了解患者过去在眼科护理方面遇到的障碍以及通过远程医疗计划开展的密歇根州青光眼和眼部健康筛查与干预项目中如何解决这些障碍。
Understanding Patient Experience With Past Barriers to Eye Care and How Barriers Were Addressed in the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program.
作者信息
Webber Emily, Lu Ming-Chen, Woodward Maria A, Elam Angela, Bicket Amanda, Wood Sarah Dougherty, John Denise, Johnson Leroy, Kershaw Martha, Heisler Michele, Newman-Casey Paula Anne
机构信息
From the Department of Ophthalmology and Visual Sciences (E.W., M.L., M.W., A.E., A.B., S.D.W., D.J., P.N.), University of Michigan, Ann Arbor, Michigan, USA.
From the Department of Ophthalmology and Visual Sciences (E.W., M.L., M.W., A.E., A.B., S.D.W., D.J., P.N.), University of Michigan, Ann Arbor, Michigan, USA; Institute for Healthcare Policy and Innovation (M.W., A.E., A.B., M.H., P.N.), University of Michigan, Ann Arbor, Michigan, USA.
出版信息
Am J Ophthalmol. 2025 Apr 11;276:157-169. doi: 10.1016/j.ajo.2025.04.007.
PURPOSE
To use community engaged research to understand barriers to eye care utilization and explore participant experiences with free glaucoma screenings through the Michigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program.
DESIGN
Qualitative study Subjects, Participants, and/or Controls: Purposive sampling of 42 participants out of 254 total participants from 2 community clinics in Flint and Ypsilanti, Michigan enrolled between 10/29/21 and 12/22/21.
METHODS, INTERVENTION, OR TESTING: We conducted semi-structured interviews that explored past barriers to eye care, motivations for attending and overall experience with the MI-SIGHT program. Interviews were transcribed then coded using Grounded Theory; and thematic analysis was completed.
MAIN OUTCOME MEASURES
Themes were compared between (1) the 2 clinics; (2) those who did and did not screen positive for glaucoma; and (3) of those who screened positive for glaucoma, comparing between those randomized to standard care and those randomized to personalized coaching and education.
RESULTS
The most common past barriers to eye care included cost, insurance status, and transportation. Motivations to attending glaucoma screenings with the MI-SIGHT program included affordability, location of community clinics, and having a trusted referral source endorse the program. Overall, participants most valued the rapport and communication received when interacting with the ophthalmic technicians who also acted as care navigators as part of MI-SIGHT.
CONCLUSIONS
The MI-SIGHT program was able to address barriers such as cost and transportation through having free eye screenings located at the community clinic. Developing trust and rapport with the participants and the community clinics was critical to the program's high satisfaction rates.
目的
运用社区参与式研究来了解眼部护理利用的障碍，并通过密歇根州青光眼及眼部健康远程医疗筛查与干预（MI-SIGHT）项目，探索参与者接受免费青光眼筛查的体验。
设计
定性研究。研究对象、参与者和/或对照组：从密歇根州弗林特和伊普西兰蒂的2家社区诊所的254名总参与者中，有目的地抽取42名参与者，他们于2021年10月29日至2021年12月22日入组。
方法、干预措施或测试：我们进行了半结构化访谈，探讨过去眼部护理的障碍、参加MI-SIGHT项目的动机以及总体体验。访谈内容转录后使用扎根理论进行编码；并完成了主题分析。
主要观察指标
比较以下几方面的主题：（1）两家诊所之间；（2）青光眼筛查呈阳性和未呈阳性的参与者之间；（3）在青光眼筛查呈阳性的参与者中，比较随机分配至标准护理组和随机分配至个性化指导与教育组的参与者之间。
结果
过去眼部护理最常见的障碍包括费用、保险状况和交通。参加MI-SIGHT项目青光眼筛查的动机包括可承受性、社区诊所的位置以及有可靠的推荐来源认可该项目。总体而言，参与者最看重与眼科技术人员互动时所获得的融洽关系和沟通，这些技术人员在MI-SIGHT项目中还担任护理导航员。
结论
MI-SIGHT项目能够通过在社区诊所提供免费眼部筛查来解决费用和交通等障碍。与参与者和社区诊所建立信任和融洽关系对该项目的高满意度至关重要。
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