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Teasdale RM, Strasser M, Moore C, Graham KE. Evaluative criteria in practice: Findings from an analysis of evaluations published in Evaluation and Program Planning. EVALUATION AND PROGRAM PLANNING 2023; 97:102226. [PMID: 36645955 DOI: 10.1016/j.evalprogplan.2023.102226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/22/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evaluative criteria represent values about characteristics that define a successful evaluand. Criteria direct evaluators' lines of inquiry, including how aims are framed, which questions are asked, and what conclusions are reached. Yet, criteria often remain unstated, and little is known about criteria employed in practice. METHODS We analyzed 141 evaluations published in Evaluation and Program Planning over four years (2016-2019). Applying a model of criteria domains, we utilized collaborative, interpretive coding to surface and examine the criteria embedded in evaluation aims, questions, and conclusions. We also identified methods used to gather evaluation data. FINDINGS Analysis illuminated eight criteria domains evident in the sample and revealed how multiple domains were combined within individual evaluations. We found overlap among data collection methods used to investigate different domains. CONCLUSIONS Findings reveal the variety of criteria employed in practice and how evaluators combine criteria to examine multifaceted evaluands. Findings also highlight the need for evaluators to understand how to adapt methods to investigate different criteria domains. This article contributes to the empirical knowledge base about evaluative criteria and identifies revisions to the criteria model.
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Affiliation(s)
- Rebecca M Teasdale
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Mikayla Strasser
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Ceily Moore
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Kara E Graham
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
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Huang Y, Mustapha J, Harrison-Williams L, Fashina T, Randleman C, Ifantides C, Shantha JG, Yeh S. Global Ophthalmic Health Initiatives in Ebola and Emerging Infectious Disease Outbreaks: Implications for Vision Health Systems, Program Implementation, and Disease Surveillance. Int Ophthalmol Clin 2023; 63:79-89. [PMID: 36598835 PMCID: PMC9819215 DOI: 10.1097/iio.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Massie J, Block SS, Morjaria P. The Role of Optometry in the Delivery of Eye Care via Telehealth: A Systematic Literature Review. Telemed J E Health 2022; 28:1753-1763. [PMID: 35612473 PMCID: PMC9805855 DOI: 10.1089/tmj.2021.0537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective: Optometrists are increasingly adopting teleoptometry as an approach to delivering eye care. The coronavirus disease 2019 (COVID-19) pandemic has created further opportunities for optometrists to utilize innovation in telehealth to deliver eye care to individuals who experience access barriers. A systematic literature review is presented detailing the evidence to support the use of teleoptometry. Methods: Databases of MEDLINE, Global Health, and Web of Science were searched, and articles were included if they reported any involvement of optometrists in the delivery of telehealth. Findings were reported according to the mode of telehealth used to deliver eye care, telehealth collaboration type, and the format and geographical areas where eye care via telehealth is being delivered. Results: Twenty-seven relevant studies were identified. Only 11 studies included the role of optometrists as a member of the telehealth team where the scope of practice extended beyond creating and receiving referrals, collecting clinical data at in-person services, and continuing in-person care following consultation with an ophthalmologist. Both synchronous and asynchronous telehealth services were commonly utilized. Optometrists were most commonly involved in ophthalmology-led telehealth collaborations (n = 19). Eight studies reported optometrists independently delivering primary eye care via telehealth, and commonly included videoconferencing. Conclusion: The application of teleoptometry to deliver eye care is rapidly emerging, and appears to be a viable adjunct to the delivery of in-person optometry services. The review highlighted the scarcity of evidence surrounding the clinical benefits, safety, and outcomes of teleoptometry. Further research is required in this area.
