Overcoming Barriers in Vision Care Utilization of African Americans with Diabetes

描述：根据DHHS/CDC RFA-DP- 10-004，威尔斯眼科健康系统提议建立一个多学科的威尔斯眼科转化研究中心（“WETRC”）。WETRC将开展题为“克服非洲裔糖尿病患者视力保健利用障碍”的项目。根据美国眼科学会和美国糖尿病协会，建议所有糖尿病患者每年进行眼底扩张检查（dfs），以降低视力丧失的风险。尽管如此，只有50%到60%的成年糖尿病患者遵循这一建议，而且与高加索人相比，非洲裔美国人看眼科医生或接受DFE的可能性更小。因此，WETRC的目标是加强费城非洲裔糖尿病患者的眼科护理，提高以人群为基础的眼科护理服务质量，缩小最佳循证眼科护理与现有实践之间的差距。WETRC专项研究（AIMS）旨在：1)对现有眼科数据集进行回顾性分析，以评估和评价影响糖尿病患者视力保健可及性和质量的个人水平和系统水平因素；2)使用焦点小组方法确定提供有效和具有成本效益的眼科护理的障碍和促进因素，以防止非洲裔美国糖尿病患者的视力丧失和促进眼睛健康；3)实施基于电话和教育的干预措施，以提高非裔美国糖尿病患者DFE随访依从性，采用前瞻性基于集群的随机队列。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）之间的最佳双向沟通。本网络研究的目的是通过增加PCP向眼科医生报告的糖化血红蛋白，提高眼科医生对患者的血糖控制教育。提高PCP对患者DR严重程度的认识，并建议进行眼部随访。TRC特异性研究和协作TRC网络研究的成功完成将有助于克服获得持续dfs的障碍，减少视力保健利用方面的差异。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75%的糖尿病患者每年进行一次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.