June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Impact of a Teacher Incentive on Children’s Use of Eyeglasses: A Cluster-Randomized Controlled Trial
Author Affiliations & Notes
  • HONGMEI YI
    Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
  • Haiqing Zhang
    College of Economics and Management, Shanghai Ocean University, Shanghai, China
  • Xiaochen Ma
    Stanford Center for International Development, Stanford University, Stanford, CA
    Department of Agriculture and Resource Economics, University of California Davis, Davis, CA
  • Linxiu Zhang
    Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
  • Nathan G Congdon
    State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen Universit, Guangzhou, China
    ORBIS International, New York, NY
  • Xiuqin Wang
    State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen Universit, Guangzhou, China
  • Kovin Shunmugam Naidoo
    Brien Holden Vision Institute, Durban, South Africa
    AVRI, University of KwaZulu-Natal, Durban, South Africa
  • Hasan Minto
    Brien Holden Vision Institute, Durban, South Africa
  • Haidong Zou
    Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
  • Scott Rozelle
    Stanford Center for International Development, Stanford University, Stanford, CA
  • Footnotes
    Commercial Relationships HONGMEI YI, None; Haiqing Zhang, None; Xiaochen Ma, None; Linxiu Zhang, None; Nathan Congdon, None; Xiuqin Wang, None; Kovin Naidoo, None; Hasan Minto, None; Haidong Zou, None; Scott Rozelle, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2949. doi:
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      HONGMEI YI, Haiqing Zhang, Xiaochen Ma, Linxiu Zhang, Nathan G Congdon, Xiuqin Wang, Kovin Shunmugam Naidoo, Hasan Minto, Haidong Zou, Scott Rozelle; Impact of a Teacher Incentive on Children’s Use of Eyeglasses: A Cluster-Randomized Controlled Trial. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2949.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The impact of school-time wear of glasses on children’s education has been shown to be limited by lack of regular compliance in half or more of children, even when free glasses are given. We sought to study the impact of free glasses combined with teacher incentives on in-school use of glasses among Chinese urban migrant children.

 
Methods
 

Children in a single randomly-selected fifth grade class in each of 94 randomly chosen primary schools in migrant communities in urban China, underwent measurement of visual acuity (VA) and assessment of spectacle wear and answered questionnaires. Children with VA <= 6/12 in either eye correctable to > 6/12 in both eyes underwent randomization by school to receive free glasses together with a teacher incentive (Incentive), or to Control. In the Incentive group, teachers were told that if >= 80% of children given glasses were wearing them at the time of two un-announced class visits, the class would receive a tablet computer. The Incentive group also received a previously-tested educational intervention promoting glasses use. Control children received prescriptions for glasses and a note to their parents. Self-reported and observed spectacle wear were assessed at 6 weeks and 6 months after distribution, with randomization groups compared by intention to treat using multiple regression.

 
Results
 

Among 4376 children, 728 (16.7%, mean age 10.9 years, 51.0% boys) met enrollment criteria and were randomized, 358 (49.2%, at 47 schools) to Incentive and 370 (50.8% at 47 schools) to Control. Among these, 693 children (95.2%) completed the study. Unadjusted and adjusted rates of spectacle wear were significantly higher at 6 weeks and 6 months among Incentive group children compared to Controls (P < 0.001 for observed and reported wear). (Table). In a previous study (Ma et al., BMJ, 2014) in western China, observed wear at six months in a group of similar-aged children receiving glasses and the identical education intervention without teacher incentives was significantly lower at 44.0% (P < 0.001).

 
Conclusions
 

Teacher incentives can significantly improve in-school use of glasses among children in this setting, and when combined with free spectacle distribution can maintain wear in two-thirds of children needing them over the course of a school year. Low wear among Controls demonstrates the need for such interventions.  

 
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