HEY: Hispanic Eye Study

总结 失明是全世界各种族和人群的首要健康恐惧。中重度视力丧失 老年对个人来说是一种个人危机，给社会带来重大的社会和经济代价。 西班牙裔人受到3种主要非传染性疾病（NCD）致盲原因的影响- 青光眼、糖尿病性视网膜病变和白内障--但制定和实施干预措施， 促进识别、随访和治疗失明高危人群，以减少失明， 中度至重度视力障碍（MSVI）在这些人群中仍然是初步的和不充分的。 筛查高风险但无功能性视力丧失的个体和早期病例发现可以显著提高视力。 改善失明和MSVI的预防，同时辅之以适当的治疗和支持。除了 设备成本，在LAC中实施此类干预措施受到以下限制：1）对失明的文化信仰 中年和老年人的视力障碍，以及我们对其理解的差距; 2）缺乏容易的 现有的标准化的、文化上敏感的、实用的、可适用于不同环境的协议 拉丁美洲和加勒比地区，针对高风险人群，如居住在卫生保健服务差的地区的人群， 高NCD率。 这个探索发展项目的目的是开始克服这些障碍， 和试点测试西班牙裔眼睛（HEY）研究，一个以社区为基础的干预，重点是改善 在委内瑞拉（VZ）获得眼科保健，我们在那里建立了研究和能力建设， 基础设施将使我们能够实现以下具体目标：目标1。为了评估社会，行为， 影响主要致盲原因筛查和早期病例发现的文化和结构因素， 以及遵守后续建议，为制定和启动促进 设计和实施以社区为基础的方案，以加强预防、早期发现和 在VZ提供适当的治疗。目标二。测试西班牙裔眼的可行性、可接受性和有效性 (HEY)在VZ的研究，我们将制定，实施和评估一项试点研究，有350名圣诞老人的高风险居民 马拉开波VZ的Lucía和圣罗莎社区。为了实现这些目标，我们的团队包括专家 在人口科学、眼科学、分析流行病学、 实施科学和VZ人群。结果将生成所需的初步数据，以证明完整的 R 01合作研究，并确定具体的研究问题，显示最大的希望，以促进 预防拉美裔人的视力丧失，并提供重要的新知识，以促进广泛的 在拉丁美洲和加勒比地区实施、传播和持续应用循证眼科护理战略， 美国高风险人群。

SUMMARY Blindness is a top health fear across ethnic groups and populations worldwide. Severe vision loss in middle and old age constitutes a personal crisis for individuals, with important social and economic costs to society. Hispanics are disproportionally affected by 3 leading noncommunicable disease (NCD) causes of blindness – glaucoma, diabetic retinopathy and cataracts – but development and implementation of interventions that can facilitate identification, follow-up and treatment of individuals at high risk of blindness to reduce blindness and moderate-to-severe visual impairment (MSVI) in such populations remains preliminary and inadequate. Screening of individuals at high risk but without functional visual loss and early case-detection can significantly improve prevention of blindness and MSVI, when coupled with appropriate treatment and support. Besides cost of equipment, implementation of such interventions in LAC is limited by 1) cultural beliefs toward blindness and visual impairment in middle and older ages, and gaps in our understanding thereof; and 2) lack of readily available standardized, culturally sensitive protocols that are practical and adaptable to use in diverse settings of LAC, targeting populations at high risk, such as those residing in regions of poor health care access and high NCD rates. The purpose of this exploratory-developmental project is to begin to overcome these barriers by developing and pilot-testing the Hispanic Eye (HEY) study, a community-based intervention that focuses on improving access to eye health care in Venezuela (VZ), where our established research and capacity-building infrastructure will allow us to accomplish the following specific aims: Aim 1. To assess social, behavioral, cultural and structural factors that impact screening and early case detection of leading causes of blindness, as well as adherence to follow-up recommendations to inform development and initiation of a plan to promote the design and implementation of a community-based program to improve efforts to prevent, detect early and provide appropriate treatments in VZ. Aim 2. To test feasibility, acceptability and efficacy of the Hispanic Eye (HEY) study in VZ we will develop, implement and assess a pilot study with 350 high-risk residents of Santa Lucía and Santa Rosa communities in Maracaibo VZ. To achieve these aims, our team encompasses expert scientists extensively experienced in population science, ophthalmology, analytical epidemiology, implementation science, and VZ populations. The results will generate preliminary data needed to justify a full R01 collaborative study, and identify specific research questions show the greatest promise to advance prevention of visual loss in Hispanics, and provide critical new knowledge to facilitate widespread implementation, dissemination and sustained application of evidence-based eye care strategies in LAC and in high-risk U.S. populations.