Abstract
Purpose:
Diabetes is a common condition disproportionally impacting African-Americans (AA). One in two AAs is projected to develop diabetes during their lifetime, increasing the risk of developing diabetic eye complications. Our study aim was to evaluate the efficacy of a behavioral intervention to increase rates of dilated fundus exams (DFEs) and to characterize perceived risks of ophthalmic disease in older AAs non-adherent to follow-up.
Methods:
A prospective clinical trial of AA patients aged ≥ 65, with type 2 diabetes, and no DFE within the past year was performed. We collected the baseline data including: education level, diabetes risk perceptions and self-care behaviors, vision function (NEI-VFQ), and A1C level. Analysis of relationships between perceived risk of future vision problems and self-care behaviors, A1C, and visual function was performed.
Results:
Data are reported on 169 subjects. Subjects were grouped according to perceived vision risk (low (42%), moderate (33.7%), and high (24%) risk). Vision risk perception was not related to A1C, self-care behaviors, or education. However, it was related to the following NEI-VFQ scales: near activities (p<0.01), distance activities (p<0.01), mental health (p<0.01), role difficulties (p=0.01), and driving (p=0.03). Compared to the other 2 groups, those in the high risk group had worse near and distance scores, general health, mental health, role function, and driving scores.
Conclusions:
African Americans with diabetes who perceive themselves as being at a high risk for future vision problems are more likely to report impairments in vision-related functioning. Despite subject’s increased perceived risk to eye care problems and functional impairment, there was not an increased adherence to recommended ophthalmic care in the high risk perception population. Additional research is needed to better understand health promoting behaviors in AA with diabetes.
Keywords: 499 diabetic retinopathy •
468 clinical research methodology •
498 diabetes