常见原因。
居住在中产阶级社区、难以获得眼科护理服务以及健康素养低可能会影响弱势群体的随访。
