City Research Online

Abstract

AIM: To identify barriers and enablers of diabetic eye screening (DES) attendance amongst young adults with diabetes living in the UK.

METHODS: Semi-structured qualitative interviews with adults aged 18-34 years with diabetes. Participants were purposively sampled to aim for representation across gender, geographical locations, diabetes type, years since diabetes diagnosis and patterns of attendance (i.e. regular attenders, occasional non-attenders, regular non-attenders). Data were collected and analysed using the Theoretical Domains Framework (TDF) to explore potential individual, socio-cultural and environmental influences on attendance. Data were analysed using a combined deductive and inductive thematic analysis approach. Barriers/enablers were mapped to behaviour change techniques (BCTs) to identify potential strategies to increase attendance.

RESULTS: Key barriers to attendance reported by the sample of 29 study participants with type 1 diabetes, fell within the TDF domains: [1] (e.g. not understanding reasons for attending DES or treatments available if diabetic retinopathy is detected), [Social Influences] (e.g. lack of support following DES results), [Social role and Identity] (e.g. not knowing other people their age with diabetes, feeling 'isolated' and being reluctant to disclose their diabetes) and [Environmental Context and Resources] (e.g. lack of appointment flexibility and options for rescheduling). Enablers included: [Social Influences] (e.g. support of family/diabetes team), [Goals] (e.g. DES regarded as 'high priority'). Many of the reported barriers/enablers were consistent across groups. Potential BCTs to support attendance include: Instructions on how to perform the behaviour; Information about health consequences; Social support (practical) and Social comparison.

CONCLUSIONS: Attendance to diabetic eye screening in young adults is influenced by a complex set of interacting factors. Identification of potentially modifiable target behaviours provides a basis for designing more effective, tailored interventions to help young adults regularly attend eye screening and prevent avoidable vision loss.

Publication Type:	Article
Additional Information:	This is the pre-peer reviewed version of the following article: Prothero, L. , Lawrenson, J. G. , Cartwright, M. , Crosby-Nwaobi, R., Burr, J. M., Gardner, P., Anderson, J., Presseau, J., Ivers, N., Grimshaw, J. M., Lorencatto, F. and EROS Study Investigators, (2021). Barriers and enablers to diabetic eye screening attendance: an interview study with young adults with type 1 diabetes. Diabetic Medicine, e14751, which has been published in final form at https://doi.org/10.1111/dme.14751. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Publisher Keywords:	barriers and enablers, behaviour change, diabetic eye screening, qualitative research
Subjects:	H Social Sciences > HM Sociology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RE Ophthalmology
Departments:	School of Health & Psychological Sciences > Healthcare Services Research & Management School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:	Symplectic Administrator

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