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Affiliation(s)
- Jessica Massie
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Address correspondence to: Jessica Massie, BVisSci/MOptom, MScPHEC, International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | | | - Priya Morjaria
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Glaucoma Treatment Outcomes in Open Angle Glaucoma Patients of African Descent. J Glaucoma 2022; 31:479-487. [PMID: 35353787 PMCID: PMC9246921 DOI: 10.1097/ijg.0000000000002027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/19/2022] [Indexed: 01/31/2023]
Abstract
Open angle glaucoma (OAG), characterized by structural changes to the optic nerve head and retinal nerve fiber layer, is a progressive multifactorial optic neuropathy and a leading cause of irreversible blindness globally. Currently, intraocular pressure is the only modifiable risk factor; however, others have been identified, including genetics and race. Importantly, OAG is much more prevalent in persons of African descent (AD) compared with those of European descent (ED). OAG patients of AD are also known to have a more severe course of the disease, a finding potentially explained by structural and/or vascular differences within eye tissues. In addition, disparities in treatment outcomes have been identified in OAG patients of AD. Specifically, prostaglandin analogues have been suggested to be more effective in patients of AD than in those ED, while beta-adrenergic receptors have been suggested to be less effective, although the evidence is inconsistent. AD has also been identified as a risk factor for trabeculectomy failure while laser trabeculoplasty has been conversely found to be very effective in lowering intraocular pressure in patients of AD. Alternative surgical options, including Ex-Press shunt implantation, viscocanalostomy, and canaloplasty are promising in equivalence but require further research to evaluate disparity in outcome properly. In addition to treatment outcomes, social disparities affecting clinical care also exist for AD persons in the form of reduced adherence, access, and choice. Overall, data suggest the need for properly designed prospective trials with AD populations as a primary focus to identify the potential mechanisms driving disparities in treatment and address overall potential bias in glaucoma management.
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Brach JS, Juarez G, Perera S, Cameron K, Vincenzo JL, Tripken J. Dissemination and Implementation of Evidence-Based Falls Prevention Programs: Reach and Effectiveness. J Gerontol A Biol Sci Med Sci 2022; 77:164-171. [PMID: 34244780 PMCID: PMC8751789 DOI: 10.1093/gerona/glab197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, we describe the implementation of evidence-based fall prevention programs (EBFPPs) by Administration for Community Living grantees during 2014-2019. METHOD Forty-four grantees contributed to the national data repository. Data components include workshop information, participant information, attendance records, and organizational data. Data were collected before and after implementation of the EBFPPs. RESULTS Ten different programs were offered in 35 states with the most common settings being senior centers (25.3%), residential facilities (16.8%), health care organizations (12.5%), and faith-based organizations (11.1%). Individuals who participated in the programs (N = 85 848) had an age of 75.5 ± 9.7 years and were primarily female (79.7%), and the majority (86.2%) reported at least some fear of falling. At the postprogram assessment, 31.8% reported less fear of falling, 21.6% reported fewer falls, and 10.1% reported fewer injurious falls (all p < .0001). CONCLUSIONS EBFPPs implemented by Administration for Community Living grantees reached over 85 000 older adults. Participation in the EBFPPs resulted in improved confidence, decreased fear of falling, and fewer falls and injurious falls. Future efforts should focus on reaching specific underserved minorities and examining the effectiveness of individual programs.
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Affiliation(s)
- Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pennsylvania, USA
| | - Gardenia Juarez
- Department of Physical Therapy, University of Pittsburgh, Pennsylvania, USA
| | - Subashan Perera
- Department of Medicine, University of Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, University of Pittsburgh, Pennsylvania, USA
| | - Kathleen Cameron
- National Council on Aging Center for Healthy Aging, Arlington, Virginia, USA
| | - Jennifer L Vincenzo
- Department of Physical Therapy, University of Arkansas Medical Sciences, Fayetteville, USA
| | - Jennifer Tripken
- National Council on Aging Center for Healthy Aging, Arlington, Virginia, USA
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Garcia Moraes Pagano C, de Campos Moreira T, Sganzerla D, Matzenbacher AMF, Faria AG, Matturro L, Cabral FC, Rucks Varvaki Rados D, Decavata Szortyka A, Falavigna M, Vinadé Chagas ME, Harzheim E, Gonçalves M, Umpierre R, Lutz de Araujo A. Teaming-up nurses with ophthalmologists to expand the reach of eye care in a middle-income country: Validation of health data acquisition by nursing staff in a telemedicine strategy. PLoS One 2021; 16:e0260594. [PMID: 34847193 PMCID: PMC8631620 DOI: 10.1371/journal.pone.0260594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/13/2021] [Indexed: 11/21/2022] Open
Abstract
Telemedicine can be used to conduct ophthalmological assessment of patients, facilitating patient access to specialist care. Since the teleophthalmology models require data collection support from other health professionals, the purpose of our study was to assess agreement between the nursing technician and the ophthalmologist in acquisition of health parameters that can be used for remote analysis as part of a telemedicine strategy. A cross-sectional study was conducted with 140 patients referred to an ophthalmological telediagnosis center by primary healthcare doctors. The health parameters evaluated were visual acuity (VA), objective ophthalmic measures acquired by autorefraction, keratometry, and intraocular pressure (IOP). Bland-Altman plots were used to analyze agreement between the nursing technician and the ophthalmologist. The Bland-Altman analysis showed a mean bias equal to zero for the VA measurements [95%-LoA: -0.25–0.25], 0.01 [95%-LoA: -0.86–0.88] for spherical equivalent (M), -0.08 [95%-LoA: -1.1–0.95] for keratometry (K) and -0.23 [95%-LoA: -4.4–4.00] for IOP. The measures had a high linear correlation (R [95%CI]: 0.87 [0.82–0.91]; 0.97 [0.96–0.98]; 0.96 [0.95–0.97] and 0.88 [0.84–0.91] respectively). The results observed demonstrate that remote ophthalmological data collection by adequately trained health professionals is viable. This confirms the utility and safety of these solutions for scenarios in which access to ophthalmologists is limited.
