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Roberta McKean-Cowdin, Malcolm Barrett, Mina Torres, Alicia Fairbrother-Crisp, Xuejuan Jiang, Bruce Burkemper, Rohit Varma; Psychosocial Predictors of Eye Care Utilization in the African American Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1597.
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To quantify eye care utilization in a population-based sample of African Americans approximately 12-18 months after receiving a referral for eye care due to eye disease or an annual preventive eye examination. Further to evaluate demographic, socioeconomic and psychosocial predictors of receiving eye-care subsequent to referral.
A population-based sample of African American adults residing in Los Angeles County, CA underwent comprehensive clinical eye exams and questionnaire based interviews on sociodemographics, lifestyle, medical history, and psychosocial predictors of health care utilization. Examinations were completed at baseline from 2014-2017; an interview was conducted 12-18 months after baseline to evaluate follow-up eye care. Psychosocial predictors of obtaining follow-up eye care were evaluated using an Integrated Behavioral Model. Categories of variables considered included attitudes, perceived norms, and personal agency, as well as knowledge and skills, salience, environmental constraints, and habit. The proportion of participants who received eye care overall and by eye condition was calculated. The fit of the theoretical model and the individual paths in the model were evaluated using structural equation modeling.
Approximately 2300 participants were referred for follow-up eye care; 62% with eye disease and 52% of those referred for an annual eye exam reported receiving eye care. The highest eye care utilization was among participants diagnosed with glaucoma (82%), followed by lens opacity (61%) and diabetic retinopathy (58%). Participants who received eye care were more likely to be older, female, college educated, and with health and vision insurance. Three psychometric constructs were predictive of receiving follow-up care including: attitude-experiential, environmental constraints and salience.
A high proportion of African American adults did receive follow-up eye care within 12-18 months of referral when recommended by an eye care specialist. Psychosocial models indicate that factors influencing whether a person sought care were influenced by their level of concern about eye disease, availability of care, cost, insurance, knowledge of where to get care, and whether they had received messages about the importance of receiving care in the media and from their doctor.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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