Abstract
Purpose: :
To assess knowledge, attitudes, and beliefs regarding dilated fundus examinations (DFEs) among African–Americans. Of particular interest were barriers and benefits of obtaining DFEs.
Methods: :
We held 10 focus groups stratified by age (40–64, 65+) and DFE status (did and did not receive DFE in past two years). We recruited participants through print ads, radio announcements, and word of mouth. A moderator guide was used to address general eye questions, attitudes about eye exams, knowledge of glaucoma risk factors, knowledge of diabetic retinopathy risk factors, and physician communication. Qualitative analysis involved both areas of inquiry driven by specific research questions and themes that emerged from participants’ own perspectives and conclusions.
Results: :
Of the 86 participants, 67% had not had a recent eye exam, 60% were 65 years or older, and 75% were female. When asked if anyone had told them to get a DFE, less than a third indicated a physician had recommended they do so. Benefits of having regular DFEs identified by participants were the prevention and early detection of eye disease, and the ongoing monitoring of existing conditions. Vision problems or a diagnosis of glaucoma or diabetes were the strongest motivators for having DFEs. The primary barriers to regular DFEs included the cost of exams, lack of sufficient health insurance, lack of symptoms, having a busy schedule, and cultural barriers, including pride and denial in the African–American community. Participants mentioned family history, other illnesses and diet as risk factors for glaucoma, and diet/exercise, regular doctor visits, and medications as factors in the control of diabetes. Many respondents did not know the correct guidelines regarding frequency of eye exams. Finally, although a majority were satisfied with the information they received from their physicians, many reported that they had to play a more active role to get the medical information and care that they needed.
Conclusions: :
Developing interventions to increase the proportion of people who get DFEs at the recommended intervals can have a major public health impact, because as the population of the U.S. ages, vision loss due to eye disease will continue to grow. The information from these focus groups will help us develop interventions to increase eye examination behavior in the African–American community.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology