scholarly journals School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stevens Bechange ◽  
Munazza Gillani ◽  
Emma Jolley ◽  
Robina Iqbal ◽  
Leena Ahmed ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Screening Programme ◽  
Public Health Problem ◽  
Care Hospital ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Training Experience ◽  
Screening Guidelines ◽  
School Based

Abstract Background Visual impairment in children is a significant public health problem affecting millions of children globally. Many eye problems experienced by children can be easily diagnosed and treated. We conducted a qualitative study with teachers and optometrists involved in a school-based vision screening programme in Quetta district of Pakistan to explore their experiences of training, vision screening and referrals and to identify factors impacting on the effectiveness of the programme. Methods Between April 2018 and June 2018, we conducted semi-structured in-depth interviews with 14 teachers from eight purposefully selected schools with high rates of inaccurate (false positive) referrals. Interviews were also conducted with three optometrists from a not-for profit private eye care hospital that had trained the teachers. Interviews were audio recorded and professionally transcribed. NVIVO software version 12 was used to code and thematically analyze the data. Results Findings suggest that the importance of school-based vision screening was well understood and appreciated by the teachers and optometrists. Most participants felt that there was a strong level of support for the vision screening programme within the participating schools. However, there were a number of operational issues undermining the quality of screening. Eight teachers felt that the duration of the training was insufficient; the training was rushed; six teachers said that the procedures were not sufficiently explained, and the teachers had no time to practice. The screening protocol was not always followed by the teachers. Additionally, many teachers reported being overburdened with other work, which affected both their levels of participation in the training and the time they spent on the screening. Conclusions School-based vision screening by teachers is a cost-effective strategy to detect and treat children’s vision impairment early on. In the programme reviewed here however, a significant number of teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach. To maximise the effectiveness and efficiency of school-based screening, future initiatives should give sufficient attention to the duration of the teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of those trained.

scholarly journals Eye-care utilization among a Canadian diabetic refugee population: retrospective cohort study of an interdisciplinary care model

2021 ◽  
pp. 205343452110610
Author(s):  
Stuti M Tanya ◽  
Bonnie He ◽  
Christine Aubrey-Bassler
Keyword(s):  
Retrospective Cohort ◽  
Care Delivery ◽  
Family Physicians ◽  
Care Utilization ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Settlement Services ◽  
Screening Services ◽  
Eye Care Utilization

Introduction Vision health is an important and underutilized health service among newly arrived refugees in Canada, yet the body of literature on eye-care delivery in this population is limited. The study objective was to identify patterns of eye-care utilization among refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL) under an interdisciplinary clinic model comprised of family physicians, eye-care providers, and settlement services. Methods This was a retrospective cohort study at the Memorial University Family Medicine clinic. All patients with a new T2DM diagnosis between 2015–2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full ethics approval. Results Seventy-three (18 refugee, 55 non-refugee) patients were included. Refugees had a higher rate of referral to an eye-care provider ( p = 0.0475) and were more likely to attend their eye-care provider appointment than non-refugees ( p = 0.016). The time from diagnosis to referral was longer for refugees than non-refugees ( p = 0.0498). A trend towards longer time from referral to appointment attendance for refugees than non-refugees was noted ( p = 0.9069). Discussion Refugee patients had higher rates of referral to eye-care providers and utilization of eye-care services. However, refugees also experienced a longer time to access vision screening services suggesting possible gaps in accessible care delivery. This suggests that the interdisciplinary model of care may be effective in referring refugee patients for vision screening and there may be a role for increased collaboration across family physicians, eye-care providers, and settlement services to improve accessibility of vision screening services.

scholarly journals Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists

2021 ◽  
Vol 8 (3) ◽  
pp. 1052
Author(s):  
Soe Min Oo ◽  
Myo Mon Mon ◽  
Khaing Lay Mon
Keyword(s):  
Qualitative Study ◽  
School Children ◽  
Refractive Error ◽  
Service Providers ◽  
Screening Program ◽  
Care Program ◽  
World Health ◽  
Vision Screening ◽  
School Based ◽  
Vision Care

