May 2008
Volume 49, Issue 13
ARVO Annual Meeting Abstract  |   May 2008
Qualitative Pilot Study: Healthcare Delivery Changes to Improve Use of Eye Care by Non-Users
Author Affiliations & Notes
  • A. R. Elam
    Duke University School of Medicine, Durham, North Carolina
  • P. P. Lee
    Duke University Eye Center, Duke University School of Medicine, Durham, North Carolina
  • Footnotes
    Commercial Relationships  A.R. Elam, None; P.P. Lee, None.
  • Footnotes
    Support  Research to Prevent Blindess-Lew R. Wasserman Merit Award, Alcon Research Institute
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4978. doi:
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      A. R. Elam, P. P. Lee; Qualitative Pilot Study: Healthcare Delivery Changes to Improve Use of Eye Care by Non-Users. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4978. doi:

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

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Purpose: : Significant gaps and disparities in use of eye care continue to exist. Finding ways to better reach persons who underutilize eye care and those at high risk for eye disease and vision loss could result in a decrease in avoidable blindness. While much prior work has focused on identifying barriers to care, less attention has been focused on directly asking those who do not use care regularly their perceptions and suggestions as to how to change the eye care system and increase appropriate utilization.

Methods: : Four initial interviews and 3 focus groups were conducted with individuals at high risk for eye conditions who do not regularly use eye care in North Carolina and Virginia. Focus groups ranged in size from 3 to 8 people. A pilot tested script was used in each group conducted by the principal investigator. Content analysis was used to identify key concepts.

Results: : Content analysis of the transcripts from the interviews and focus groups yielded similar results to previous studies in regards to barriers-to-care, such as cost, communication, trust and insurance coverage. Additional barriers emphasized in this study were lack of choice of providers and providers’ respect for the patient and interest in the patient. Suggestions on ways to increase eye care utilization included community-focused education, incorporating eye care needs into school health education programs, and recommendations on improving interactions by eye care providers with underserved communities.

Conclusions: : Though the needs and barriers-to-care among those who underutilize eye care vary with factors such as education and residential location, education on eye care and disease was a common theme among non-users. Implementing specific suggestions on educational approaches to how to improve interactions with the eye care delivery system (such as neighbor to neighbor networks or follow-up communication after initial visits) may help to increase eye care utilization, thereby reducing disparities in eye care.

Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower 

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