Dataset Information

Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT): Baseline Methodology for Implementing and Assessing a Community-based Program.

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.

SUBMITTER: Newman-Casey PA

PROVIDER: S-EPMC8085066 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT): Baseline Methodology for Implementing and Assessing a Community-based Program.

Newman-Casey Paula A PA Musch David C DC Niziol Leslie M LM Elam Angela R AR Zhang Jason J Moroi Sayoko E SE Johnson Leroy L Kershaw Martha M Saadine Jinan J Winter Suzanne S Woodward Maria A MA

Journal of glaucoma 20210501 5

<h4>Precis</h4>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.<h4>Purpose</h4>To describe the methodology of the implementation and evaluation of the MI-SIGHT Program.<h4>Methods</h4>The MI-SIGHT Program uses community engagement, telemedicine, and health c ...[more]

PMID: 33596017

Similar Datasets

Project description:PurposeTo assess whether increased poverty is associated with increased risk of screening positive for glaucoma or suspected glaucoma in a large public screening and intervention program.DesignCross-sectional study from 2020 to 2022.ParticipantsAdults ≥ 18 years old without acute ocular symptoms.MethodsMichigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program participants' sociodemographic characteristics and area deprivation index (ADI) values were summarized from the clinical sites, which included a free clinic and a Federally Qualified Health Center (FQHC). The ADI, a composite measure of neighborhood deprivation (range, 1-10; 10 is worst deprivation), was assigned on the basis of the participants' addresses. Group comparisons were performed via 2-sample t tests or Wilcoxon Mann-Whitney tests for continuous measures and chi-square tests or Fisher exact tests with Monte Carlo simulation for categorical measures; Holm adjustment was used for multiple comparisons.Main outcome measuresRisk factors for screening positive for glaucoma or suspected glaucoma.ResultsOf the 1171 enrolled participants, 1165 (99.5%) completed the screening: 34% at the free clinic and 66% at the FQHC. Participants were on average aged 55.1 ± 14.5 years, 62% were women, 54% self-reported as Black/African-American, 34% White, 10% Hispanic or Latino, and 70% earned < $30 000 annually. The mean ADI was 7.2 ± 3.1. The FQHC had higher (worse) ADI than the free clinic (free clinic: 4.5 ± 2.9, FQHC: 8.5 ± 2.1, P < 0.0001). One-quarter (24%) of participants screened positive for glaucoma or suspected glaucoma. Screening positive for glaucoma or suspected glaucoma was associated with being older (P = 0.01), identifying as Black/African-American (P = 0.0001), having an established eyecare clinician (P = 0.0005), and not driving a personal vehicle to the appointment (P = 0.001), which is a proxy for increased poverty. Participants who screened positive had worse ADI than those who screened negative (7.7 ± 2.8 vs. 7.0 ± 3.2, P = 0.002). A larger percentage of White participants screened positive at the FQHC compared with White participants at the free clinic (21.3% vs. 12.3%, P = 0.01). FQHC White participants had worse ADI than free clinic White participants (7.5 ± 2.5 vs. 3.7 ± 2.7, P < 0.0001).ConclusionsPersonal poverty, assessed as not driving a personal vehicle to the appointment, and neighborhood-level poverty were both associated with increased rates of screening positive for glaucoma or suspected glaucoma.Financial disclosure(s)Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Project description:PurposeHousing and food insecurity are social risk factors that can impact eye health outcomes. This study investigated the association of these social risk factors with vision and ophthalmic pathologic characteristics.DesignCross-sectional study from July 28, 2020, through July 27, 2021, for the free clinic and January 27, 2021, through January 26, 2022, for the Federally Qualified Health Center.ParticipantsMichigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine program first-year participants.MethodsData collected included sociodemographic features, housing and food insecurity status, and results from a comprehensive telemedicine assessment. Individual-level and neighborhood-level characteristics were summarized with descriptive statistics. Differences in participant characteristics between housing and food security status were tested by 2-sample t tests for continuous measures and chi-square or Fisher exact tests for categorical measures. Logistic regression was used to test the independent associations between housing and food insecurity and ophthalmic disease, adjusted for age. The Holm’s procedure was performed to adjust for multiple comparisons.Main outcome measuresVisual impairment (VI; presenting visual acuity [VA], < 20/40), uncorrected or undercorrected refractive error (PVA, < 20/40; and best-corrected VA, ≥ 20/40), glaucoma, diabetic retinopathy, cataract, and macular degeneration.ResultsParticipants (n = 1165) were mean ± standard deviation [SD] of 55 ± 14.5 years of age, 62% identified as female, 54% identified as Black or African American, 10% identified as Hispanic or Latino, 49.7% had annual household income of less than $20 000, and 20% reported no medical insurance. Presenting VA was mean ± SD of 0.12 ± 0.19 logarithm of the minimum angle of resolution units (Snellen equivalent, 20/26 ± 1.9 lines). Visual impairment and uncorrected or undercorrected refractive error were identified in 10.3% and 8.3% of participants, respectively. Participants reported housing insecurity (3.4%) and food insecurity (28.9%), and 2.2% reported both. Among participants with unstable housing, 26.3% showed VI and 23.7% showed uncorrected or undercorrected refractive error. Unstable housing was associated with higher odds of VI (odds ratio, 3.53; P = 0.006) and uncorrected or undercorrected refractive error (odds ratio, 3.74; P = 0.006). No associations were observed between unstable housing and other ocular pathologic features or food insecurity and any ocular pathologic features.ConclusionsBecause unstable housing is associated with VI and uncorrected refractive error, future initiatives could focus on interventions to address both unstable housing and the increased need for eye care among those with unstable housing.Financial disclosure(s)Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Project description:PURPOSE:The purpose was to identify factors associated with older glaucoma patients' knowledge of, perceptions of, and predispositions for telemedicine use. MATERIALS AND METHODS:Established patients age 60 years and above with a diagnosis of primary open-angle glaucoma, glaucoma suspect, or ocular hypertension followed by a glaucoma fellowship-trained ophthalmologist were enrolled in the study at an academic, urban, tertiary referral eye clinic. Enrolled patients were administered a Life Space Questionnaire (LSQ), scored 0 to 9, and Preferences for Telemedicine Questionnaire (PTQ), a Likert scale validated tool. χ testing analyzed PTQ responses by age, race, education, employment status, LSQ score, and distance traveled from home address to clinic. A Mann-Whitney U test was used to compare PTQ responses by visual field index and visual acuity for the better and worse eye. RESULTS:Of 110 patients enrolled, 71% of patients agreed or were neutral to receiving telediagnosis and 74% of patients agreed or were neutral to receiving teleintervention. Patients aged 60 to 69 years compared with those 70 and above had significantly greater knowledge about types of telemedicine: telediagnosis (53% vs. 31%, P=0.02), teleintervention (49% vs. 24%, P=0.006), teletriage (80% vs. 47%, P=0.0004), and telemonitoring (55% vs. 27%, P=0.003). Patients of European descent had significantly more knowledge about teletriage compared with those of non-European descent (72% vs. 53%, P=0.04). Patients with more education (>high school) compared with those with less education (≤high school) had more knowledge about telemedicine (39% vs. 16%, P=0.007) and all the uses of it: telediagnosis (61% vs. 45%, P<0.001), teleintervention (54% vs. 14%, P<0.001), teletriage (86% vs. 35%, P<0.001), and telemonitoring (59% vs. 18%, P=0.001). Patients with a LSQ score ≥6, meaning they traveled a greater distance from home in the previous 3 days, displayed significantly more knowledge about telediagnosis (49% vs. 25%, P=0.02), teleintervention (43% vs. 19%, P=0.01), and telemonitoring (47% vs. 25%, P=0.03) than those with an LSQ<6. Responses to the PTQ were not significantly different by distance traveled. CONCLUSIONS:Knowledge of telemedicine was variable but between one third and one half of patients had favorable attitudes toward using telemedicine for glaucoma care.

