Abstract
Purpose :
Despite providing eye care access directly in schools, consent rates to participate in school-based vision programs are often low. There is limited literature investigating the factors influencing consent rates. We examined school-level factors associated with participation consent rates in a city-wide school-based vision program in Baltimore, Maryland.
Methods :
All students who failed vision screening in 123 Baltimore City public schools participating in a school-based vision program between 2016-19 (41 schools/year) were offered eye exams through the school-based vision program. A signed parental consent was required for the eye exam. We calculated consent rates among students enrolled in all 123 participating schools. We obtained data on school-level characteristics, including percent of students who failed vision screening at the school, using aggregate program data and available public resources (Civil Rights Data Collection, Maryland State Department of Education, Baltimore City Public Schools). Complete data was available and analyzed for 113 schools. We used listwise deletion and generalized linear modeling to examine the association between school characteristics and school-level consent rates. Multivariable models were adjusted for school year in the program (2016-17, 2017-18, 2018-19) and school type (elementary, middle school, or combined).
Results :
Overall, consent rate was 58.06%, with a range from 9.4% to 100%. Schools with a higher percentage of students eligible for free and reduced-price lunch and greater parental engagement, as approximated by parental response rate to an annual school climate survey, were associated with higher consent rates (p = 0.014 and p = 0.013, respectively). Schools with higher enrollment and middle schools were associated with lower consent rates (p = 0.015 and p = 0.046, respectively) (Table).
Conclusions :
School-based vision programs are an important strategy to increase access to vision care, but consent challenges limit participation. Consent rates were higher in schools with a higher concentration of poverty and greater parental engagement. Efforts to increase consent rates in school-based vision programs will need to include targeted strategies for impoverished schools with higher student enrollment and for middle schools, as well as design ways to optimize parental engagement.
This is a 2020 ARVO Annual Meeting abstract.