title: Tailored and targeted interventions to encourage dilated fundus examinations in older African Americans.
abstract: OBJECTIVE
  To compare the effects of a tailored (individualized) and targeted (designed for a subgroup) print intervention in promoting dilated fundus examinations (DFEs) in older African Americans and to determine whether other factors (eg, demographics, preventive health practices, health literacy score, behavioral intentions, and DFE rates) are associated with getting a DFE.
  
  
  METHODS
  African Americans aged 65 years or older who had not had a DFE in at least 2 years were recruited from community settings. Participants were randomized to receive either a tailored or targeted newsletter. Telephone follow-up was conducted at 1, 3, and 6 months to ascertain eye examination status. All participant-reported DFEs were confirmed by contacting their eye doctor (optometrist or ophthalmologist) by telephone. Main Outcome Measure  Eye doctor-confirmed DFE at 6 months.
  
  
  RESULTS
  Of the 329 participants enrolled, 128 (38.9%) had an eye doctor-confirmed DFE. No significant difference was noted in this measure by intervention group (relative risk, 1.07; 95% confidence interval, 0.82-1.40), with 66 participants in the tailored group (40.2%) and 62 participants in the targeted group (37.6%) having an eye doctor-confirmed DFE. Based on logistic regression analysis, reading the newsletter (odds ratio, 1.76; 95% confidence interval, 1.08-2.87) and planning to make an appointment for a DFE (odds ratio, 2.46; 95% confidence interval, 1.42-4.26) were significant predictors for DFE.
  
  
  CONCLUSIONS
  The tailored and targeted interventions were equally effective in promoting eye doctor-confirmed DFEs at 6 months. Given the increased cost and effort associated with tailoring, our results suggest that well-designed targeted print messages can motivate older African Americans to get DFEs. Trial Registration  clinicaltrials.gov Identifier: NCT00649766.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W Redwood St, Ste 100, Baltimore, MD 21201, USA. nellish@epi.umaryland.edu
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Ellish
authors.forename: Renee
authors.initials: R
authors.lastname: Royak-Schaler
authors.forename: Eve J
authors.initials: EJ
authors.lastname: Higginbotham
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000517:prevention & control*; D005260:Female; D005654:Fundus Oculi; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D010353:Patient Education as Topic / Q000379:methods*; D011680:Pupil / Q000187:drug effects; D011795:Surveys and Questionnaires; D015351:Vision Screening
chemical_list: D009184:Mydriatics