title: Effect of an eye health education program on older African Americans' eye care utilization and attitudes about eye care.
abstract: We examined the impact of an eye health education program for older African Americans on attitudes about eye care and utilization, using a randomized trial design in a community setting. Participants were older African Americans attending activities at senior centers: Ten centers were randomized to an eye health education (InCHARGE) or social-contact control presentation. InCHARGE addressed the importance of annual dilated comprehensive examination and strategies reducing barriers to care. The control presentation was on the importance of physical activity. Outcomes were attitudes about eye care 6 months post event through questionnaire and eye care utilization during 12 months post event through medical record abstraction. At baseline, more than 80% participants in both arms said transportation and finding, communicating, and trusting a doctor were not problematic and agreed that yearly care was important. One-fourth said eye examination cost was problematic; one-half said spectacle cost was problematic. There were no group differences 6 months post event. During the 12 months pre event, the dilated exam rate was similar in the groups (38.3% InCHARGE, 40.8% control) and unchanged during the 12 moiths post event. Results suggest fewer than half of older African Americans received annual dilated eye care. Group-administered eye health education did not increase this rate. Even before the program, they had positive attitudes about care, yet many cited examination and spectacle cost as problematic, which was not mitigated by health education. Evidence-based strategies in a community setting for increasing eye care utilization rate in older African Americans have yet to be identified. Policy changes may be more appropriate avenues for addressing cost.
  
  
  BACKGROUND
  NCT00591110, www.ClinicalTrials.gov
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, 700 S 18th St, Ste 609, Birmingham, AL 35294-0009, USA. owsley@uab.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Karen
authors.initials: K
authors.lastname: Searcey
authors.forename: June
authors.initials: J
authors.lastname: Weston
authors.forename: Angelia
authors.initials: A
authors.lastname: Johnson
authors.forename: Beth T
authors.initials: BT
authors.lastname: Stalvey
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Girkin
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology