TY - JOUR
T1 - Knowledge, attitudes and eye health-seeking behaviours in a population-based sample of people with diabetes in rural China
AU - Chen, Tingting
AU - Jin, Ling
AU - Zhu, Wenhui
AU - Wang, Congyao
AU - Zhang, Guoshan
AU - Wang, Xiuqin
AU - Wang, Jun
AU - Yang, Ke
AU - Cochrane, Gillian M.
AU - Lamoureux, Ecosse Luc
AU - Friedman, David S.
AU - Gilbert, Suzanne
AU - Lansingh, Van C.
AU - Resnikoff, Serge
AU - Zhao, Jialiang
AU - Xiao, Baixiang
AU - He, Mingguang
AU - Congdon, Nathan
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Aims To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake. Methods Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression. Results A total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. € Very likely' or € likely' acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%). Conclusions Improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.
AB - Aims To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake. Methods Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression. Results A total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. € Very likely' or € likely' acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%). Conclusions Improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.
KW - Child health (paediatrics)
KW - Clinical Trial
KW - Contact lens
KW - Epidemiology
KW - Eye (Globe)
KW - Glaucoma
KW - Infection
KW - Intraocular pressure
KW - Lens and zonules
KW - Low vision aid
KW - Medical Education
KW - Optic Nerve
KW - Public health
KW - Rehabilitation
KW - Retina
KW - Vision
KW - Visual perception
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U2 - 10.1136/bjophthalmol-2020-316105
DO - 10.1136/bjophthalmol-2020-316105
M3 - Article
C2 - 32737033
AN - SCOPUS:85089547771
SN - 0007-1161
VL - 105
SP - 806
EP - 811
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 6
ER -