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

ABSTRACT

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.

KEYWORDS:

• School-based vision program
• paediatric eye health
• vision screening
• refractive error
• qualitative research

Acknowledgments

We wish to thank our program partners in Baltimore and Chicago for their help in making this research possible.

In Baltimore, we gratefully acknowledge the contributions of the following individuals from the Vision for Baltimore program: Mary Beth Haller, Francine Childs, Joy Twesigye, Tempestt Little from the Baltimore City Health Department; Louise Fink from Baltimore City Public Schools; Ann Hollister, Damian Carroll, Wade Brown from Vision To Learn; Hannah Reeve and Jesse Schultz Sneath from Warby Parker; Christine SySantos Levy, Grace Galliani, Anne Currie from Johns Hopkins University.

In Chicago, we gratefully acknowledge the contributions of the following individuals from the Vision for Chicago program: Dr. Kenneth Fox, Chicago Public Schools, Chief Health Officer; Kenneth Papineau, MA, Chicago Public Schools, Office of Student Health and Wellness, Manager; Katheryn Stafford-Hudson, MPA, Chicago Public Schools, Office of Student Health and Wellness, Project Manager; Iman Little, MPH, Chicago Public Schools, Office of Student Health and Wellness, Student Health Specialist; and Berenice Tow, MPH, Director and Jennifer Vidis, JD, Deputy Commissioner from the Chicago Department of Public Health.

Declaration of Interest

Dr. Collins is a Medical Policy Council member for Versant Health and previously served as a consultant for Warby Parker, a company that manufactures the eyeglasses provided in the Baltimore vision program. This arrangement was reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies..

Additional information

Funding

This work was supported by the Johns Hopkins Catalyst Awards.