Focus Groups of Older African Americans and Eye Care Providers Serving Their Communities: Perceived Barriers to Care and Knowledge About Vision and Eye Care

Abstract

Abstract: : Purpose: Older African Americans are less likely to receive routine eye care compared to other groups. Our purpose was to identify their perceived barriers to receiving eye care and their knowledge, beliefs, and attitudes about vision and eye care. We also gathered the perspective on these issues from the eye care providers who practice in their communities. Methods: 17 focus groups of African Americans adults age 60 and over residing in Birmingham or Montgomery, AL were lead by an experienced facilitator. Discussion was stimulated by a semi–structured script focusing on knowledge about vision and eye care and perceived barriers to care. 6 focus groups of ophthalmologists and optometrists addressed the same topics. The discussions were audiotaped, transcribed, and coded using a multi–step content analysis protocol. Results: 119 African Americans (M age 70 yrs, SD 8) and 35 eye care providers (split evenly between ophthalmologists and optometrists; 26% African American) participated. 75% of eye care providers worked in clinics whose clientele was 33% African American or greater. For older African Americans, by far the most commonly cited perceived barrier to care was doctor trust, with communication with doctor and transportation next most cited. For eye care providers, one of the most frequently cited barriers was cost, which was among the least cited by older African Americans. With respect to knowledge about vision and eye care, African Americans made a majority of positive of comments about their knowledge (67%), whereas the eye care providers' comments were largely negative (84%) citing the inadequacy of older African Americans' knowledge base on vision and eye care. Conclusions: These mismatches between the two groups underscore the lack of common ground between older African Americans and their eye doctors, which could be contributing to the low rates of seeking eye care among older African Americans. This information will be used to design educational curricula for both older African Americans and the eye care providers in their communities and to develop questionnaire instruments for process evaluation of these intervention efforts.

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