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Affiliation(s)
| | | | | | - Ana Maria Frölich Matzenbacher
- Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | | | | | - Erno Harzheim
- Programa de Pós Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcelo Gonçalves
- Programa de Pós Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberto Umpierre
- Programa de Pós Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Aline Lutz de Araujo
- Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Hamm LM, Yashadhana A, Burn H, Black J, Grey C, Harwood M, Peiris-John R, Burton MJ, Evans JR, Ramke J. Interventions to promote access to eyecare for non-dominant ethnic groups in high-income countries: a scoping review. BMJ Glob Health 2021; 6:e006188. [PMID: 34493531 PMCID: PMC8424858 DOI: 10.1136/bmjgh-2021-006188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries. METHODS We searched MEDLINE, Embase and Global Health for studies that described an intervention to promote access to eyecare for the target population. Two authors independently screened titles and abstracts followed by review of the full text of potentially relevant sources. For included studies, data extraction was carried out independently by two authors. Findings were summarised using a combination of descriptive statistics and thematic analysis. RESULTS We screened 5220 titles/abstracts, of which 82 reports describing 67 studies met the inclusion criteria. Most studies were conducted in the USA (90%), attempted to improve access for Black (48%) or Latinx (28%) communities at-risk for diabetic retinopathy (42%) and glaucoma (18%). Only 30% included the target population in the design of the intervention; those that did tended to be larger, collaborative initiatives, which addressed both patient and provider components of access. Forty-eight studies (72%) evaluated whether an intervention changed an outcome measure. Among these, attendance at a follow-up eye examination after screening was the most common (n=20/48, 42%), and directly supporting patients to overcome barriers to attendance was reported as the most effective approach. Building relationships between patients and providers, running coordinated, longitudinal initiatives and supporting reduction of root causes for inequity (education and economic) were key themes highlighted for success. CONCLUSION Although research evaluating interventions for non-dominant, non-Indigenous ethnic groups exist, key gaps remain. In particular, the paucity of relevant studies outside the USA needs to be addressed, and target communities need to be involved in the design and implementation of interventions more frequently.
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Affiliation(s)
- Lisa M Hamm
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Aryati Yashadhana
- Centre for Health Equity Training Research & Evaluation, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Helen Burn
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Joanna Black
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Corina Grey
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Performance Improvement, Auckland District Health Board, Auckland, New Zealand
| | - Matire Harwood
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Roshini Peiris-John
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Moorfields Eye Hospital, London, UK
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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Bastos de Carvalho A, Lee Ware S, Belcher T, Mehmeti F, Higgins EB, Sprang R, Williams C, Studts JL, Studts CR. Evaluation of multi-level barriers and facilitators in a large diabetic retinopathy screening program in federally qualified health centers: a qualitative study. Implement Sci Commun 2021; 2:54. [PMID: 34022946 PMCID: PMC8141191 DOI: 10.1186/s43058-021-00157-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/11/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports. Previous studies of determinants of TDRS focus on patients' perspectives, with few studies targeting upstream multi-level barriers and facilitators. Addressing this gap, this qualitative study aimed to identify and evaluate multi-level perceived determinants of TDRS in Federally Qualified Health Centers (FQHCs), to inform the development of targeted implementation strategies. METHODS We developed a theory-based semi-structured interview tool based on the Consolidated Framework for Implementation Research (CFIR). We conducted 22 key informant interviews with professionals involved in TDRS (administrators, clinicians, staff). The interviews were audio-recorded and transcribed verbatim. Reported barriers and facilitators were organized into emergent themes and classified according to CFIR constructs. Constructs influencing TDRS implementation were rated for each study site and compared across sites by the investigators. RESULTS Professionals identified 21 main barriers and facilitators under twelve constructs of the five CFIR domains. Several identified themes were novel, whereas others corroborated previous findings in the literature (e.g., lack of time and human resources, presence of a champion). Of the 21 identified themes, 13 were classified under the CFIR's Inner Setting domain, specifically under the constructs Compatibility and Available Resources. Themes under the Outer Setting domain (constructs External Incentives and Cost) were primarily perceived by administrators, whereas themes in other domains were perceived across all professional categories. Two Inner Setting (Leadership Engagement, Goals and Feedback) and two Process (Champion, Engaging) constructs were found to strongly distinguish sites with high versus low TDRS performance. CONCLUSIONS This study classified barriers and facilitators to TDRS as perceived by administrators, clinicians, and staff in FQHCs, then identified CFIR constructs that distinguished high- and low-performance clinics. Implementation strategies such as academic detailing and collection and communication of program data and successes to leadership; engaging of stakeholders through involvement in implementation planning; and appointment of intervention champions may therefore improve TDRS implementation and sustainment in resource-constrained settings.
