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Chunyi Hsu, Xuejuan Jiang, Mina Torres, Rohit Varma; Noncompliance with Vision Care Guidelines in Chinese Americans with Type 2 Diabetes Mellitus. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5563.
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© ARVO (1962-2015); The Authors (2016-present)
The American Diabetes Association (ADA) guidelines recommend yearly dilated eye exams for type 2 diabetes mellitus (T2DM) patients. Compliance with ADA guidelines among Asian Americans may be more difficult because of additional barriers of language, differences in cultures, and the shortage of resources due to the minority status of the population. We aim to assess the prevalence of noncompliance with ADA vision guidelines among 50+ years old Chinese Americans with T2DM and identify personal risk factors associated with noncompliance.
Data were from the population-based Chinese American Eye Study. All participants with a self-reported history and treatment of diabetes were asked about health and vision care utilization and diabetes self-care. Noncompliance was defined as having had no dilated eye examination in the previous 12 months. Logistic regression analyses were used to identify personal factors associated with noncompliance.
Among the 540 Chinese Americans who self-reported having physician-diagnosed diabetes, 324 (60%) had not complied with ADA guidelines. When compared with those with T2DM who complied with ADA guidelines, noncompliers were more likely to be younger (50-59 vs. 80+ years old: odds ratio [OR], 4.36; 95% confidence interval [CI], 2.25-8.45), have never been advised by a physician to have annual eye exams (OR, 2.20; 95% CI, 1.49-3.24), have no usual place for care (OR, 3.11; 95% CI, 1.65-5.88), and have a glycosylated hemoglobin level ≥ 8.0% (OR, 2.17; 95% CI, 1.11-4.25).
Our data suggest that similar to Hispanics and African Americans, a majority of Chinese Americans with T2DM are not receiving recommended vision care. This high rate of noncompliance is unexpected given the high level of education of these Chinese Americans. Intervention programs targeted at Chinese Americans should focus on improving psychosocial predictors such as lower intentions (e.g. personal agency), salience of the behavior (e.g. recommendations from a physician), and local constraints instead of systemic constraints (e.g. financial barriers, lack of insurance).
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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