title: Ocular screening adherence across Hispanic/Latino heritage groups with diabetes: results from the Ocular SOL ancillary to the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
abstract: OBJECTIVE
  The objective of this study was to examine the prevalence and correlates of ocular screening adherence among select Hispanics/Latinos living with diabetes.
  
  
  METHODS
  Data were obtained through an ancillary study of the Hispanic Community Health Study/Study of Latinos (Miami site). Participants included Hispanics/Latinos aged 40+ years who underwent a baseline examination/risk factor assessment (2008-2011) and then completed a survey on vision health/knowledge (conducted October 2011-September 2013; sample n=1235; diabetic subsample=264). The dependent variable was having a dilated eye examination within the past 12 months. Covariate candidate selection for entry into sequential multivariable logistic regression models was guided by Anderson's Behavioral Model of Health Services Use and the Behavioral Model for Vulnerable Populations.
  
  
  RESULTS
  Participants aged 65+ were more likely to have dilated eye examinations (OR 2.62, 95% CI 1.22 to 5.60) compared with those aged 40-54 years. Participants less likely to have dilated examinations had a high school degree or general educational development (GED) (OR 0.30, 95% CI 0.10 to 0.96, compared to no degree) and those currently uninsured or never insured ((OR 0.34, 95% CI 0.14 to 0.83) and (OR 0.19, 95% CI 0.07 to 0.51)) compared to those currently insured. Participants who heard or saw something about eye health from two or more sources (eg, media outlets, doctor's office, relatives/friends) compared to those who reported no sources in the past 12 months were more likely to have a dilated eye examination (OR 2.82, 95% CI 1.26 to 6.28).
  
  
  CONCLUSIONS
  Lack of health insurance is strongly associated with low screening uptake in Hispanics/Latinos living with diabetes. Health promotion strategies stressing the importance of annual dilated eye examinations and increasing sources of information on eye health are other potential strategies to increase screening uptake in Hispanics/Latinos.
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami, Florida , USA.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Tannenbaum
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami, Florida , USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: McClure
authors.affiliation: Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami, Florida , USA.
authors.forename: D Diane
authors.initials: DD
authors.lastname: Zheng
authors.affiliation: Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, Florida , USA.
authors.forename: Byron L
authors.initials: BL
authors.lastname: Lam
authors.affiliation: Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami, Florida , USA.
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
authors.affiliation: Department of Ophthalmology and Visual Sciences, Division of Epidemiology and Biostatistics , School of Public Health, University of Illinois at Chicago , Chicago, Illinois , USA.
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Joslin
authors.affiliation: Division of Behavioral Sciences , Graduate School of Public Health, San Diego State University , San Diego, California , USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Talavera
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
keywords: Epidemiology; Hispanics; Ophthalmology; Vision Impairment