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dc.contributor.authorGraham-Rowe, E.
dc.contributor.authorLorencatto, F.
dc.contributor.authorLawrenson, J. G.
dc.contributor.authorBurr, J. M.
dc.contributor.authorGrimshaw, J. M.
dc.contributor.authorIvers, N. M.
dc.contributor.authorPresseau, J.
dc.contributor.authorVale, L.
dc.contributor.authorPeto, T.
dc.contributor.authorBunce, C.
dc.contributor.authorFrancis, J. J
dc.identifier.citationGraham-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 .
dc.identifier.otherPURE: 253171252
dc.identifier.otherPURE UUID: e4622e55-a634-4752-abc5-b1cfb71eb7a9
dc.identifier.othercrossref: 10.1111/dme.13686
dc.identifier.otherScopus: 85053719190
dc.identifier.otherORCID: /0000-0002-9478-738X/work/60196192
dc.identifier.otherWOS: 000445328800002
dc.descriptionFunding was received from the National Institute for Health Research Health Technology Assessment Programme (NIHR-HTA; Project Reference Number 13/137/05).en
dc.description.abstractAims:  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.
dc.relation.ispartofDiabetic Medicineen
dc.rights© 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
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.titleBarriers to and enablers of diabetic retinopathy screening attendance : a systematic review of published and grey literatureen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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