Implementing and evaluating a school-based program to improve childhood vision.

Background: Approximately 20% of the American schoolchildren have a vision problem. Children from low-income urban areas have been shown to have more than twice the normal rate of vision problems. This study evaluated the effectiveness of A Vision for Success, a school-based program designed to provide eyeglasses to children in a timely manner in selected New York City public elementary schools and to encourage their regular use at school.

Methods: An intervention-control group design with 265 first- and second-grade students across 8 New York City public schools was implemented. Participating students had failed a prior mandated vision screening. Students in A Vision for Success received (1) a school-based professional optometric screening, (2) provision of 2 pairs of eyeglasses (1 kept by the teacher for classroom use), and (3) teachers' encouragement of eyeglass use as prescribed in school. Mean rates of classroom eyeglass use were assessed between groups by direct observation prior to and after the optometric screening.

Results: Mean rates of eyeglass use for students in intervention and control groups at baseline were 22% and 19%, respectively (p > .10). At follow-up, eyeglass use rose to 47% in the intervention group, whereas the control group's rate remained consistent at 19% (p < .001). Significant differences persisted for boys and girls.

Conclusions: Children disproportionately affected by visual dysfunction can receive glasses in a timely manner and wear them regularly in the classroom. Even more intensive efforts will be needed for some children to help ensure that they wear glasses in school.