title: Glaucoma medication adherence among African Americans: program development.
abstract: OBJECTIVE
  To elucidate barriers and facilitators related to glaucoma medication adherence among African Americans (AA) with glaucoma and to elicit input from a community-based participatory research team to guide the development of a culturally informed health promotion program for improving glaucoma medication adherence among AAs.
  
  
  METHODS
  The nominal group technique (NGT), a highly structured focus group methodology, was implemented with 12 separate groups of AA patients with glaucoma (N = 89) to identify barriers and facilitators related to glaucoma medication usage. Participant rank-ordering votes were summed across groups and categorized into themes. Next, an individually and culturally targeted health promotion program promoting appropriate medication adherence was developed based on focus group results and input from a community-based participatory research team.
  
  
  RESULTS
  The top five barriers included problems with forgetfulness, side effects, cost/affordability, eyedrop administration, and the eyedrop schedule. The most salient top five facilitators were fear or thoughts about the consequences of not taking eyedrops; use of memory aids, cues, or strategies; maintaining a regular routine or schedule for eyedrop administration; ability to afford eyedrops; and keeping eyedrops in the same area. The resulting health promotion program was based on a multicomponent empowerment framework that included glaucoma education, motivational interviewing, and problem-solving training to improve glaucoma medication adherence.
  
  
  CONCLUSIONS
  Barriers and facilitators related to glaucoma medication adherence among AAs are multifactorial. Based on the NGT themes and input from the community-based participatory research team, a culturally informed health promotion program was designed and holds great promise for improving medication adherence among this vulnerable population.
authors.affiliation: Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. dreer@uab.edu
authors.forename: Laura E
authors.initials: LE
authors.lastname: Dreer
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Girkin
authors.forename: Lisa
authors.initials: L
authors.lastname: Campbell
authors.forename: Andy
authors.initials: A
authors.lastname: Wood
authors.forename: Liyan
authors.initials: L
authors.lastname: Gao
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D005901:Glaucoma / Q000188:drug therapy* / Q000208:ethnology; D006293:Health Promotion; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D016730:Program Development; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents