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Lindsay Anne Rhodes, Carrie E Huisingh, Gerald McGwin, Stephen Mennemeyer, John Crews, Christopher A Girkin, Cynthia Owsley; The EQUALITY Program: Evaluating Change in Patient Attitudes and Knowledge about Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3705.
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The Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) telemedicine program provided evidence-based eye health education tailored for patients at-risk for glaucoma seeking eye care at Walmart Vision Centers. The education program was based on the InCHARGE eye health education program designed for African Americans1-3 and materials from Prevent Blindness and NEI’s National Eye Health Education Program.4,5 This study investigated the impact of EQUALITY’s eye health education on at-risk patients’ knowledge and attitudes about glaucoma.
Patients with any of these criteria were eligible to participate: African American or Hispanic ≥40 years, white ≥50 years, diabetes, family history of glaucoma, and/or a pre-existing glaucoma diagnosis. A survey was administered prior to the patient’s eye exam, the eye health education was given, and a follow-up survey was conducted 2-4 weeks later by phone. Within-group changes of survey responses from baseline to follow-up were compared using McNemar’s test. Logistic regression assessed the association of patient characteristics (age, sex, race, prior glaucoma diagnosis, employment status, educational level) with improvement in knowledge and attitudes.
521 patients completed both the pre- and post-educational surveys. From baseline to follow-up, the percent that agreed "it was important to go to the eye doctor once every two years" increased from 88% to 93% (p=0.0017) and that "it was important to go even if they’re not having an eye problem" increased from 80% to 87% (p<0.001). Improvement in knowledge was observed for correctly reporting: a person can have glaucoma and not know it (87% vs. 96%), glaucoma can be controlled (73% vs. 82%), vision loss cannot be restored (35% vs. 70%), a complete exam is more than measuring eye pressure (46% vs. 65%), and an eye exam should be done through dilated pupils (76% vs. 84%) (p<0.05 for all questions). Multivariate analysis indicated that participants who were unemployed or had less than a high school education were less likely to improve their knowledge (OR 0.64, 95% CI 0.43-0.96; OR 0.55, 95% CI 0.29-1.0 respectively).
EQUALITY’s eye health education program improved attitudes and knowledge about eye care and glaucoma. Future eye health education should aim to address the needs of the unemployed and less educated in order to improve disease understanding in this group.
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