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Abstract

Understanding barriers to seeking eye care and providing evidence-based theory55 informed solutions can improve the uptake of eye care services. Therefore, in this cross56 sectional study, we aim to report and analyse barriers to seeking eye care services among individuals with vision impairment in the Akividu region of Andhra Pradesh, India.

Methods:
Out of the 3,000 enumerated participants, a total of 2,587 were examined. All participants with vision impairment were asked to report barriers for not seeking eye care despite noticing reduced vision using a validated questionnaire. The reported barriers were mapped to the Theoretical Domains Framework (TDF), to explore potential individual and environmental influences on the uptake of eye care services.

Results:
Barriers to seeking eye care services are most frequently mapped to the ‘beliefs about capabilities’, ‘environmental context and resources’, and ‘social influences’ domains of the TDF. The most frequently reported barrier was “aware of the problem but can manage” (beliefs about capabilities), expressed by 43.4% (n=156) and, 55.7% (n=337) of participants with distance and near vision impairment respectively. “No one toaccompany” for an appointment (social influences) was a significant barrier for participants with distance vision impairment (n=44, 12.2%) in comparison to participants with near vision impairment (n=19, 3.1%). Additionally, fear of losing eyesight or operation or consultation (emotion) was a major deterrent for seeking eye care services particularly among participants with distance vision impairment (n=31, 8.6%) when compared to near vision impairment (n=17, 2.8%).

Conclusion: The uptake of eye care services is influenced by a complex set of interacting factors. Identification of potentially modifiable target behaviours provides an opportunity to develop theory-informed solutions to improve uptake of services and prevent avoidable vision loss.

Publication Type:	Article
Additional Information:	This is the peer reviewed version of the following article: Yelagondula, V., Lawrenson, J., Subramanian, A. & Marmamula, S. (2024). Uptake of eye care services in South India: retrospective mapping of self-reported barriers using the Theoretical Domains Framework. Ophthalmic and Physiological Optics, which has been published in final form at http://dx.doi/ doi: 10.1111/opo.13424. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords:	Barriers to eye care, eye care, eye health seeking behavior, theoretical domains framework, access to eye care
Subjects:	D History General and Old World > DS Asia H Social Sciences > HN Social history and conditions. Social problems. Social reform R Medicine > RE Ophthalmology
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:	Symplectic Administrator

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