Abstract
Purpose :
Latinx populations have the highest rates of visual impairment and blindness of any ethnic group in the U.S. More than 50% will develop diabetes in their lifetime and of these, 34% go on to develop diabetic retinopathy. However, 95% of diabetic retinopathy cases among Latinx patients are undiagnosed due to lack of yearly eye screening as recommended by the American Diabetes Association. Given the need to prevent avoidable blindness in Latinx communities, we aimed to identify factors influencing teleophthalmology use for diabetic eye screening at an urban federally qualified health center serving a low-income community in Madison, WI with a large Latinx population (40%).
Methods :
We conducted semi-structured individual interviews with 20 Latinx patients with diabetes at an urban, federally qualified health center in Madison, WI. Interviews were transcribed verbatim, professionally translated from Spanish to English, and analyzed using QSR NVivo software. We performed both inductive open coding and deductive coding using the National Institutes of Minority Health and Disparities (NIMHD) Research Framework. In the latter phases of analysis, we also drew upon concepts from the Socio-Ecological Model of Health.
Results :
Participants had a mean age of 59.8 years (range: 33-79), 60% were women, 75% preferred to speak Spanish during clinic appointments, and 60% had low or moderate health literacy. We developed a model to understand relationships between factors influencing teleophthalmology use for diabetic eye screening among Latinx patients with diabetes. Barriers included a lack of culturally adapted education materials, financial/insurance concerns, and limited access to care due to immigration status. Facilitators included the convenience of using teleophthalmology in the primary care clinic, the belief that teleophthalmology is technologically superior to dilated eye exams, trust and comfort with their primary care provider and clinic, and fear of blindness. In addition, a lack of Spanish-speaking eye care providers was reported to be a barrier to obtaining in-person eye exams for diabetic eye screening.
Conclusions :
We identified factors influencing teleophthalmology use for diabetic eye screening among urban Latinx patients. Addressing these barriers and facilitators may enhance the effectiveness of interventions to prevent blindness from diabetes in urban Latinx communities.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.