Eye Care Quality and Accessibility Improvement in the Community (EQUALITY): impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care.
OBJECTIVE
To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) telemedicine program on at-risk patients' knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY.


METHODS
New or existing patients presenting for a comprehensive eye exam (CEE) at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients' CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2-4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar's test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized.


RESULTS
At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions). Those who were unemployed (odds ratio =0.63, 95% confidence interval =0.42-0.95, P=0.026) or had lower education (odds ratio =0.55, 95% confidence interval =0.29-1.02, P=0.058) were less likely to improve their knowledge after adjusting for age, sex, race, and prior glaucoma diagnosis. This association was attenuated after further adjustment for other patient-level characteristics. Ninety-eight percent (n=501) of patients reported being likely to have a CEE within the next 2 years, whereas 63% (n=326) had a CEE in the previous 2 years. Patient satisfaction with EQUALITY was high (99%).


CONCLUSIONS
Improved knowledge about glaucoma and a high intent to pursue eye care may lead to improved detection of early disease, thus lowering the risk of blindness.
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Lindsay A
LA
Rhodes
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Carrie E
CE
Huisingh
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Gerald
G
McGwin
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Stephen T
ST
Mennemeyer
Prevent Blindness, Chicago, IL, USA.
Mary
M
Bregantini
Prevent Blindness, Chicago, IL, USA.
Nita
N
Patel
Vision Health Initiative, Divisi of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jinan
J
Saaddine
Vision Health Initiative, Divisi of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.
John E
JE
Crews
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Christopher A
CA
Girkin
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Cynthia
C
Owsley
blindness prevention; patient satisfaction; patient-related outcome; telemedicine