Abstract
Objective Although the purpose of community eye screening programs is to reduce health care
disparities, the effectiveness of these programs is limited by the follow-up adherence
of their participants. The aim of this review is to investigate factors that may promote
or hinder participants from attending follow-up ophthalmological exams after community
eye screenings and identify interventions to increase follow-up rates.
Methods For literature review, PubMed, Web of Science, Embase, Proquest/Global Health Library,
and Google Scholar databases were searched to identify studies of community eye screenings
published between January 2000 and May 2023. Data from these articles were analyzed
to identify barriers and facilitators of follow-up adherence after community eye screenings
in the United States and to examine strategies used to increase follow-up rates. Only
published manuscripts were included. We excluded studies of school screenings and
clinic-based screenings.
Results A total of 28 articles were included. Follow-up rates ranged from 12.5 to 89%. Nineteen
articles reviewed facilitators and barriers to follow-up. Eighteen articles were non
interventional and seven (see [Table 1] and [2], respectively) articles described interventions that were tested to improve follow-up
rates after screening. Interventions included prescheduled appointments, transportation
assistance, patient education, and patient navigators.
Conclusion Several interventions are promising to increase follow-up adherence in community
eye screenings, but more evidence is needed. Future research should focus on randomized
trials of isolated interventions to improve follow-up adherence of disadvantaged populations,
although this may be limited given ethical considerations and documented lack of follow-up
after screening.
Keywords
Health care disparities - ophthalmology - community health - screenings - follow-up
adherence
