title: Effect of rehabilitation worker input on visual function outcomes in individuals with low vision: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Visual Rehabilitation Officers help people with a visual impairment maintain their independence. This intervention adopts a flexible, goal-centred approach, which may include training in mobility, use of optical and non-optical aids, and performance of activities of daily living. Although Visual Rehabilitation Officers are an integral part of the low vision service in the United Kingdom, evidence that they are effective is lacking. The purpose of this exploratory trial is to estimate the impact of a Visual Rehabilitation Officer on self-reported visual function, psychosocial and quality-of-life outcomes in individuals with low vision.
  
  
  METHODS
  In this exploratory, assessor-masked, parallel group, randomised controlled trial, participants will be allocated either to receive home visits from a Visual Rehabilitation Officer (n = 30) or to a waiting list control group (n = 30) in a 1:1 ratio. Adult volunteers with a visual impairment, who have been identified as needing rehabilitation officer input by a social worker, will take part. Those with an urgent need for a Visual Rehabilitation Officer or who have a cognitive impairment will be excluded. The primary outcome measure will be self-reported visual function (48-item Veterans Affairs Low Vision Visual Functioning Questionnaire). Secondary outcome measures will include psychological and quality-of-life metrics: the Patient Health Questionnaire (PHQ-9), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), the Adjustment to Age-related Visual Loss Scale (AVL-12), the Standardised Health-related Quality of Life Questionnaire (EQ-5D) and the UCLA Loneliness Scale. The interviewer collecting the outcomes will be masked to the group allocations. The analysis will be undertaken on a complete case and intention-to-treat basis. Analysis of covariance (ANCOVA) will be applied to follow-up questionnaire scores, with the baseline score as a covariate.
  
  
  CONCLUSIONS
  This trial is expected to provide robust effect size estimates of the intervention effect. The data will be used to design a large-scale randomised controlled trial to evaluate fully the Visual Rehabilitation Officer intervention. A rigorous evaluation of Rehabilitation Officer input is vital to direct a future low vision rehabilitation strategy and to help direct government resources.
  
  
  BACKGROUND
  The trial was registered with ( ISRCTN44807874 ) on 9 March 2015.
authors.affiliation: School of Optometry & Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, Wales, UK. actonj@cardiff.ac.uk.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Acton
authors.affiliation: School of Optometry & Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, Wales, UK. MolikBN@cardiff.ac.uk.
authors.forename: Bablin
authors.initials: B
authors.lastname: Molik
authors.affiliation: School of Optometry & Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, Wales, UK. alison.binns.1@city.ac.uk.|Division of Optometry, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, England, UK. alison.binns.1@city.ac.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: Binns
authors.affiliation: School of Optometry & Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, Wales, UK.|Institute of Health and Wellbeing, University of Glasgow, 1st floor, Administration Building, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Court
authors.affiliation: School of Optometry & Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, Wales, UK.
authors.forename: Tom H
authors.initials: TH
authors.lastname: Margrain
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D003150:Community Health Workers; D006792:House Calls; D006801:Humans; D057187:Independent Living; D051346:Mobility Limitation; D011788:Quality of Life; D012107:Research Design; D058992:Social Participation; D011795:Surveys and Questionnaires; D013997:Time Factors; D015354:Vision, Low / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D014785:Vision, Ocular; D019987:Persons with Visual Disabilities / Q000523:psychology / Q000534:rehabilitation*; D014852:Wales