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Barriers and enablers to diabetic retinopathy screening : a cross-sectional survey of young adults with type 1 and type 2 diabetes in the UK

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Date
23/11/2022
Author
Prothero, Louise
Cartwright, Martin
Lorencatto, Fabiana
Burr, Jennifer M
Anderson, John
Gardner, Philip
Presseau, Justin
Ivers, Noah
Grimshaw, Jeremy M
Lawrenson, John G
Keywords
RE Ophthalmology
RC Internal medicine
NDAS
NIS
MCC
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Abstract
Introduction : Diabetic retinopathy screening (DRS) attendance in young adults (YAs) is consistently below recommended levels. The aim of this study was to identify barriers and enablers of DRS attendance among YAs in the UK living with type 1 (T1D) and type 2 diabetes (T2D). Research design and methods : YAs (18–34 years) were invited to complete an anonymous online survey in June 2021 assessing agreement with 30 belief statements informed by the Theoretical Domains Framework (TDF) of behavior change describing potential barriers/enablers to DRS. Results : In total, 102 responses were received. Most had T1D (65.7%) and were regular attenders for DRS (76.5%). The most salient TDF domains for DRS attendance were ‘Goals’, with 93% agreeing that DRS was a high priority, and ‘Knowledge’, with 98% being aware that screening can detect eye problems early. Overall, 67.4% indicated that they would like greater appointment flexibility (Environmental context/resources) and 31.3% reported difficulties getting time off work/study to attend appointments (Environmental context/resources). This was more commonly reported by occasional non-attenders versus regular attenders (59.1% vs 23.4%, p=0.002). Most YAs were worried about diabetic retinopathy (74.3%), anxious when receiving screening results (63%) (Emotion) and would like more support after getting their results (66%) (Social influences). Responses for T1D and T2D were broadly similar, although those with T2D were more likely have developed strategies to help them to remember their appointments (63.6% vs 37.9%, p=0.019) (Behavioral regulation). Conclusions : Attendance for DRS in YAs is influenced by complex interacting behavioral factors. Identifying modifiable determinants of behavior will provide a basis for designing tailored interventions to improve DRS in YAs and prevent avoidable vision loss.
Citation
Prothero , L , Cartwright , M , Lorencatto , F , Burr , J M , Anderson , J , Gardner , P , Presseau , J , Ivers , N , Grimshaw , J M & Lawrenson , J G 2022 , ' Barriers and enablers to diabetic retinopathy screening : a cross-sectional survey of young adults with type 1 and type 2 diabetes in the UK ' , BMJ Open Diabetes Research and Care , vol. 10 , no. 6 , e002971 . https://doi.org/10.1136/bmjdrc-2022-002971
Publication
BMJ Open Diabetes Research and Care
Status
Peer reviewed
DOI
https://doi.org/10.1136/bmjdrc-2022-002971
ISSN
2052-4897
Type
Journal article
Rights
Copyright © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions.
Description
Funding: This report is independent research funded by the National Institute for Health Research (Policy Research Program, Enabling diabetic RetinOpathy Screening: Mixed methods study of barriers and enablers to attendance (EROS study), PR-R20-0318-22001).
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/26531

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