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Affiliation(s)
- Ana Bastos de Carvalho
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA.
| | - S Lee Ware
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Tamara Belcher
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Franceska Mehmeti
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Eric B Higgins
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Rob Sprang
- Kentucky Telecare, University of Kentucky, Lexington, KY, USA
| | - Cody Williams
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Cancer Prevention and Control Program, University of Colorado Cancer Center, Aurora, CO, USA
| | - Christina R Studts
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Waterland JL, Chahal R, Ismail H, Sinton C, Riedel B, Francis JJ, Denehy L. Implementing a telehealth prehabilitation education session for patients preparing for major cancer surgery. BMC Health Serv Res 2021; 21:443. [PMID: 33971869 PMCID: PMC8108411 DOI: 10.1186/s12913-021-06437-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background Prehabilitation services assist patients in preparing for surgery, yet access to these services are often limited by geographical factors. Enabling rural and regional patients to access specialist surgical prehabilitation support with the use of telehealth technology has the potential to overcome health inequities and improve post-operative outcomes. Aim To evaluate the current and likely future impact of a telehealth preoperative education package for patients preparing for major abdominal cancer surgery. Methods A telehealth alternative to a hospital based pre-operative education session was developed and implemented at a dedicated cancer hospital. Adult patients (≥18 years) scheduled for elective major cancer surgery were offered this telehealth alternative. Impact evaluation was conducted using the RE-AIM framework. Results To date, 35 participants have consented to participate in the study. Thirty-one participants attended the intervention; 24 (69%) residing in rural or regional areas. Twenty-four (77%) reported that if given a choice they would prefer the online session as opposed to attending the hospital in person. The majority (97%) reported they would recommend the intervention to others preparing for surgery. Session information was recalled by all 26 participants and 77% of participants reported acting on recommendations 2 weeks after the session. Lessons learnt and recommendations for providers implementing similar programs are reported. Conclusion Telehealth alternatives to hospital based pre-operative education are well received by patients preparing for major cancer surgery. We make seven recommendations to improve implementation. Further evaluation of implementation strategies alongside clinical effectiveness in future studies is essential. Trial registration ACTRN12620000096954, 04/02/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06437-w.
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Affiliation(s)
- Jamie L Waterland
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia. .,Department of Physiotherapy, The University of Melbourne, Melbourne, Australia. .,Division of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Rani Chahal
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Catherine Sinton
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Bernhard Riedel
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Jill J Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Linda Denehy
- Division of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia.,School of Health Sciences, The University of Melbourne, Melbourne, Australia
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Newman-Casey PA, Musch DC, Niziol LM, Elam AR, Zhang J, Moroi SE, Johnson L, Kershaw M, Saadine J, Winter S, Woodward MA. Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT): Baseline Methodology for Implementing and Assessing a Community-based Program. J Glaucoma 2021; 30:380-387. [PMID: 33596017 PMCID: PMC8085066 DOI: 10.1097/ijg.0000000000001812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/07/2021] [Indexed: 12/22/2022]
Abstract
PRECIS The Michigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program leverages community-engaged research, telemedicine, and health coaching to overcome key logistical and psychosocial barriers to improve glaucoma screening in underserved communities. PURPOSE To describe the methodology of the implementation and evaluation of the MI-SIGHT Program. METHODS The MI-SIGHT Program uses community engagement, telemedicine, and health coaching to overcome key logistical and psychosocial barriers to glaucoma identification and care among underserved populations. The MI-SIGHT Program will be evaluated in 2 community clinics: Hamilton Community Health Network, a federally qualified health center in Flint, Michigan, and the Hope Clinic, a free clinic in Ypsilanti, Michigan. A Community Advisory Board including the research team and health care providers, administrators, and patients from both clinics will guide program implementation. An ophthalmic technician at the community clinics will conduct screening tests for glaucoma and eye disease. The data will be transmitted through electronic health record to be reviewed by an ophthalmologist who will make recommendations for follow-up care. The ophthalmic technician will conduct a return visit to fit low-or no-cost glasses, help arrange follow-up with an ophthalmologist, and provide education. Those diagnosed with glaucoma or suspected glaucoma will be randomized to standard education or personalized glaucoma education and coaching. Costs will be assessed. RESULTS The authors hypothesize that the MI-SIGHT Program will detect a higher prevalence rate of glaucoma than that found in the general population, improve upon presenting visual acuity, enhance vision-related quality of life, and demonstrate that personalized glaucoma education and coaching improve adherence to follow-up care. CONCLUSION The MI-SIGHT Program may serve as a model for glaucoma screening and care in high-risk communities.
