Glaucoma is the major cause of irreversible blindness among African-Americans, with a higher prevalence among African-Americans compared to whites. Current guidelines recommend that African-Americans over the age of 40 have a dilated fundus examination (DFE) every two years, and diabetics, who are at an increased risk of glaucoma, should have annual DFEs. However, research indicates that people are not getting DFEs according to recommended guidelines. Current computer technology has made it possible to generate tailored messages, which are individualized messages based on each person's unique characteristics. Although tailored health messages have been shown to influence various health-related behaviors, this health communication strategy has not been applied to eye examination behavior. In fact, there has been little research examining interventions to increase eye examination behavior. Given that glaucoma is asymptomatic, has serious consequences if untreated, and has treatments available to prevent or stop the progression of disease, developing interventions to increase the proportion of people who get DFEs at the recommended schedule can have a major impact on people's vision-related and general health-related quality of life. Therefore, the purpose of this project is to design, implement, and evaluate the efficacy of tailored print health messages compared to targeted print messages to increase eye examination behavior in an urban, older African-American population. Constructs from the Health Belief Model, Stages of Change Model, and newer Precaution Adoption Process Model, will guide the project. During the formative phase, focus groups will be conducted, and an assessment questionnaire and tailored print messages will be developed. For the intervention phase, African-Americans 65 years of age and older will be recruited from various community settings and randomized to receive either tailored health messages or targeted messages. Participants will complete a self-administered assessment questionnaire, be mailed tailored or targeted print health messages, and receive follow-up telephone calls at three and six months post-intervention to collect information about eye examination behavior. The evaluation phase will include process and outcome evaluation. This proposal addresses the need for research to assess tailored print communications to increase eye examination behavior in a minority population at increased risk for glaucoma.
| Ellish, Nancy J; Royak-Schaler, Renee; Higginbotham, Eve J (2011) Tailored and targeted interventions to encourage dilated fundus examinations in older African Americans. Arch Ophthalmol 129:1592-8 |
| Ellish, Nancy J; Scott, Deborah; Royak-Schaler, Renee et al. (2009) Community-based strategies for recruiting older, African Americans into a behavioral intervention study. J Natl Med Assoc 101:1104-11 |
| Ellish, Nancy J; Royak-Schaler, Renee; Passmore, Susan R et al. (2007) Knowledge, attitudes, and beliefs about dilated eye examinations among African-Americans. Invest Ophthalmol Vis Sci 48:1989-94 |
