Increasing Eye Care Utilization in Black Americans At High Risk For Glaucoma Using A Community-Engaged and Faith-Based Intervention

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT There are significant gaps in our understanding between well-established, evidence-based guidelines for detection and treatment of glaucoma and effectively applying those guidelines within the high-risk populations that continue to develop blindness. As outlined by the National Academy of Medicine, great opportunity exists to incorporate principles of population health and community engagement to close this observed glaucoma detection gap. The overall objective of this study is to design and implement a faith-based, community health worker-delivered (CHW) support program for individuals at high risk for glaucoma, specifically Black Americans. The central hypothesis is that a personalized faith-based support program will result in increased eye care utilization in Black Americans at high risk for glaucoma who currently underutilize eye care. The rationale is that increasing appropriate eye care utilization in high-risk individuals and beginning treatment at earlier stages of the disease will decrease the risk of unpreventable blindness. The candidate will reach the overall objective by achieving the following 2 specific aims: 1) Use implementation science framework and community-engaged methods to adapt an existing glaucoma coaching program and develop a multilevel intervention that addresses the key determinants of successfully increasing eye care utilization in Black Americans; and 2) Implement and evaluate the feasibility and acceptability of the Community-Based Treatment for Glaucoma program (ComBaT Glaucoma), for Black Americans. In Aim 1, the Tailored Implementation for Chronic Diseases (TICD) implementation science framework will be used to guide semi-structured interviews with community members, leaders, and local eye care providers to identify barriers and potential facilitators of increasing eye care utilization in Black Americans; and b) adapt the Support, Educate and Empower (SEE) Program to the needs and culture of the community to develop and the faith-based CHW-delivered program that uses implementation strategies and behavior change techniques linked to community-identified determinants for optimal success. In Aim 2, the ComBaT Glaucoma program will be implemented by conducting a single-arm pilot study with 50 Black Americans. The candidate will use mixed methods to assess the feasibility and acceptability of the ComBaT Glaucoma program. This study is significant because it addresses a gap between well-established guidelines for glaucoma and high-risk individuals that continue to go blind despite these data. It is innovative because it employs implementation science framework, a community-engaged, faith-based tailored approach to create a support program to increase eye care utilization in Black Americans at high risk for glaucoma. Dr. Elam will use the skills acquired during this training award to become one of the few ophthalmologists trained in implementation science and community-engaged health disparities research to improve glaucoma care for all people in the United States.