title: Barriers for poor cataract surgery uptake among patients with operable cataract in a program of outreach screening and low-cost surgery in rural China.
abstract: OBJECTIVE
  To identify the reasons for poor uptake of cataract surgery in a program of outreach screening and low-cost surgery in Pucheng County, a rural area in northwestern China.
  
  
  METHODS
  Detailed interviews with a semi-structured questionnaire were conducted by telephone or face-to-face for participants who had been advised to attend a low-cost cataract surgery program but did not schedule the surgery within 3 months after the initial screening.
  
  
  RESULTS
  Among 432 eligible subjects, 355 (82.2%) were interviewed (mean age 70.6 ± 6.6 years, 73.8% female). A total of 138 subjects (38.9%) were interviewed by phone and 217 (61.1%) were interviewed face-to-face. Lack of family support (n = 106, 29.9%) and failure to understand the need for surgery (n = 96, 27.0%) were the two main reasons for not undergoing cataract surgery. Other factors included fear of surgery (n = 62, 17.5%), lack of faith in doctors (n = 36, 10.1%), financial constraints (n = 25, 7.0%) and lack of transportation (n = 4, 1.1%).
  
  
  CONCLUSIONS
  The principal barriers to low-cost cataract surgery uptake in rural China included lack of family support and failure to understand the need for surgery. Education targeting entire families to eliminate these barriers and development of community support systems at the family level are required to achieve greater uptake of low-cost cataract surgery programs in rural China.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong , Hong Kong , China .
authors.forename: Xiu Juan
authors.initials: XJ
authors.lastname: Zhang
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Christopher Kai-Shun
authors.initials: CK
authors.lastname: Leung
authors.forename: Emmy Y
authors.initials: EY
authors.lastname: Li
authors.forename: Yingpeng
authors.initials: Y
authors.lastname: Liu
authors.forename: Chongren
authors.initials: C
authors.lastname: Zheng
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
authors.forename: David F
authors.initials: DF
authors.lastname: Chang
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
authors.forename: Dennis S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001766:Blindness / Q000517:prevention & control*; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000191:economics* / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005251:Fees, Medical; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Blindness prevention; cataract; cataract barriers; cataract screening; low-cost surgery program