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N. J. Ellish, R. Royak-Schaler, D. Scott; Assessing Opinions About Dilated Eye Exams and Knowledge About Eye Disease in an Older, African American Population. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2403.
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To assess intentions to get a dilated fundus examination (DFE), barriers and benefits of DFEs, and knowledge about eye disease among older African-Americans.
We recruited African-Americans 65 years of age and older who had not had a DFE in the past two years as part of a study to increase eye examination behavior. Participants were administered a questionnaire to determine their intention to get an eye exam, their perceived barriers and benefits to getting a DFE, and their knowledge about glaucoma and diabetic retinopathy.
We enrolled 54 participants from senior centers, senior apartments, and church health fairs in Baltimore city. Our study population was 59% female, with 38% having less than a h.s. education, 38% graduating from h.s., and 24% having at least some college. Four people (7%) reported having glaucoma and 9 (17%) reported having diabetes, with 2 diagnosed with diabetic retinopathy. Regarding intentions to get a DFE, 44% were in the precontemplation stage, including people who had never thought about a DFE, had not decided, or did not plan on making an appointment in the next 6 months. 24% were planning on making an appointment in the next 6 months (contemplation), and 31% planned on making an appointment in the next month (preparation). The most frequently cited benefit of protecting vision was being able to live on their own (39%). Being able to read, to work or do hobbies, and perform everyday tasks were each selected by 13-14% of the participants. Regarding barriers to getting DFEs, 61% said they had not had a recent DFE because they were putting it off. Other barriers reported by at least 25% of the participants was that it was hard to find someone to go with them, they had more important problems, and they did not have an eye doctor to go to. Many participants did not know the risk factors for glaucoma. 46% did not know that African-Americans are at increased risk, 59% did not know that glaucoma tends to run in families, and 41% did not know that risk increases with age. Of the 9 diabetics, 3 did not know they should have annual eye exams and 4 did not know that diabetic retinopathy can be treated to prevent vision loss.
Almost 70% of the participants were not planning on making an appointment for a DFE within the next 6 months despite the fact they were at increased risk for glaucoma because of their age and race. Interventions to address perceived barriers and benefits, and to increase knowledge about glaucoma and diabetic retinopathy are needed to increase eye examination behavior.
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