title: Predictors of adequate correction following vision screening failure.
abstract: OBJECTIVE
  To determine whether compliance with referral 1 year after vision screening failure was associated with care model, demographic, or ocular factors.
  
  
  METHODS
  Data were analyzed from 798 children in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study with habitual logMAR visual acuity (VA) ≥0.26 (20/40 + 2 or worse) in either eye due to uncorrected or undercorrected refractive error and who returned the following year. The parents of 492 children failing in TX and CA were sent letters indicating the need for a complete vision examination (screening model), while 306 children seen primarily in AZ and AL received a free complete examination and eyeglasses if needed (complete care model). Presenting to follow-up with adequate correction (logMAR <0.26) in each eye was considered compliant. Logistic regression models for compliance were fit to assess whether care model, ethnicity, sex, age, uncorrected logMAR in the better eye, or parental income, education, or myopia were predictors.
  
  
  RESULTS
  Overall compliance was 28%. Age [p = 0.01, odds ratio (OR) = 1.12] and uncorrected logMAR (p < 0.001, OR = 1.13) were associated with compliance but care model, ethnicity, and sex were not. Among the 447 children for whom data on parental factors were available, 27% were compliant. In this model, age, ethnicity, sex, parental income, parental education, and parental myopia were not associated with compliance, but uncorrected logMAR (p = 0.005; OR = 1.13) was predictive. An interaction between unaided VA and care model predicted improved compliance with poorer unaided VA in the complete care model.
  
  
  CONCLUSIONS
  Expensive complete care screening programs may not improve compliance over typical notification and referral screening protocols in school-aged children, unless unaided VA is worse than the common 20/40 referral criteria. Unaided VA had less impact on predicted compliance in the screening-only protocol.
authors.affiliation: University of Houston, College of Optometry, Houston, TX 77204, USA. rmanny@uh.edu
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Manny
authors.forename: Loraine T
authors.initials: LT
authors.lastname: Sinnott
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jones-Jordan
authors.forename: Dawn
authors.initials: D
authors.lastname: Messer
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Twelker
authors.forename: Susan A
authors.initials: SA
authors.lastname: Cotter
authors.forename: Robert N
authors.initials: RN
authors.lastname: Kleinstein
authors.forename: Mabel
authors.initials: M
authors.lastname: Crescioni
mesh_terms: D000293:Adolescent; D002648:Child; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010349:Patient Compliance; D015995:Prevalence; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D015351:Vision Screening