Manhattan Vision Screening and Follow-Up Study in Vulnerable Populations: 1-Month Feasibility Results.
Manhattan Vision Screening and Follow-Up Study in Vulnerable Populations: 1-Month Feasibility Results.
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曼哈顿视力筛查和弱势群体的后续研究：1 个月的可行性结果。
DOI：
10.1080/02713683.2021.1905000
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发表时间：
2021
影响因子：
2
通讯作者：
Sapru,
中科院分区：
文献类型：
--
作者：
Hark,LisaA;Tan,CamilleS;Kresch,YochevedS;DeMoraes,CGustavo;Horowitz,JasonD;Park,Lisa;Auran,JamesD;Gorroochurn,Prakash;Stempel,Stella;Maruri,StefaniaC;Besagar,Sonya;Saaddine,JinanB;Lambert,BiancaC;Pizzi,LauraT;Sapru,
目的/目的：在美国，视力障碍和眼疾的高发率不成比例地影响到那些无法获得眼科保健的人，特别是弱势群体。本研究的目的是测试仪器，实施方案，并为一项为期5年的大型研究收集初步数据，该研究旨在通过社区卫生工作者（CHW）和患者导航员改善弱势人群眼病的检测和随访眼保健。在这项研究中，训练有素的卫生保健员进行视力筛查，病人导航员安排现场眼科检查，并为转介到眼科的病人安排预约，以提高他们对后续眼科护理的依从性。材料和方法：从纽约市曼哈顿上城的Riverstone老年中心招募年龄在40岁及以上的符合条件的个体。参与者接受了现场视力筛查（视力矫正、眼压测量和眼底摄影）。未通过视力筛查的人被安排到现场验光师那里进行视力检查；那些有眼部病变的患者被转介给眼科医生。参与者还接受了由社区卫生工作者进行的国家眼科研究所视觉功能问卷-8 （NEI-VFQ-8）和阻止老年人事故、死亡和伤害（STEADI）测试。结果：参与者（n = 42）主要是老年人，平均年龄为70.0±9.8岁，女性（61.9%）和西班牙裔（78.6%）。大多数人（78.6%,n = 33）视力筛查失败。在不及格人士中，84.8% （n = 28）参加视光师的现场视力检查。眼部诊断：屈光不正13/28(46.4%)，青光眼/疑似青光眼9/28(32.1%)，白内障7/28(25.0%)，视网膜异常6/28 (21.4%)；13人需要戴眼镜。结论：本研究表明，在弱势群体中，使用CHWs和患者导航员可以减少视力筛查和验光师眼科检查的障碍，最终提高眼病的早期发现，并将个人与额外的眼科保健预约联系起来。这项为期五年的研究旨在进一步研究这些结果。
Purpose/Aim: In the United States, high rates of vision impairment and eye disease disproportionately impact those who lack access to eye care, specifically vulnerable populations. The objective of our study was to test instruments, implement protocols, and collect preliminary data for a larger 5-year study, which aims to improve detection of eye diseases and follow-up eye care in vulnerable populations using community health workers (CHW) and patient navigators. In the study, trained CHWs conducted vision screening and patient navigators scheduled on-site eye exams and arranged appointments for those referred to ophthalmology to improve adherence to follow-up eye care.Materials and Methods:Eligible individuals age 40-and-older were recruited from the Riverstone Senior Center in Upper Manhattan, New York City. Participants underwent on-site vision screening (visual acuity with correction, intraocular pressure measurements, and fundus photography). Individuals who failed the vision screening were scheduled with an on-site optometrist for an eye exam; those with ocular pathologies were referred to an ophthalmologist. Participants were also administered the National Eye Institute Visual Function Questionnaire-8 (NEI-VFQ-8) and Stopping Elderly Accidents, Deaths, and Injuries (STEADI) test by community health workers.Results:Participants (n = 42) were predominantly older adults, with a mean age of 70.0 ± 9.8, female (61.9%), and Hispanic (78.6%). Most individuals (78.6%, n = 33) failed vision screening. Of those who failed, 84.8% (n = 28) attended the on-site eye exam with the optometrist. Ocular diagnoses: refractive error 13/28 (46.4%), glaucoma/glaucoma suspect 9/28 (32.1%), cataract 7/28 (25.0%), retina abnormalities 6/28 (21.4%); 13 people required eyeglasses.Conclusion:This study demonstrates the feasibility of using CHWs and patient navigators for reducing barriers to vision screening and optometrist-based eye exams in vulnerable populations, ultimately improving early detection of eye disease and linking individuals to additional eye care appointments. The full five-year study aims to further examine these outcomes.