Implementing enhanced education to improve the UCLA Preschool Vision Program

The Impact of Socioeconomic Status on Visual Acuity Changes in Schoolchildren: A One-Year Follow-Up

(1) Background: Visual acuity (VA) is essential for children's quality of life, and its relationship with socioeconomic status (SES) highlights disparities in healthcare. This study investigated the influence of SES on changes in schoolchildren's VA over one year. (2) Methods: Initial examinations were conducted on 1822 children (8-10 years). Follow-up was performed on 804 of these children a year later. Uncorrected (UCVA) and presenting (PVA) distance VA were measured monocularly using a decimal Snellen chart. Very reduced UCVA (<0.5) was considered a proxy of myopia. (3) Results: The prevalence of initially very reduced UCVA (myopia) was similar in children with low and high SES (12.6% vs. 12.4%) (χ2; p = 0.153). After one year, the prevalence of very reduced UCVA increased to 14.1% in children with a low SES compared with 11.1% in children with a high SES (p = 0.001). Significant disparities related to SES were also found in PVA so that children with a low SES exhibited a greater reduction in PVA than children with a high SES (5.2% vs. 3.5%) (χ2; p = 0.004). (4) Conclusions: Children with a low SES showed an increase in reduced UCVA values over one year and a higher number of children with very reduced PVA compared with those with a high SES.

Adherence to referrals from preschool vision screening and identification of barriers for non-adherence in Israel

CLINICAL RELEVANCE

Preschool vision screening is essential for the early detection and treatment of eye and vision problems.

BACKGROUND

The rate of parental adherence to referrals for comprehensive examination was assessed and factors and potential barriers associated with adherence were identified.

METHODS

In a prospective cohort study design, parents were offered to bring their 3-6 year old aged children to free-of-charge vision screening tests at community-based Mother Child Health Centers. Children with abnormal findings were referred to an ophthalmologist examination. Parents were interviewed three to six months after the referral to evaluate adherence and barriers. Barriers were organised into a conceptual framework of parental predisposing and health system factors. Adherence and barriers were assessed by sex, age, ethnic group and socio-economic-status.

RESULTS

Altogether 1283 children (mean age 4.5 ± 0.6 years, 47.8% girls) were screened in the Jerusalem district, Israel. The ethnic groups, Jewish (ultra-Orthodox 51.4%, secular/religious 33.2%) and Arab (15.4%), were similar by age and sex, but not by socio-economic status. The overall referral rate was 23.0% (N = 295). Referral rate was not associated with demographic factors. Overall, 54.3% (N = 160) of parents adhered to the referral to bring the child for a full eye examination. Adherence did not differ with sex, ethnicity or socio-economic-status. Parents of 5-6-year-old children were significantly more likely to adhere than parents of younger children. Of parents who did not adhere, 79.3% were attributed to predisposing factors, 16.3% to system factors and 4.4% to other reasons.

CONCLUSIONS

Only half the parents proceeded with the recommended full eye examination. Parents of older children were more likely to adhere to referral. In contrast with vaccinations provided by Mother Child Health Centers, adherence to vision screening did not vary based on ethnicity or socio-economic factors. Since most barriers were associated with predisposing factors of parents, interventions to improve adherence should include parental education.

Parental Trust in School-Based Health Care: A Systematic Review

BACKGROUND

Health care delivery in schools is a frequently adopted approach to reduce health care inequalities. Lack of parental trust has been identified as impacting participation in school-based health care programs (SBHPs). The aim of our systematic review is to outline themes related to parental trust in SBHPs.

METHODS

We searched MEDLINE, Embase, CINHAL, ERIC, PsycInfo, and Web of Science for articles published between 1969 and 2019. Eligible studies (1) were peer-reviewed primary research articles; (2) were school-based health interventions or screening programs; (3) included parental trust data; and (4) were carried out on schoolchildren from pre-K to grade 12. Study location, data collection date, number of participants, demographics, intervention type, study aim and methodology, and all trust themes mentioned, were extracted. Studies were critically appraised using the CASP checklist for qualitative research.

RESULTS

We identified 9 themes related to parental trust in SBHPs: (1) safety; (2) effectiveness; (3) health professionals' training and credentials; (4) communication; (5) confidentiality; (6) providers; (7) government, authorities, and health service; (8) the pharmaceutical industry; and (9) research and data sharing.

CONCLUSIONS

The themes identified provide a framework for examining trust in SBHPs, and may guide the development of interventions to increase trust and engagement in SBHPs.

Effects of Parental Involvement in a Preschool-Based Eye Health Intervention Regarding Children's Screen Use in China

In this digital era, young children spend a considerable amount of time looking at telephone, tablet, computer and television screens. However, preventative eye health behavior education could help avoid and relieve asthenopia. The effects of parental influence on their children's eye health behavior through the preschool eye health education intervention program were examined. The Health Belief Model was used to develop parental involvement strategy and eye health curriculum. The study was conducted in a large public preschool with five branches in Beijing, China. A total of 248 parent-child pairs participated in the baseline and follow-up surveys, of which 129 were in the intervention group and 119 were in the comparison group. The generalized estimating equation analysis results indicated that parental involvement in preschool-based eye health intervention on screen uses had positive influence on parents' eye health knowledge, cues to action, and parenting efficacy. The intervention program also had positive effects on the increasing level of children's eye health knowledge, beliefs, cues to action, self-efficacy, and behaviors. The results supported the implementation of a preschool-based eye health intervention program with parental involvement, which could potentially enhance children's and parents' eye health beliefs and practices.

Assessment of availability, awareness and perception of stakeholders regarding preschool vision screening in Kumasi, Ghana: An exploratory study

BACKGROUND

Regardless of the importance of preschool vision screening (PSVS), there is limited data on the current state of these programs in Africa (particularly Ghana). This study sought to investigate the level of awareness and perception of stakeholders regarding PSVS, its availability and related policies/programmes in the Kumasi Metropolis, Ghana.

METHODS

This descriptive cross-sectional study included 100 systematically sampled preschools in the metropolis (using probability proportional-to-size method); 72 private schools and 28 public schools. Convenience sampling was used to recruit stakeholders of preschools (teachers, head teachers, proprietors, administrators, directors, and educationists), and were interviewed using a well-structured questionnaire. Questionnaires were administered to all eligible respondents who were present at the time of data collection.

RESULTS

A total of 344 respondents participated in the study; 123 (35.8%) males and 221 (64.2%) females. The overall mean age of respondents was 37.63 ±12.20 years (18-71 years). Of the respondents, 215 (62.5%), 94 (27.3%), and 35 (10.2%) were enrolled from private schools, public schools, and Metropolitan Education Directorate, respectively. 73.8% of respondents reported the absence of routine PSVS in schools whereas 90.1% reported no written policies for PSVS in schools. Only 63.6% of respondents were aware of PSVS whereas more than half (59.6%) of all respondents perceived PSVS to be very important for preschoolers. Private school ownership was significantly associated with availability of PSVS whereas age, teachers, private school ownership, and preschool experience > 10 years were significantly associated with awareness of PSVS (P < 0.05). However, there was no significant association between sociodemographic factors and perception of PSVS.

CONCLUSION

PSVS is largely unavailable in most Ghanaian schools. Majority of stakeholders were aware of PSVS and agreed to its implementation and incorporation into schools' health programmes. There is the need to implement a national programme/policy on preschool vision screening in Ghana.