Eye Care Utilization in A Community-oriented Mobile Screening Programme for Improving Eye Health in Iran: A Cluster Randomized Trial

ABSTRACT

Purpose

To evaluate the effect of a mobile-based screening programme on eye care utilization in Iran.

Method

In this cluster randomized community trial, a representative sample of residents aged≥50 years from urban and rural areas in four districts in Tehran province were enrolled. The clusters were randomly assigned to one of the three parallel arms; the mHealth arm with digital data collection, vision screening test and retina evaluation using an integrated mobile application, the conventional arm with manual data collection and screening tests using Snellen chart and Fundus photography at the local primary healthcare facility, and the control arm with manual data collection without screening tests. The main outcome measure was eye care utilization which was defined as at least one visit to an optometrist or ophthalmologist.

Results

Of 3312 eligible individuals, 2520 (76.1%) participated. In the first 3 months after the screening programme, eye care utilization was higher among those who were referred by the mHealth method (35.6% 95%CI: 31.1–40.4%) compared to those referred by the conventional method (32.7%, 95%CI: 27.5–38.2%) and to those observed in the control arm (4.5%, 95%CI: 3.2–6.0). Eye care utilization improved (OR = 1.5, 95%CI: 1.2–1.9) among the referred people after the screening programme compared to the utilization before this programme; however, this improvement was significantly higher in the mHealth method (OR: 1.7, 95%CI: 1.2–2.4) compared to the conventional method (OR: 1.2, 95%CI: 0.8–1.8).

Conclusion and relevance

The mobile-based screening programme can significantly improve eye care utilization at the community level.

KEYWORDS:

• Blindness
• Utilization
• mHealth
• Screening
• Needs Assessment

Acknowledgments

The authors gratefully acknowledge the community members and PHCWs who participated in this study and the following institutions that contributed substantially in data collection and developing mHealth tool: Peek Vision Team, World Health Organization Collaborating Centre for Eye Health and Prevention of Blindness in Iran, and the Department of eHealth, Asre Danesh Afzar (ADA).

Conflicts of interest

None of the authors have any proprietary interests or conflicts of interest related to this study.

Additional information

Funding

None, this study is a joint academic project between Aarhus University and Shahid Beheshti University of Medical Sciences.