Background: Refractive error (RE) is one of the global leading causes of vision impairment among children. The World Health Organization outlined the school-based vision care program aided by school teachers as one solution. In Myanmar, although the prevalence of RE among school children is expected at about two million, a regular eye check-up program has not been established. This study aimed to explore the barriers, feasibility, and limitations of the children with RE and service providers to establish a program.Methods: This qualitative study was conducted in eight public schools,that have been involved in the pilot school-based vision screening program, in Yangon.  Focus group discussions with school children and teachers from these schools, key informant interviews with optometrists and ophthalmologists, involved in the program, and working at Yangon Eye Hospital and North Okala General Hospital, were carried out from January to August 2020. Qualitative data analysis was manually performed using the grounded theory according to the pre-defined themes.Results: Almost all school children showed positive perspectives but they expressed their psychosocial barriers of the cost, time, and care given by their parents on the next vision examination. All teachers mentioned optimism to be volunteers. The optometrist and ophthalmologists revealed the feasibility to establish the program despite having limitations in human resources, logistic requirements, and low awareness level on visual impairment of the children by parents.Conclusions: This study highlighted that a school-based vision care program can be initiated in Myanmar despite having some barriers and limitations.

scholarly journals Parents’ reasons for nonadherence to referral to follow-up eye care for schoolchildren who failed school-based vision screening in Cross River State, Nigeria—A descriptive qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259309
Author(s):  
Lynne Lohfeld ◽  
Christine Graham ◽  
Anne Effiom Ebri ◽  
Nathan Congdon ◽  
Ving Fai Chan
Keyword(s):  
Focus Group ◽  
Contextual Factors ◽  
Vision Screening ◽  
Eye Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross River ◽  
Cross River State ◽  
School Based

Background Uncorrected refractive error (URE) is a major cause of vision impairment in children worldwide. Cases are often detected through a school-based vision screening program and then treated in a follow-up appointment. This requires parents or guardians (‘parents’) to adhere to referrals for the eye exam and care plan. We aim to understand the reasons for parents’ referral non-adherence in Cross River State, Nigeria, using qualitative methods. Methods Ten focus groups were held with parents who had not adhered to the referral for a follow-up eye examination. Participants were recruited with help from staff in schools hosting the vision screening programme. Interviews were conducted using a semi-structured interview guide, audio taped and transcribed verbatim. After identifying relevant quotes, the researchers labelled each one with a descriptive code/subcode label. Then they clustered the data into categories and overarching themes. Results Forty-four parents participated in 10 focus group discussions with 28 women and 16 men. Three themes and participated in the focus group discussions with 28 women (63%). Twelve themes were generated. The three megathemes were Modifiable Factors (with 4 themes), Contextual Factors (with 6 themes), and Recommendations (with 2 themes). Conclusion Participants identified modifiable barriers that make it difficult for parents to adhere to a referral for a follow-up eye exam. These include not believing their child has a vision problem or the screening test, and issues with the referral letter. They also described important contextual factors such as poverty, logistical problems, parental attitudes towards their children and beliefs about appropriate care. Many of these issues could be addressed by following their recommendation to educate the public on the importance of child eye care and correct parents’ misconceptions. These themes will be used by the Nigerian government to enhance and scale up its child eye health programme.

National survey of paediatric vision screening programs across Canada: Identifying major gaps and call to action

2021 ◽  
Author(s):  
Yasmin Jindani ◽  
Dallas Nash ◽  
Natalie Fleming ◽  
Kourosh Sabri
Keyword(s):  
Public Health ◽  
Age Groups ◽  
Cost Effective ◽  
Kindergarten Students ◽  
Kindergarten Children ◽  
Screening Tests ◽  
Vision Screening ◽  
Eye Care ◽  
Screening Programs ◽  
School Based

Abstract Objective Paediatric vision screening programs identify children with ocular abnormalities who would benefit from treatment by an eye care professional. A questionnaire was conducted to assess existence and uptake of school-based vision screening programs across Canada. A supplementary questionnaire was distributed among Ontario’s public health units to determine implementation of government mandated vision screening for senior kindergarten children. Methods Chief Medical Officers of Health for each province and territory, and Ontario’s thirty-four public health units were sent a questionnaire to determine: 1) whether school-based vision screening is being implemented; 2) what age groups are screened; 3) personnel used for vision screening; 4) the type of training provided for vision screening personnel; and 5) vision screening tests performed. Results Of the thirteen provinces/territories in Canada, six perform some form of school-based vision screening. Two provinces rely solely on non-school-based programs offering eligible children an eye examination by an optometrist and three rely on ocular assessment conducted by a nurse at well-child visits. In Ontario, where since 2018 vision screening for all senior kindergarten students is government mandated, only seventeen public health jurisdictions are implementing universal vision screening programs using a variety of personnel ranging from food safety workers to optometrists. Conclusion Good vision is key to physical and emotional development. There is an urgent need for a universal, evidence-based and cost-effective multidisciplinary approach to standardize paediatric vision screening across Canada and break down barriers preventing children from accessing eye care.

