Divergent Perceptions of Barriers to Diabetic Retinopathy Screening Among Patients and Care Providers, Los Angeles, California, 2014–2015

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Lu, Yang ; Serpas, Lilian ; Genter, Pauline ; Anderson, Betty ; Campa, David ; Ipp, Eli
• Description:
  Introduction
  
  Despite availability of screening for diabetic retinopathy, testing is underused by many low-income and racial/ethnic minority patients with diabetes. We examined perceived barriers to diabetic retinopathy screening among low-income patients and their health care providers and provider staffers.
  
  Methods
  
  We collected survey data from 101 patients with diabetes and 44 providers and staffers at a safety-net clinic where annual diabetic retinopathy screening rates were low. Barriers specified in the survey were derived from the literature.
  
  Results
  
  Patients surveyed (mean [standard deviation] age, 54.0 [7.7] y; 41% were male) were primarily Hispanics (70%) and African Americans (27%) of low socioeconomic status. Overall, 55% of patients received diabetic retinopathy screening in the previous year. Patients who could not explain why this screening is needed reported more barriers than patients who could (2.5 vs 1.4 barriers, P = .02). Fewer patients reported that they experienced barriers such as transportation (15%), language issues (15%), cultural beliefs or myths (4%), denial (8%), and fear (5%), which providers and staffers considered very or extremely important (all P < .001). Financial burdens (26%) and depression (22%) were most commonly reported by patients as barriers, yet providers and staffers did not rate these barriers as important, P < .001.
  
  Conclusion
  
  Patients and health care providers had markedly divergent perceptions of barriers to diabetic retinopathy screening. Patients with poor understanding of the need for screening were more likely to report such barriers. These results suggest a need for active community engagement to find key elements for education programs and other interventions to increase rates of diabetic retinopathy screening, particularly among low-income, minority populations.
  
  
• Subjects:
  Communication Barriers Cross-Sectional Studies Diabetic Retinopathy Female Health Knowledge, Attitudes, Practice Health Services Accessibility Humans Male Mass Screening Middle Aged Racial Groups Safety-net Providers Surveys And Questionnaires Transportation

  More +
• Source:
  Prev Chronic Dis. 13.
• DOI:
  http://dx.doi.org/10.5888/pcd13.160193
• ISSN:
  1545-1151
• Pubmed ID:
  27710765
• Pubmed Central ID:
  PMC5055399
• Document Type:
  Journal Article
• Place as Subject:
  Los Angeles , CA
• Volume:
  13
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:8d89a9817d0eba637a4dc0b43139d7413738b4c436af0e753ade9178b352dbdf627973502bd573446278e483a81e74d24753da630f407ee99e95b94dd2060dcc
• Download URL:
  https://stacks.cdc.gov/view/cdc/42572/cdc_42572_DS1.pdf
• File Type:
  [PDF - 310.72 KB ]