Overcoming Barriers in Vision Care Utilization of African Americans with Diabetes

描述：Wills眼睛健康系统建议建立一个多学科Wills眼睛翻译研究中心(“WETRC”)，以响应DHHS/CDC RFA-DP-10-004。WETRC将开展题为“克服糖尿病非裔美国人视力护理利用中的障碍”的项目。根据美国眼科学会和美国糖尿病协会的说法，建议所有糖尿病患者进行年度扩张性眼底检查(DFES)，以降低他们丧失视力的风险。尽管如此，只有50%到60%的成年糖尿病患者遵循这一建议，与高加索人相比，非裔美国人看眼科医生或获得DFE的可能性较小。因此，WETRC的目标是加强费城糖尿病非裔美国人的眼睛护理，改善以人群为基础的眼睛护理服务质量，缩小最佳循证眼睛护理与现有实践之间的差距。WETRC的具体研究(目的)是：1)对现有眼科数据集进行回顾性分析，以评估和评估影响糖尿病患者视力护理可及性和质量的个人层面和系统层面因素；2)采用焦点小组方法，确定提供有效、具成本效益的眼睛护理服务的障碍和促成因素，以防止非裔美国人糖尿病患者的视力丧失和促进眼睛健康；3)利用前瞻性分组随机队列研究，实施电话干预和教育干预措施，提高非裔美国人糖尿病患者DFE后续随访的依从性。WETRC的研究人员还将参与协作TRC网络研究的设计和实施，该研究旨在确保眼科医生和患者的初级保健医生(PCP)之间进行最佳的双向沟通。这项网络研究的目标是通过增加从初级保健医生到眼科医生的HA1C报告来改善眼科医生对患者血糖控制的教育。它还旨在提高PCP对其患者的DR严重性和推荐的眼部随访的了解。TRC特定研究和协作TRC网络研究的成功完成将有助于克服获得持续DFES的障碍，并减少视力护理利用方面的差距。我们的目标是使患有糖尿病的非裔美国人更接近2010年健康人群的目标，即所有糖尿病患者中75%的人每年都有DFE。

DESCRIPTION: The Wills Eye Health System proposes to establish a multidisciplinary Wills Eye Translational Research Center (the "WETRC") in response to the DHHS/CDC RFA-DP- 10-004. The WETRC will conduct the project entitled, "Overcoming Barriers in Vision Care Utilization of African Americans with Diabetes." According to the American Academy of Ophthalmology and the American Diabetes Association, annual dilated fundus examinations (DFEs) are recommended for all people with diabetes to reduce their risk of vision loss. Despite this fact, only 50% to 60% of adults with diabetes follow this recommendation, and African Americans are less likely to see an eye doctor or get a DFE compared to Caucasians. Therefore, the goal of the WETRC is to enhance the eye care of underserved, African Americans in Philadelphia with diabetes, improve the population-based quality of eye care services and close the gap between optimal evidence-based eye care and existing practice. The WETRC specific studies (AIMS) are to: 1) Develop a retrospective analysis of existing ophthalmic data sets to assess and evaluate individual-level and system-level factors that impact access to and quality of vision care in patients with diabetes; 2) Use focus group methodology to identify barriers and enablers to the delivery of efficacious and cost-effective eye care that prevent vision loss and promote eye health in African Americans with diabetes; and 3) Implement telephone-based and educational interventions to improve DFE follow-up adherence in African Americans with diabetes utilizing a prospective cluster-based, randomized, cohort. The investigators at the WETRC will also participate in the design and implementation of a Collaborative TRC Network study, which aims to assure optimal two-way communication between the ophthalmologist and their patients' primary care physician (PCP). This Network study goals are to improve the ophthalmologists' patient education about blood sugar control by increasing the HA1C reporting from the PCP to the ophthalmologist. It also aims to improve PCP knowledge regarding their patients' severity of DR and recommended ocular follow-up. Successful achievement of the TRC-specific studies and the Collaborative TRC Network study will help to overcome barriers to obtaining ongoing DFEs and reduce disparities in vision care utilization. Our goal is to bring African Americans with diabetes closer to the Healthy People 2010 goal of 75% of all persons with diabetes having an annual DFE.