scholarly journals Colorectal cancer: evolution of screening strategies

2019 ◽  
Vol 92 (1) ◽  
pp. 21-24
Author(s):  
Daniel Sur ◽  
Marius Colceriu ◽  
Genel Sur ◽  
Emanuela Floca ◽  
Loredana Dascal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Health Care Providers ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Average Risk ◽  
Care Providers ◽  
Screening Guidelines ◽  
Screening Strategies

Background and aim. Colorectal cancer is considered to be a major public health problem. It is the third most frequent cancer at a global level and also the fourth most frequent cause of death. Previous scientific findings have proved that a significant percentage of colorectal cancer deaths are due to the abscence of screening. The aim of this review is to present the evolution of the screening strategies by using the most recommended and recent colorectal cancer screening guidelines. Methods. A systematic literature search on the scientific databases was performed, identifying some of the most important colorectal cancer screening guidelines publications. Results. The most recent guidelines of American Cancer Society (2018) recommend that adults aged 45 years and older with an average risk of colorectal cancer should undergo regular screening. All the guidelines have considered fecal occult blood testing (annual or biennial), fecal immunochemical test (annual), flexible sigmoidoscopy (every 5 years) and colonoscopy (every 10 years) as the most preferred screening options. However, there are discrepancies with regards to which tests should be preferred for screening. Conclusion. Increased compliance with colorectal cancer screening recommendations has the potential to improve patients’ health and to reduce colorectal cancer morbidity and mortality rates. It is important for health care providers to have an understanding of the risk factors for colorectal cancer and various stages of disease development in order to recommend appropriate screening strategies.

scholarly journals Eye-care Utilization Among a Canadian Diabetic Refugee Population: A Retrospective Cohort Pilot Study

2021 ◽  
Author(s):  
Stuti M Tanya ◽  
Bonnie He ◽  
Christine Aubrey-Bassler
Keyword(s):  
Newfoundland And Labrador ◽  
Primary Care Providers ◽  
Small Sample ◽  
Care Utilization ◽  
Study Cohort ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Refugee Population ◽  
Eye Care Utilization

Abstract Background: Diabetic retinopathy (DR) is a leading and preventable cause of blindness. DR screening lies at the intersection of many documented challenges in access to care for refugees. Additionally, vision screening is determined to be an important health need and a critical locus for underutilization of health services among refugees resettling in Canada. To date, there is a limited body of evidence on the ocular health of refugees in Canada and no known studies on diabetic vision screening among refugees. Our objective was to identify patterns of eye-care utilization among refugee and non-refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL).Methods: We conducted a retrospective comparative cohort study at the Memorial University Family Medicine clinic, which includes the province’s largest dedicated refugee clinic. All patients with a new T2DM diagnosis between 2015-2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full approval from the Newfoundland and Labrador Health Research Ethics Board. Results: 73 (18 refugee, 55 non-refugee) patients were included. Refugees had a significantly higher rate of referral to an eye-care provider (ECP) (p=0.0475) and were more likely to attend their ECP appointment than non-refugees (p=0.016). The time from diagnosis to referral was significantly longer for refugees than non-refugees (p=0.0498). A trend towards a longer time from referral to appointment attendance for refugees than non-refugees was noted (p=0.9069). Conclusions: Our study is the first to report eye-care utilization among an Atlantic Canadian refugee population, and among the first to report access to diabetic vision care among refugees worldwide. Although refugee patients in our study cohort had higher rates of referral to ECPs and utilization of eye-care services, they also experienced a longer time to access care. Specialist care is known to be more challenging to access for vulnerable populations. Our findings suggest that there may be a role for ECPs to collaborate with primary care providers to improve access to vision screening services. Limitations include the small sample size as well as selection and detection bias inherent to a retrospective chart review.

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