The impact of educational workshops on individuals at risk for glaucoma in the Philadelphia Glaucoma Detection and Treatment Project

Johnson, Deiana; Stratford, Shayla; Shyu, Andrew P.; Sembhi, Harjeet; Molineaux, Jeanne; Reamer, Courtney; Spaeth, George L.; Myers, Jonathan S.; Hark, Lisa A; Katz, L. Jay; Waisbourd, Michael

doi:10.1016/j.pec.2015.11.026

Cited by 12 publications

(4 citation statements)

References 15 publications

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“…Previously identified barriers to eye care were effectively minimized by this project’s design: Workshops were designed to increase awareness and knowledge of glaucoma 39 ; examinations with same-day treatment options were offered at the community-based sites, thus reducing transportation issues, decreasing the number of follow-up visits, and increasing convenience; on-site translators were used if necessary to overcome language barriers; and all eye examinations and interventions were free, except for the cost of any prescribed medications, lessening the barrier of cost of care.…”

Section: Discussionmentioning

confidence: 99%

The Philadelphia Glaucoma Detection and Treatment Project

et al. 2016

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Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT, and 103 (6.2%) who were prescribed IOP-lowering medication. Conclusions Targeting individuals at risk for glaucoma in underserved communities in Philadelphia yielded a high detection rate (39.1%) of glaucoma-related diagnoses. Providing examinations and offering treatment, including first-line laser procedures, at community-based sites providing services to older adults are effective to improve access to eye care by underserved populations.

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Section: Discussionmentioning

confidence: 99%

The Philadelphia Glaucoma Detection and Treatment Project

et al. 2016

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“…13 However, Hark et al 12 has demonstrated that through reminder phone calls, individual counselling, reminders, and education, the follow-up rate can improve as much as up to 70%. Similarly, Johnson et al 51 and Zyl et al 52 have shown that providing glaucoma patients with educational workshops and definite follow-up appointment, respectively, were effective in improving rates of follow-up care. We have found that the follow-up rate for comprehensive ophthalmic examinations among Hope Clinic patients is high in this context at around 76.6%.…”

Section: Discussionmentioning

confidence: 90%

Facilitators and Barriers to Glaucoma Screening Identified by Key Stakeholders in Underserved Communities: A Community-engaged Research Approach

Ballouz¹,

Cho²,

Woodward

et al. 2020

Journal of Glaucoma

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The aim was to identify the facilitators and barriers to implementing glaucoma screening programs in 2 community clinics.Methods: A concurrent mixed-methods process analysis using CER. Key stakeholders-including patients, providers, and staff membersfrom 2 community clinics were interviewed using a semistructured interview guide. Interviews had 2 parts: (1) asking patients about community-based facilitators and barriers to implementing glaucoma screening and care and (2) eliciting feedback about a personalized coaching program. The transcripts were coded using Grounded Theory. Number of participants and number of representative citations were counted per theme. The qualitative analysis was coded using Dedoose 8.3.17 (Los Angeles, CA).Results: Thematic saturation was reached after coding 12 interviews. 30 participants were interviewed, 13 from Hamilton Clinic (Flint, MI; 8 patients, 5 providers and staff members) and 17 from Hope Clinic (Ypsilanti, MI; 6 patients, 11 providers and staff members). The most commonly cited themes were: Priorities (98 citations, 30 participants), Knowledge (73, 26) Transportation (63,26), Cost (60,23), and Convenience/Access (63,22). Broadly applicable barriers to glaucoma care, such as Cost, Transportation, and Trust were identified alongside community-specific barriers such as Language and Convenience/Access. Participants rated their likelihood to follow up with an ophthalmologist after participating in the personalized coaching program at a mean of 8.83 (on a scale of 1 to 10 with 10 being the most confident).Conclusions: CER enables researchers to identify communityspecific barriers and facilitators, allowing more effective program implementation.

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“… 16 Indeed, community educational workshops about glaucoma have been shown to increase glaucoma evaluation appointments. 17 Even though the health fairs in the current study were organized as multidisciplinary screening sites (and were not constructed to be glaucoma educational workshops) direct patient counseling and education about diagnosis and the importance of follow-up was explicitly provided by a physician, and none of the respondents reported an issue communicating with the doctor (n = 0). When presented as an open-ended question, none of the respondents reported lack of trust in their physician as a reason why they did not follow up.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Socioeconomic Factors Affecting Follow-Up in a Glaucoma Screening Program

Staropoli¹,

Lee²,

Kroeger³

et al. 2021

OPTH

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Purpose To determine what socioeconomic factors affect follow-up in a glaucoma screening program. Patients and Methods This was a retrospective cohort study of six health fairs in South Florida from October 2012 to March 2013 among socially and economically disadvantaged populations. Visual acuity (VA), intraocular pressure (IOP), cup-to-disc ratio (CDR), and visual field testing were obtained to identify glaucoma suspects. Glaucoma suspects were defined as having intraocular pressure ≥24 mm Hg, cup-to-disc ratio of ≥0.6 in either eye, or glaucomatous defects on visual field testing. In July 2015, telephone surveys were administered to assess follow up and socioeconomic factors. Results Seventy-two out of 144 (50%) glaucoma suspects responded to the survey and were included in the analysis. Of the 72 respondents, average age was 52.8 years old and 65% were female. The most common race was African American (69%) and ethnicity was Haitian (51%). Glaucoma suspects who followed up were significantly more likely to have health insurance compared to those who did not follow up (74% vs 43%, p = 0.014). No significant difference in follow-up based on age (p = 0.125), education (p = 0.151), gender (p = 0.48), or ethnicity (p = 0.707) was identified. Of the 30 respondents, who did not follow up, the most common reasons were “no insurance” (57%, 17/30) and “not worried” (33%, 10/30). Conclusion Insurance was the main socioeconomic factor in determining whether glaucoma suspects followed up after community health screenings. Streamlining social services could increase clinical access of glaucoma suspects.

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The impact of educational workshops on individuals at risk for glaucoma in the Philadelphia Glaucoma Detection and Treatment Project

Cited by 12 publications

References 15 publications

The Philadelphia Glaucoma Detection and Treatment Project

The Philadelphia Glaucoma Detection and Treatment Project

Facilitators and Barriers to Glaucoma Screening Identified by Key Stakeholders in Underserved Communities: A Community-engaged Research Approach

Analysis of Socioeconomic Factors Affecting Follow-Up in a Glaucoma Screening Program

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