Dismantling Sociocultural Barriers to Eye Care with Tele-Ophthalmology: Lessons from an Alberta Cree Community

Abstract

Purpose: ere are signi cant disparities in access to health care amongst Aboriginal Canadians. e purpose of this study was to determine whether tele-ophthalmology services, provided to Aboriginal Canadians in a culturally-sensitive community-based clinic, could overcome social and cultural barriers in ways that would be di cult in the traditional hospital-based setting.Methods: e Aboriginal Diabetes Wellness Program of Alberta incorporates culturallysensitive health-related activities and rituals as a component of a diabetic retinopathy teleophthalmology screening program. Metrics of program attendance were collected while stakeholders participated in a survey to identify barriers to healthcare delivery.Results: Aboriginal patients, cultural liaison, nurses and program administrators revealed economic, geographic, social and cultural barriers to healthcare faced by Aboriginal people. It was found that the introduction of culturally-sensitive programs led to increased appointment attendance; from 25% to 85%. Involvement of Aboriginal nurses, inclusion of culturally-sensitive activities and participation in spiritual ceremonies led to qualitative accounts of increased patient satisfaction, trust towards the healthcare team and communication amongst participants. Conclusions:A culturally-sensitive model of healthcare delivery in a community-based health clinic improved access to tele-ophthalmology services. is was demonstrated by increased attendance at appointments and increased satisfaction amongst patients.TRAINEE SECTION

Prevalence and causes of ocular morbidity seen among rural adult population of Osun State, southwest Nigeria

“…[21,22] These methods also look very attractive as means of overcoming some sociocultural barriers during medical screening of a community. [23] We look forward to such medical practice in the Nigerian underserved rural populations in future. These we hope would help in the prevention and reduction of avoidable blindness and deaths.…”

Patient Attitudes Toward Telemedicine for Diabetic Retinopathy

“…''Willingness'' to try new technologies is closely tied to the concepts of trust and openness. 37,38 Patients with long-standing disease are less likely to trust a new, less-personal delivery model. In our study, the highest impact on willingness was convenience.…”

Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature

“…Financial concerns, such as the cost of the eye examination/care and the cost or lack of insurance were common, especially in the studies from the USA [19,20], but attendance was sometimes not influenced by insurance [21]. Self-employed or casual employees reported costs owing to lost income when they took time off work to attend screening appointments [22,23].…”