title: Improving access to optometry services for people at risk of preventable sight loss: a qualitative study in five UK locations.
abstract: BACKGROUND
  Reducing preventable sight loss is an increasing priority for public health and health care providers. We examined the factors affecting people's use of optometry services in population groups at increased risk of sight loss.
  
  
  METHODS
  This is a qualitative study in five UK locations. In England, participants were from the Pakistani and Black Caribbean communities; in Scotland from the Pakistani community; and in Northern Ireland and Wales from white socio-economically deprived communities. Thirty-four focus groups were conducted (n = 289). The study included people who attend optometry services and people not engaged with services.
  
  
  RESULTS
  Barriers to access included limited awareness of eye health and eye disease, concern about the cost of spectacles and the appropriateness of optometry in a commercial setting. Attendance at the optometrist was primarily symptom led. A positive previous experience or continuing relationship with the optometrist helped to alleviate the barriers and promote attendance.
  
  
  CONCLUSIONS
  Addressing the disparity between the broader messages about eye health and the current perception of the function of optometry could help improve access to services. Uptake may be improved through the co-production of interventions that better resonate with local communities. Non-retail service delivery options should be explored.
authors.affiliation: Evidence and Service Impact Unit, Royal National Institute of Blind People (RNIB), London WC1H 9NE, UK.
authors.forename: S
authors.initials: S
authors.lastname: Leamon
authors.affiliation: Shared Intelligence, London WC1X 0GB, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hayden
authors.affiliation: Sight Loss Prevention Unit, Royal National Institute of Blind People (RNIB), London WC1H 9NE, UK.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: Shared Intelligence, London WC1X 0GB, UK.
authors.forename: D
authors.initials: D
authors.lastname: Trudinger
authors.affiliation: Shared Intelligence, London WC1X 0GB, UK.
authors.forename: E
authors.initials: E
authors.lastname: Appelbee
authors.affiliation: Shared Intelligence, London WC1X 0GB, UK.
authors.forename: D-L
authors.initials: DL
authors.lastname: Hurrell
authors.affiliation: Shared Intelligence, London WC1X 0GB, UK.
authors.forename: I
authors.initials: I
authors.lastname: Richardson
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D017691:Caribbean Region; D005128:Eye Diseases / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009907:Optometry; D010154:Pakistan; D011369:Professional-Patient Relations; D036301:Qualitative Research; D006113:United Kingdom
keywords: at-risk groups; barriers; optometry; service utilization