title: The challenges to ophthalmologic follow-up care in at-risk pediatric populations.
abstract: OBJECTIVE
  To identify barriers to ophthalmological follow-up in high-risk children who are identified by vision screening and eye examination.
  
  
  METHODS
  The records of patients identified as needing follow-up through two free eye care programs (organized optometric and ophthalmologic screening sessions aimed at identifying and treating ocular pathology) targeted toward inner-city youths of low socioeconomic status were reviewed. Parents were contacted by phone, and a questionnaire on barriers to follow-up was administered. Callers attempted to schedule appointments at that time. Data were assessed by means of descriptive analysis.
  
  
  RESULTS
  Of 93 patients, 54 (58%), were successfully contacted. Of these, 23 (25%) were eventually scheduled. Five (5%) patients elected follow-up elsewhere. Twenty (22%) with working phones were still unable to be scheduled. Additional obstacles included families' lack of awareness of the need for follow-up (13%), assumption by families that they would be contacted (5%), scheduling conflicts (4%), concerns about insurance, and difficulty finalizing referrals (2%). A total of 39 patients (42%) were not successfully contacted because of inoperable phone services, and none of the families responded to the mailed questionnaire.
  
  
  CONCLUSIONS
  Inability to contact families was the greatest barrier to follow-up. Our findings suggest that immediate arrangement of follow-up care, on-site visual assessment, and a program director may be useful in increasing follow-up for high-risk children.
authors.affiliation: Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Summer
authors.initials: S
authors.lastname: Williams
authors.forename: Brynn N
authors.initials: BN
authors.lastname: Wajda
authors.forename: Rizwan
authors.initials: R
authors.lastname: Alvi
authors.forename: Colleen
authors.initials: C
authors.lastname: McCauley
authors.forename: Sarah
authors.initials: S
authors.lastname: Martinez-Helfman
authors.forename: Alex V
authors.initials: AV
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009885:Ophthalmology; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population