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C. Owsley, G. McGwin, Jr., K. E. Searcey, J. Weston, A. Johnson, B. T. Stalvey, B. Liu, C. A. Girkin; Effect of an Eye Health Education Program on Older African Americans' Eye Care Utilization and Attitudes about Eye Care. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5362.
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© ARVO (1962-2015); The Authors (2016-present)
InCHARGE© is an eye health education program targeted for older African Americans. It promotes annual dilated eye exam by educating about routine preventative care and suggesting strategies for removing perceived barriers to eye care (transportation, cost, communication, trust; JNMA 2008;100). InCHARGE’s curriculum is based on health behavior theories and is a presentation given by a health educator at senior community centers. We evaluated the effect of InCHARGE on eye care utilization and attitudes about eye care in older African Americans living in the urban South.
Ten senior centers were identified in African American communities in Birmingham, Alabama. Five centers were randomized to the InCHARGE presentation and 5 to a presentation on physical activity, serving as a social-contact control. A questionnaire (Q) on attitudes about eye care was given to each participant immediately before the presentation, and then 6 months later by phone. Enrollees were asked to sign medical record releases so we could obtain their eye care medical records. Outcomes were attitudes about eye care at 6 months and eye care utilization as determined by medical record review at 12-months after the presentation.
There were 54 participants in the InCHARGE group and 61 in the control group with baseline and follow-up Q data. Both groups had a similar age (M age 75, p=.38) and pre-event Q results. The vast majority responded it would not be hard to find an eye doctor (90%), have transportation to eye doctor (83%), are comfortable talking to doctor (92%), think it is important to go to eye doctor yearly (92%) and think eye doctor cares about their eyesight (98%). Costs for an exam and glasses were a problem for 25% and 50% respectively. 6-months later the percentage having these attitudes was largely unchanged and similar in the two groups, with the exception that a decreased % of the InCHARGE group said that cost of the exam and eyeglasses was a problem (p<=.05). Neither group showed a change in % receiving a dilated eye exam in the 12-months before vs. after the presentation (all ~50%).
Older African Americans at senior centers in Birmingham, Alabama have positive attitudes about eye care even before an eye health education intervention, except for cost. InCHARGE educated about cost and gave strategies to minimize cost; after InCHARGE fewer saw cost as a problem. Half of participants were receiving annual dilated care in the 12-months prior to enrollment; InCHARGE did not impact this rate.
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