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Authors
Marsh-Tootle, Wendy L.; Frazier, Marcela G.; Kohler, Connie L.; Dillard, Carey M.; Davis, Kathryn; Schoenberger, Yu-Mei; Wall, Terry C.

Exploring Pre-school Vision Screening in Primary Care Offices in Alabama

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Abstract/Introduction

Purpose. 

To investigate practices, barriers, and facilitators of universal pre-school vision screening (PVS) at pediatric primary care offices.

Methods

Focus group sessions (FGS) were moderated on-site at nine pediatric practices. A semi-structured topic guide was used to standardize and facilitate FGS. Discussions were audiotaped, and transcriptions were used to develop themes. All authors reviewed and agreed on the resultant themes.


Conclusion/Results

Results

FGS included 13 physicians and 32 nurses/certified medical assistants (CMAs), of whom 82% personally conducted some facet of PVS. In all practices, nurses/CMAs tested visual acuity (most using a non-recommended test), and physicians completed vision screening with external observation, fix/follow, red reflex, and cover test. Facilitators included (1) accepting that PVS is a routine part of the well-child visit, and (2) using an electronic medical record with prompts to record acuity (eight of nine practices). Barriers were related to difficulty testing pre-schoolers, distractions in the office setting, time constraints, and limited reimbursement.

Conclusions. 

Responsibility for PVS is shared by physicians and nurses/CMAs; thus, interventions to improve PVS should target both. Few practices are aware of new evidence-based PVS tests; thus, active translational efforts are needed to change current primary care practices.


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