Barriers to and enablers of diabetic retinopathy screening attendance : a systematic review of published and grey literature
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Aims: To identify and synthesize studies reporting modifiable barriers/enablers associated with retinopathy screening attendance in people with Type 1 or Type 2 diabetes, and to identify those most likely to influence attendance. Methods: We searched MEDLINE, EMBASE, PsycINFO, Cochrane Library and the ‘grey literature’ for quantitative and qualitative studies to February 2017. Data (i.e. participant quotations, interpretive summaries, survey results) reporting barriers/enablers were extracted and deductively coded into domains from the Theoretical Domains Framework; with domains representing categories of theoretical barriers/enablers proposed to mediate behaviour change. Inductive thematic analysis was conducted within domains to describe the role each domain plays in facilitating or hindering screening attendance. Domains that were more frequently coded and for which more themes were generated were judged more likely to influence attendance. Results: Sixty‐nine primary studies were included. We identified six theoretical domains [‘environmental context and resources’ (75% of included studies), ‘social influences’ (51%), ‘knowledge’ (50%), ‘memory, attention, decision processes’ (50%), ‘beliefs about consequences’ (38%) and ‘emotions’ (33%)] as the key mediators of diabetic retinopathy screening attendance. Examples of barriers populating these domains included inaccurate diabetic registers and confusion between routine eye care and retinopathy screening. Recommendations by healthcare professionals and community‐level media coverage acted as enablers. Conclusions: Across a variety of contexts, we found common barriers to and enablers of retinopathy screening that could be targeted in interventions aiming to increase screening attendance.
Graham-Rowe , E , Lorencatto , F , Lawrenson , J G , Burr , J M , Grimshaw , J M , Ivers , N M , Presseau , J , Vale , L , Peto , T , Bunce , C & Francis , J J 2018 , ' Barriers to and enablers of diabetic retinopathy screening attendance : a systematic review of published and grey literature ' , Diabetic Medicine , vol. 35 , no. 10 , pp. 1308-1319 . https://doi.org/10.1111/dme.13686
© 2018 Diabetes UK. This work has been made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1111/dme.13686
DescriptionFunding was received from the National Institute for Health Research Health Technology Assessment Programme (NIHR-HTA; Project Reference Number 13/137/05).
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