Project description:ObjectiveTo determine which baseline sociodemographic, lifestyle, anthropometric, clinical, and ocular risk factors predict the development of open-angle glaucoma (OAG) in an adult population.DesignA population-based, prospective cohort study.ParticipantsA total of 3772 self-identified Latinos aged ?40 years from Los Angeles, California, who were free of OAG at baseline.MethodsParticipants from the Los Angeles Latino Eye Study had standardized study visits at baseline and 4-year follow-up with structured interviews and a comprehensive ophthalmologic examination. We defined OAG as the presence of an open angle and a glaucomatous visual field abnormality and/or evidence of glaucomatous optic nerve damage in ?1 eye. Multivariate logistic regression with stepwise selection was performed to determine which potential baseline risk factors independently predict the development of OAG.Main outcome measuresOdds ratios for various risk factors.ResultsOver the 4-year follow-up, 87 participants developed OAG. The baseline risk factors that predict the development of OAG include older age (odds ratio [OR] per decade, 2.19; 95% confidence interval [CI], 1.74-2.75; P<0.001), higher intraocular pressure (IOP; OR per mmHg, 1.18; 95% CI, 1.10-1.26; P<0.001), longer axial length (OR per mm, 1.48; 95% CI, 1.22-1.80; P<0.001), thinner central cornea (OR per 40 ?m thinner, 1.30; 95% CI, 1.00-1.70; P = 0.050), higher waist-to-hip ratio (OR per 0.05 higher, 1.21; 95% CI, 1.05-1.39; P = 0.007) and lack of vision insurance (OR, 2.08; 95% CI, 1.26-3.41; P = 0.004).ConclusionsDespite a mean baseline IOP of 14 mmHg in Latinos, higher IOP is an important risk factor for developing OAG. Biometric measures suggestive of less structural support such as longer axial length and thin central corneal thickness were identified as important risk factors. Lack of health insurance reduces access to eye care and increases the burden of OAG by reducing the likelihood of early detection and treatment of OAG.Financial disclosure(s)The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Dataset Information

Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT): Baseline Methodology for Implementing and Assessing a Community-based Program.

Precis

Purpose

Methods

Results

Conclusion

Publications

Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT): Baseline Methodology for Implementing and Assessing a Community-based Program.

Similar Datasets

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