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Perceived barriers and enablers to the provision of diabetic retinopathy screening for young adults: a cross-sectional survey of healthcare professionals working in the UK National Diabetic Eye Screening Programme

Prothero, L. ORCID: 0000-0002-5385-0397, Lorencatto, F., Cartwright, M. ORCID: 0000-0002-3404-5659, Burr, J. M., Gardner, P., Anderson, J., Presseau, J., Ivers, N., Grimshaw, J. M., Lawrenson, J. ORCID: 0000-0002-2031-6390 and EROS Study Investigators, (2021). Perceived barriers and enablers to the provision of diabetic retinopathy screening for young adults: a cross-sectional survey of healthcare professionals working in the UK National Diabetic Eye Screening Programme. BMJ Open Diabetes Research and Care, 9(2), e002436. doi: 10.1136/bmjdrc-2021-002436

Abstract

INTRODUCTION: Diabetic retinopathy screening (DRS) attendance in young adults is consistently below recommended levels. The aim of this study was to conduct a survey of screening providers in the UK Diabetic Eye Screening Programme (DESP) to identify perceived barriers and enablers to DRS attendance in young adults and elicit views on the effectiveness of strategies to improve screening uptake in this population.

RESEARCH DESIGN AND METHODS: Members of the British Association of Retinal Screening (n=580) were invited to complete an anonymous online survey in July 2020 assessing agreement with 37 belief statements, informed by the Theoretical Domains Framework (TDF) of behavior change, describing potential barrier/enablers to delivering DRS for young adults and further survey items exploring effectiveness of strategies to improve uptake of DRS.

RESULTS: In total, 140 (24%) responses were received mostly from screener/graders (67.1%). There was a high level of agreement that the DESP had a role in improving attendance in young adults (96.4%) and that more could be done to improve attendance (90.0%). The most commonly reported barriers related to TDF domains Social influences and Environmental context and resources including lack of integration of DRS with other processes of diabetes care, which limited the ability to discuss diabetes self-management. Other barriers included access to screening services and difficulties with scheduling appointments. Less than half (46.4%) of respondents reported having a dedicated strategy to improve screening uptake in young adults. Strategies perceived to be effective included: screening within the community; prompts/reminders and integrating eye screening with other diabetes services.

CONCLUSIONS: Screening providers were concerned about screening uptake in young adults, although many programs lacked a dedicated strategy to improve attendance. Problems associated with a lack of integration between DRS with other diabetes care processes were identified as a major barrier to providing holistic care to young adults and supporting diabetes self-management.

Publication Type: Article
Additional Information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
Subjects: H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
R Medicine > RE Ophthalmology
Departments: School of Health Sciences > Healthcare Services Research & Management
School of Health Sciences > Optometry & Visual Science
Project Input:
Project IDFunder NameFunder ID
PR-R20-0318-22001National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Date available in CRO: 09 Nov 2021 13:48
Date deposited: 9 November 2021
Date of acceptance: 7 October 2021
Date of first online publication: 5 November 2021
URI: https://openaccess.city.ac.uk/id/eprint/27083
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