June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Association between neighborhood deprivation and clinic appointment attendance in a free glaucoma screening program
Author Affiliations & Notes
  • Katie Flaharty
    University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Ming-Chen Lu
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Leslie Niziol
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Joah Aliancy
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Patrice Hicks
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Juno Cho
    University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Maria A Woodward
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Angela Elam
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Jason Zhang
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Leroy Johnson
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Martha Kershaw
    University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
  • David Musch
    University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Amanda Kiely Bicket
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Denise John
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Paula Anne Newman-Casey
    W K Kellogg Eye Center, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Katie Flaharty None; Ming-Chen Lu None; Leslie Niziol None; Joah Aliancy None; Patrice Hicks None; Juno Cho None; Maria Woodward None; Angela Elam None; Jason Zhang None; Leroy Johnson None; Martha Kershaw None; David Musch None; Amanda Bicket None; Denise John None; Paula Anne Newman-Casey None
  • Footnotes
    Support  Center for Disease Control and Prevention U01 DP006442-01
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1642 – A0137. doi:
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    • Get Citation

      Katie Flaharty, Ming-Chen Lu, Leslie Niziol, Joah Aliancy, Patrice Hicks, Juno Cho, Maria A Woodward, Angela Elam, Jason Zhang, Leroy Johnson, Martha Kershaw, David Musch, Amanda Kiely Bicket, Denise John, Paula Anne Newman-Casey; Association between neighborhood deprivation and clinic appointment attendance in a free glaucoma screening program. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1642 – A0137.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate which participant and neighborhood characteristics are associated with not showing up for a free glaucoma screening appointment.

Methods : Participant demographics were extracted from the University of Michigan electronic health record and distance between residence and clinic site was calculated using a geographical information system. Neighborhood level characteristics obtained from the United States Census included median household income (HHI), percent of households whose rent burden is 30% or more of their income, percent of household income spent on energy costs, percent of households without vehicles, and area deprivation index (ADI). Demographic and neighborhood characteristics were summarized and compared between participants who attended their screening visits (shows) and those who did not (no-shows). Logistic regression was used to model the probability of no-show for each neighborhood characteristic and distance while adjusting for age, sex, ethnicity, and race.

Results : 1431 participants were scheduled for screening appointments between July 2020 to November 2021. Participants were on average 54.1 years old (SD=14.5), 60% female, 51% Black, 37% White, 9% Latinx, and lived an average of 7.7 miles from each clinic (SD=8.1). Participants lived in neighborhoods with an average median HHI of $49,200 (SD=30,200), where an average of 46.8% of households were rent burdened (SD=23.9%), 5.0% (SD=2.7%) were energy burdened, 11.7% (SD=6.0%) had no vehicle, and the mean ADI was 6.8 (SD=3.2, 1-10 scale where 10 is the most deprived). The no-show rate was 23% (n=330/1431). After adjusting for demographics, a 1% increase in energy burden (odds ratio, OR=1.08, p=0.003), households without a vehicle (OR=1.02, p=0.197), a 5% increase in rent burden (OR=1.04, p=0.023), and a 1-point increase in ADI (OR=1.08, p=0.002) were associated with higher odds of no-show. A 10-mile increase in distance to clinic (OR=0.85, p=0.135) and a $10k increase in median HHI (OR=0.90, p<0.001) were associated with lower odds of no-show.

Conclusions : Higher neighborhood levels of poverty were associated with higher odds of no-showing to a free glaucoma screening appointment, after adjusting for age, sex, race, and ethnicity. Providing communities with high poverty rates additional holistic support to attend free eye care services will help enable early detection and treatment for glaucoma.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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