Spectacle acceptance among secondary school students in rural China: the Xichang Pediatric Refractive Error Study (X-PRES)--report 5.
OBJECTIVE
To assess determinants of spectacle acceptance and use among rural Chinese children.


METHODS
Children with uncorrected acuity < or = 6/12 in either eye and whose presenting vision could be improved > or = 2 lines with refraction were identified from a school-based sample of 1892 students. Information on obtaining glasses and the benefits of spectacles was provided to children, families, and teachers. Purchase of new spectacles and reasons for nonpurchase were assessed by direct inspection and interview 3 months later.


RESULTS
Among 674 (35.6%) children requiring spectacles (mean age, 14.7 +/- 0.8 years), 597 (88.6%) were followed up. Among 339 children with no glasses at baseline, 30.7% purchased spectacles, whereas 43.2% of 258 children with inaccurate glasses replaced them. Most (70%) subjects paid US$13 to $26. Among children with bilateral vision < or = 6/18, 45.6% bought glasses. In multivariate models, presenting vision < 6/12 (P < 0.009), refractive error < -2.0 D (P < 0.001), and amount willing to pay for glasses (P = 0.01) were predictors of purchase. Reasons for nonpurchase included satisfaction with current vision (78% of those with glasses at baseline, 49% of those without), concerns over price or parental refusal (18%), and fear glasses would weaken the eyes (13%). Only 26% of children stated that they usually wore their new glasses.


CONCLUSIONS
Many families in rural China will pay for glasses, though spectacle acceptance was < 50%, even among children with poor vision. Acceptance could be improved by price reduction, education showing that glasses will not harm the eyes, and parent-focused interventions.
Li
Liping
L
Shantou University Medical College, Shantou, Peoples Republic of China. lpli@stu.edu.cn
Song
Yue
Y
Liu
Xiaojian
X
Lu
Bei
B
Choi
Kai
K
Lam
Dennis S C
DS
Zhang
Mingzhi
M
Zheng
Mingwei
M
Wang
Yunfei
Y
Sharma
Abhishek
A
Congdon
Nathan
N
D000293:Adolescent; D044466:Asian People; D002681:China; D005139:Eyeglasses / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012424:Rural Population; D012574:Schools; D013334:Students; D014786:Vision Disorders / Q000534:rehabilitation*