Parent and Teacher Perspectives on Factors Decreasing Participation in School-Based Vision Programs

• Published in: Ophthalmic epidemiology 2020-05, Vol.27 (3), p.226-236
• Main Authors: Vongsachang, Hursuong, Friedman, D. S., Inns, A., Kretz, A. M., Mukherjee, M. R., Callan, J., Wahl, M., Repka, M. X., Collins, M. E.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Attitude to Health; Awareness; Child; Child, Preschool; Eyeglasses; Focus Groups - methods; Health Services Accessibility - statistics & numerical data; Humans; Middle Aged; paediatric eye health; Parents - psychology; Qualitative Research; refractive error; Refractive Errors - diagnosis; Refractive Errors - epidemiology; School Health Services - standards; School Health Services - statistics & numerical data; School Teachers - psychology; School Teachers - statistics & numerical data; School-based vision program; Schools - statistics & numerical data; vision screening; Vision Screening - methods; Young Adult
• ISSN: 0928-6586; 1744-5086
• DOI: 10.1080/09286586.2020.1730910

Purpose: To examine factors decreasing participation in school-based vision programs from parent and teacher perspectives. Methods: We conducted 41 semi-structured focus groups (20 parent groups, 21 teacher/staff groups), at 10 Baltimore and 11 Chicago public elementary and middle schools offering school-based vision programs. School-based vision programs provided vision screening, eye exams, and eyeglasses if needed. Focus groups ranged in size from 2-9 participants (median = 5). Sessions were recorded, transcribed, and coded through an iterative process to develop themes using inductive analysis. Results: Ninety parents and 117 teachers/staff participated. Participants identified five major factors decreasing participation in school-based vision programs: (1) challenges with the consent form, including distribution, collection, and literacy and language barriers; (2) having existing eye care; (3) misunderstandings about the program, especially related to cost and insurance; (4) difficulty raising parental awareness of the program; and (5) certain attitudes towards vision, eye care, and school-based programs, including low prioritization of eye care, mistrust of the program, fear of sharing private information, not believing their child needs glasses, and reluctance accepting 'subsidized' services. Conclusion: Parents and teachers identified important structural barriers to participation (i.e., consent form challenges and low parental awareness) and specific reasons for non-participation (i.e., attitudes, misunderstanding of the program, existing eye care) in school-based vision programs. Effective strategies are needed to facilitate return of consent forms and promote awareness of school-based vision programs among parents. Programs should also target services towards those currently without access to eye care and increase awareness about paediatric vision needs.