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Affiliation(s)
- Paula Anne Newman-Casey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Department of Ophthalmology, Ohio State University, Columbus, Ohio
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Leslie M. Niziol
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Angela R Elam
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Jason Zhang
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Sayoko E. Moroi
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
- Department of Ophthalmology, Ohio State University, Columbus, Ohio
| | | | | | - Jinan Saadine
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suzanne Winter
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Conway MP, Forristal MT, Treacy MP, Duignan ES. Investigating the Role of Optometrists in Teleophthalmology and the Implications of Increasing Access to Advanced Imaging Techniques and Digital Referral: A Systematic Search and Review. Telemed J E Health 2020; 27:974-981. [PMID: 33275866 DOI: 10.1089/tmj.2020.0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The objective of this systematic search and review was to investigate the role of optometrists in teleophthalmology and digital referral. We examine the implications of the optometric communities' increasing access to advanced imaging, such as optical coherence tomography (OCT), in ophthalmic telemedicine schemes. Methods: A systematic search was conducted, using PubMed and Embase, in April of 2019. Eight hundred eight (n = 808) texts were retrieved and 99 articles were deemed eligible for full-text review. Twenty-six (n = 26) studies were included in the qualitative synthesis. All studies involved optometrists as principal service providers. Results: Findings demonstrate that optometrist-facilitated teleophthalmology results in consistent reductions in hospital referrals and waiting times, as well as high patient satisfaction. Optometrists are identified as crucial to the success of many projects and their access to advanced imaging technology is observed to position optometry practices as the most convenient location to establish a teleophthalmology program. OCT imaging demonstrated the potential to increase diagnostic accuracy and is increasingly prevalent in optometry practice. The importance of additional training for optometrists participating in teleophthalmology schemes is highlighted, as is the need for appropriate remuneration for those involved. Conclusion: The role of community-based ophthalmic care in reducing demands on hospital eye services (HES) is highlighted by our results, demonstrating that optometrist-facilitated teleophthalmology can dramatically reduce referrals and streamline care. In addition, the increasing prevalence of OCT in optometric practice represents an underutilized resource for HES.
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Abstract
PURPOSE OF REVIEW Approximately 10% of patients become blind despite using evidence-based guidelines developed from clinical trials and epidemiology studies. Our purpose is to review opportunities to decrease glaucoma-related blindness using the emerging principles of precision medicine. RECENT FINDINGS The current review focuses on three topics: first, candidate biomarkers for angle-based surgeries, second, head-mounted display (HMD) technology for vision and testing, and third, glaucoma risk alleles discovered by genome-wide association studies. First, in angle-based surgeries, tracers injected into the anterior chamber or Schlemm's canal have allowed visualization of aqueous veins. We describe an innovative use of optical coherence tomography angiography to visualize aqueous veins in a case with 6-year successful outcome following catheter-based trabeculotomy. Second, HMD technology can augment perceived vision and can be used for perimetry testing. Third, developing genetic risk scores that characterize patients who are at highest risk for blindness is a priority. Such biomarker risk scores will integrate genome-wide association study-based risk alleles for glaucoma along with well known demographic and clinical risk factors. SUMMARY As we gain more knowledge, precision medicine will enable clinicians to decrease glaucoma-related blindness by providing more timely interventions to those patients who are at highest risk for progression to blindness. VIDEO ABSTRACT: http://links.lww.com/COOP/A29.
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