title: Providing prescheduled appointments as a strategy for improving follow-up compliance after community-based glaucoma screening: results from an urban underserved population.
abstract: To determine if receiving a prescheduled appointment is associated with an increased likelihood of complying with follow-up eye care among individuals identified as at risk for glaucoma during community-based glaucoma screening in an urban underserved population. This study sampled 362 individuals aged ≥30 years without known glaucoma from low-income, predominantly black/Hispanic neighborhoods in New Haven, Connecticut presenting to one of twelve community-based glaucoma screening events from May 2010 to October 2012. A quasi-experimental design systematically assigned 63 individuals identified as at risk for glaucoma into either intervention or control group with a 1:2 ratio. Individuals in the control group (n = 41) received counseling on glaucoma and a recommendation for obtaining a follow-up appointment at the eye department of a local community health center, which offers affordable health services with income-adjusted fee discounts to uninsured, low-income patients. Those in the intervention group (n = 22) received the same counseling and a prescheduled appointment at the community health center. The overall rate of follow-up compliance within 3 months of screening was 30 % (41 % in the intervention group; 24 % in the control group). Multivariate logistic regression analysis adjusting for sex, age, ethnicity, health insurance status, car access, living situation, and smoking status found that follow-up compliance was significantly associated with intervention (adjusted odds ratio 4.8; 95 % confidence interval 1.1-20.9). Providing prescheduled appointments can improve follow-up compliance after community-based glaucoma screening. This finding may be potentially applicable to community-based health screening for other preventable diseases.
authors.affiliation: Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA.
authors.forename: Tavé
authors.initials: T
authors.lastname: van Zyl
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Su
authors.forename: Elaine
authors.initials: E
authors.lastname: Zhou
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Wong
authors.forename: Amir
authors.initials: A
authors.lastname: Mohsenin
authors.forename: Spencer
authors.initials: S
authors.lastname: Rogers
authors.forename: James C
authors.initials: JC
authors.lastname: Tsai
authors.forename: Susan H
authors.initials: SH
authors.lastname: Forster
mesh_terms: D000328:Adult; D001741:Black or African American; D001071:Appointments and Schedules; D003151:Community Health Centers / Q000458:organization & administration*; D003237:Connecticut / Q000453:epidemiology; D003376:Counseling; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000208:ethnology; D006297:Health Services Accessibility / Q000458:organization & administration; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology*; D012307:Risk Factors; D015351:Vision Screening; D035862:Vulnerable Populations