Predictors of early acceptance of free spectacles provided to junior high school students in China.

OBJECTIVE To examine factors influencing adherence to spectacle wear and perceived value within a prospective 1-month trial of ready-made and custom spectacles in school-aged children with uncorrected refractive error in urban China. METHODS A total of 428 students aged 12 to 15 years with at least 1 diopter of uncorrected refractive error were given free spectacles and evaluated 1 month later at an unannounced visit. Demographic factors, vision, optical effects, and perceptions were modeled as predictors of observed use and perceived value using logistic regression adjusted for spectacle allocation. RESULTS Of 415 students, 388 (93.5%) planned to use their spectacles, 227 (54.7%) valued their spectacles highly, 204 (49.2%) had their spectacles on hand, and 13 (3.0%) were lost to follow-up. Female students were 1.72 times (95% confidence interval [CI], 1.10-2.68), students from lower income households were 1.78 times (1.32-2.39), and those not concerned over appearance were 2.04 times (1.25-3.36) more likely to have spectacles on hand. Students with a pupil size of 4 mm or greater were 2.55 times (95% CI, 1.61-4.03) and students with spectacle vision worse than 20/20 were 2.06 times (1.20-3.49) more likely to have spectacles on hand. Self-report of high perceived value was 2.23 times (95% CI, 1.30-3.80) more likely with 20/20 spectacle vision, 1.63 times (1.06-2.52) more likely with base-in prismatic effects of 0.5 prism diopters or more, 3.52 times (2.03-6.13) more likely when students would not tolerate blur to avoid wearing spectacles, and 2.16 times (1.24-3.76) more likely with disbelief that spectacles would make vision worse. Spectacle type had no effect. CONCLUSIONS Although most students planned to use their spectacles, only half were observed using them. Day-to-day use might increase if students were less concerned over appearance. Optical factors and beliefs surrounding spectacles are also predictive of acceptance. These findings provide further understanding of spectacle acceptance in teenagers.

[1]  Yingfeng Zheng,et al.  Refractive error and visual impairment in school children in rural southern China. , 2007, Ophthalmology.

[2]  N. Congdon,et al.  The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa , 2007, British Journal of Ophthalmology.

[3]  R. Baltussen,et al.  Cost-effectiveness of screening and correcting refractive errors in school children in Africa, Asia, America and Europe. , 2009, Health policy.

[4]  Lisa Keay,et al.  A randomized, clinical trial evaluating ready-made and custom spectacles delivered via a school-based screening program in China. , 2009, Ophthalmology.

[5]  N. Congdon,et al.  Factors associated with spectacle-wear compliance in school-aged Mexican children. , 2006, Investigative ophthalmology & visual science.

[6]  Serge Resnikoff,et al.  Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. , 2008, Bulletin of the World Health Organization.

[7]  A D Negrel,et al.  Refractive Error Study in Children: sampling and measurement methods for a multi-country survey. , 2000, American journal of ophthalmology.

[8]  M. He,et al.  Need and Challenges of Refractive Correction in Urban Chinese School Children , 2005, Optometry and vision science : official publication of the American Academy of Optometry.

[9]  L. Ellwein,et al.  Refractive Error Study in Children: results from Mechi Zone, Nepal. , 2000, American journal of ophthalmology.

[10]  R. Khandekar,et al.  Compliance of spectacle wear and its determinants among schoolchildren of Dhakhiliya region of Oman: A descriptive study. , 2002, Journal for scientific research. Medical sciences.

[11]  L B Ellwein,et al.  Refractive Error Study in Children: results from La Florida, Chile. , 2000, American journal of ophthalmology.

[12]  Jingjing Xu,et al.  Refractive error and visual impairment in urban children in southern china. , 2004, Investigative ophthalmology & visual science.

[13]  C. Meinert,et al.  The refractive status and vision profile: a questionnaire to measure vision-related quality of life in persons with refractive error. , 2000, Ophthalmology.

[14]  E. Hemminki,et al.  Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren. , 1989, The British journal of ophthalmology.

[15]  G. Murthy,et al.  Refractive error in children in an urban population in New Delhi. , 2002, Investigative ophthalmology & visual science.

[16]  L B Ellwein,et al.  Refractive Error Study in Children: results from Shunyi District, China. , 2000, American journal of ophthalmology.

[17]  C. Gilbert,et al.  Childhood blindness in the context of VISION 2020--the right to sight. , 2001, Bulletin of the World Health Organization.

[18]  I. Scarinci,et al.  Seeking Eye Care for Children: Perceptions among Hispanic Immigrant Parents , 2009, Journal of Immigrant and Minority Health.

[19]  N. Congdon,et al.  Spectacle acceptance among secondary school students in rural China: the Xichang Pediatric Refractive Error Study (X-PRES)--report 5. , 2008, Investigative ophthalmology & visual science.

[20]  J. Stockman.  Corrective Lens Wear Among Adolescents: Findings From the National Health and Nutrition Examination Survey , 2009 .

[21]  Keith Mathers,et al.  Pediatric ophthalmology in the developing world , 2008, Current opinion in ophthalmology.

[22]  J. Todd,et al.  Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes , 2007, British Journal of Ophthalmology.

[23]  M. Bullimore,et al.  Acceptance of auto-refractor and clinician prescriptions: A randomized clinical trial , 1996 .

[24]  C. Gilbert,et al.  Barriers to Spectacle Use in Tanzanian Secondary School Students , 2008, Ophthalmic epidemiology.

[25]  S. Resnikoff,et al.  Blindness prevention programmes: past, present, and future. , 2001, Bulletin of the World Health Organization.

[26]  R. D. Toit,et al.  Tolerance to Prism Induced by Readymade Spectacles: Setting and Using a Standard , 2007, Optometry and vision science : official publication of the American Academy of Optometry.