title: Regular provision of outreach increases acceptance of cataract surgery in South India.
abstract: OBJECTIVE
  The prevalence of visual loss and blindness from cataract remains high in India. Marginalized communities are frequently reached through outreach clinics. The aim of this study was to explore the hypothesis that regular outreach, held in the same location by the same provider, leads to greater acceptance of cataract surgery than outreach clinics that are irregular in terms of timing and location.
  
  
  METHODS
  The study was integrated into outreach clinics run in two districts by Sankara Eye Centre, Coimbatore, Southern India. A semi-structured questionnaire was administered to patients who had attended outreach eye clinics and either accepted or not accepted the offer of cataract surgery.
  
  
  RESULTS
  Overall acceptance of surgery was high (91.7%), being higher in the district with regular outreach (94.6%vs. 82.3%, P < 0.001). A total of 398 participants (240, 60% acceptors) were interviewed. Acceptors were more likely to live in smaller households and in supportive families than non-acceptors who lived in larger families which could not provide support and where transport and distance were also barriers (P .001). Attending regular outreach and having had first eye cataract surgery were independent predictors of acceptance in a logistic regression model.
  
  
  CONCLUSIONS
  The findings indicate the importance of providers building trust by organizing regular outreach in the same location. Previous eye surgery was also a strong predictor of accepting cataract surgery. To promote universal access to health care, marginalized rural communities will continue to need outreach for some time to come.
authors: Department of Ophthalmology, University of Bonn, Germany. robertfinger@gmx.net
authors: Robert P
authors: RP
authors: Finger
authors: David G
authors: DG
authors: Kupitz
authors: Frank G
authors: FG
authors: Holz
authors: Seetha
authors: S
authors: Chandrasekhar
authors: Bharath
authors: B
authors: Balasubramaniam
authors: Ramanathan V
authors: RV
authors: Ramani
authors: Clare E
authors: CE
authors: Gilbert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002386:Cataract / Q000453:epidemiology; D002387:Cataract Extraction / Q000706:statistics & numerical data* / Q000639:trends; D003159:Community-Institutional Relations / Q000592:standards / Q000639:trends; D005190:Family; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012944:Social Support; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*