TY - JOUR
T1 - Telephone Intervention to Promote Diabetic Retinopathy Screening Among the Urban Poor
AU - Walker, Elizabeth A.
AU - Schechter, Clyde B.
AU - Caban, Arlene
AU - Basch, Charles E.
N1 - Funding Information:
This research was supported by National Institutes of Health grant EY13497 and partially by DK 20541, and the Rockefeller Foundation. We thank Drs. Steven Martin, Michael Camardi, and David Bernard for assistance with recruitment and Dr. Ronald Klein for consultation. We appreciate our talented health educators and staff: E. Blanco, M. Kalten, Dr. J. Usher, G. Mojica, M. Mera, T. DeWitt, and T. Johnson for the success of this study. Northwest Survey and Data Services of Eugene OR performed the telephone surveys for this study.
PY - 2008/3
Y1 - 2008/3
N2 - Background: Participation in diabetic retinopathy screening is suboptimal. The Vision is Precious study (2001-2005) tested the hypothesis that a tailored telephone intervention in urban minority diabetes populations, offered in English or Spanish, would result in greater screening for retinopathy than a standard print intervention. Design: Randomized controlled trial. Setting/Participants: Subjects (N=598) were adults with diabetes without a dilated fundus examination (DFE) in >1 year from three healthcare centers in Bronx NY. Intervention: A tailored telephone intervention to promote retinopathy screening compared to a standard print intervention over a 6-month period. Main Outcome Measures: Documentation of a DFE within 6 months was the main outcome. Data on risk perceptions using the Risk Perception Survey for Diabetes were collected pre- and post-intervention. Electronic databases were used to obtain hemoglobin A1c information. Results: Subjects were 40% men, mean age 57 years; 39% reported household incomes as <$15K; 45% reported their race as black, and 42% reported ethnicity as Hispanic/Latino; 23% chose Spanish as their preferred language. Data were analyzed in 2006. There was a 74% increase in retinopathy screening in the telephone versus print group (p<0.0005), with no differences by intervention language or by gender. Predictors of undergoing a DFE included: telephone intervention, baseline risk-perception scores indicating less worry and more realism about diabetes complications, and the interaction of self-reported worry and being in the telephone intervention. Subjects who had poor diabetes control responded with greater success to telephone interventions. Conclusions: A limited telephone intervention can improve significantly participation in retinopathy screening in a minority, low-income population. This intervention influenced risk perceptions about diabetes complications. Further research is needed to develop effective risk communications to prevent the complications of diabetes.
AB - Background: Participation in diabetic retinopathy screening is suboptimal. The Vision is Precious study (2001-2005) tested the hypothesis that a tailored telephone intervention in urban minority diabetes populations, offered in English or Spanish, would result in greater screening for retinopathy than a standard print intervention. Design: Randomized controlled trial. Setting/Participants: Subjects (N=598) were adults with diabetes without a dilated fundus examination (DFE) in >1 year from three healthcare centers in Bronx NY. Intervention: A tailored telephone intervention to promote retinopathy screening compared to a standard print intervention over a 6-month period. Main Outcome Measures: Documentation of a DFE within 6 months was the main outcome. Data on risk perceptions using the Risk Perception Survey for Diabetes were collected pre- and post-intervention. Electronic databases were used to obtain hemoglobin A1c information. Results: Subjects were 40% men, mean age 57 years; 39% reported household incomes as <$15K; 45% reported their race as black, and 42% reported ethnicity as Hispanic/Latino; 23% chose Spanish as their preferred language. Data were analyzed in 2006. There was a 74% increase in retinopathy screening in the telephone versus print group (p<0.0005), with no differences by intervention language or by gender. Predictors of undergoing a DFE included: telephone intervention, baseline risk-perception scores indicating less worry and more realism about diabetes complications, and the interaction of self-reported worry and being in the telephone intervention. Subjects who had poor diabetes control responded with greater success to telephone interventions. Conclusions: A limited telephone intervention can improve significantly participation in retinopathy screening in a minority, low-income population. This intervention influenced risk perceptions about diabetes complications. Further research is needed to develop effective risk communications to prevent the complications of diabetes.
UR - http://www.scopus.com/inward/record.url?scp=38949107347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38949107347&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2007.11.020
DO - 10.1016/j.amepre.2007.11.020
M3 - Article
C2 - 18312805
AN - SCOPUS:38949107347
SN - 0749-3797
VL - 34
SP - 185
EP - 191
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 3
ER -