Purpose: People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries.
Methods: We searched MEDLINE, Embase and Global Health for studies that described an intervention to promote access to eyecare for the target population. Two authors independently screened titles and abstracts followed by review of the full text of potentially relevant sources. For included studies, data extraction was carried out independently by two authors. Findings were summarised using a combination of descriptive statistics and thematic analysis.
Results: We screened 5220 titles/abstracts, of which 82 reports describing 67 studies met the inclusion criteria. Most studies were conducted in the USA (90%), attempted to improve access for Black (48%) or Latinx (28%) communities at-risk for diabetic retinopathy (42%) and glaucoma (18%). Only 30% included the target population in the design of the intervention; those that did tended to be larger, collaborative initiatives, which addressed both patient and provider components of access. Forty-eight studies (72%) evaluated whether an intervention changed an outcome measure. Among these, attendance at a follow-up eye examination after screening was the most common (n=20/48, 42%), and directly supporting patients to overcome barriers to attendance was reported as the most effective approach. Building relationships between patients and providers, running coordinated, longitudinal initiatives and supporting reduction of root causes for inequity (education and economic) were key themes highlighted for success.
Conclusion: Although research evaluating interventions for non-dominant, non-Indigenous ethnic groups exist, key gaps remain. In particular, the paucity of relevant studies outside the USA needs to be addressed, and target communities need to be involved in the design and implementation of interventions more frequently.
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http://dx.doi.org/10.1136/bmjgh-2021-006188 | DOI Listing |
Br J Ophthalmol
December 2024
Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA
Background/aims: Clinical risk factors for keratoconus (KCN) have previously been established. While the impact of the social determinants of health on the epidemiology and pathophysiology of KCN has been explored, further study of these associations is needed in large and diverse populations. This cross-sectional study determines how education level and income impact the prevalence of KCN in the USA using the National Institutes of Health 'All of Us' database.
View Article and Find Full Text PDFOphthalmic Physiol Opt
November 2024
School of Health & Medical Sciences, City St George's, University of London, London, UK.
Eye (Lond)
November 2024
Manchester University NHS Foundation Trust, Manchester Royal Eye Hospital, Manchester, M13 9WL, UK.
Care pathways for the management of acute ophthalmic conditions have developed and transformed significantly over recent years, owing to a combination of legislative changes, policy implementation and the pressing requirement to redistribute increased demand away from traditional secondary care providers through collaboration with primary care. Following UK healthcare devolution in 1999, each nation has developed and implemented their own strategies for managing the growing demands on acute ophthalmology services. Local commissioning across England has seen Enhanced Service Pathways develop to provide acute eye care by primary care optometrists, with provision and access dependent upon locality.
View Article and Find Full Text PDFCureus
October 2024
Optometry and Vision Science Program, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, MYS.
Ophthalmic Physiol Opt
January 2025
College of Optometrists, London, UK.
Purpose: Socioeconomic deprivation is associated with an increased incidence of sight-loss. To inform potential developments in eyecare, General Ophthalmic Service (GOS) sight-testing activity was explored in relation to deprivation for GOS contractors submitting National Health Service (NHS) claims in England.
Methods: Data on NHS sight-test claims for the financial year 2022-2023 were sought from NHS England (NHSE), including number of sight-tests by GOS contractors, their unique Organisation Data Service codes and postcodes and age-bands of patients accessing sight-testing.
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