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dc.contributor.authorGraham-Rowe, Ella
dc.contributor.authorLorencatto, Fabiana
dc.contributor.authorLawrenson, John G.
dc.contributor.authorBurr, Jennifer
dc.contributor.authorGrimshaw, Jeremy M.
dc.contributor.authorIvers, Noah M.
dc.contributor.authorPeto, Tunde
dc.contributor.authorBunce, Catey
dc.contributor.authorFrancis, Jill J.
dc.contributor.authorWIDeR-EyeS Project team
dc.identifier.citationGraham-Rowe , E , Lorencatto , F , Lawrenson , J G , Burr , J , Grimshaw , J M , Ivers , N M , Peto , T , Bunce , C , Francis , J J & WIDeR-EyeS Project team 2016 , ' Barriers and enablers to diabetic retinopathy screening attendance : protocol for a systematic review ' , Systematic Reviews , vol. 5 , no. 1 .
dc.identifier.otherPURE: 245212998
dc.identifier.otherPURE UUID: 195b9736-ebfa-4bfd-9ead-359d6c05e94a
dc.identifier.otherBibtex: urn:b41613b3332ec9fdabda77d196c649ef
dc.identifier.otherScopus: 84991573884
dc.identifier.otherORCID: /0000-0002-9478-738X/work/60196154
dc.identifier.otherWOS: 000453148200133
dc.descriptionThis report is independent research funded by the National Institute for Health Research (Health Technology Assessment, 13/137/05—What Works to Increase Attendance for Diabetic Retinopathy Screening? An Evidence sYnthEsiS (WIDeR-EyeS)).en
dc.description.abstractBackground : Diabetic retinopathy is a serious complication of diabetes which, if left untreated, can result in blindness. Population screening among people with diabetes has been shown to be clinically effective; however, suboptimal attendance with wide demographic disparities has been reported. To develop quality improvement interventions to maximise attendance, it is important to understand the theoretical determinants (i.e. barriers and enablers) of screening behaviour. The aim of this systematic review is to identify and synthesise the modifiable barriers and enablers associated with diabetic retinopathy screening attendance. Methods/design : Primary and secondary studies will be included if they report perceived barriers/enablers of diabetic retinopathy screening attendance, from the perspectives of people with diabetes and healthcare providers. There will be no restrictions on study design. Studies will be identified from published and grey literature through multiple sources. Bibliographic databases will be searched using synonyms in four search domains: diabetic retinopathy; screening; barriers/enablers; and theoretical constructs relating to behaviour. Search engines and established databases of grey literature will be searched to identify additional relevant studies. Extracted data will include: participant quotations from qualitative studies, statistical analyses from questionnaire and survey studies, and interpretive descriptions and summaries of results from reports. All extracted data will be coded into domains from the Theoretical Domains Framework (TDF) and (for organisational level data) the Consolidated Framework of Implementation Research (CFIR); with domains representing theoretical barriers/enablers proposed to mediate behaviour change. The potential role of each domain in influencing retinopathy screening attendance will be investigated through thematic analysis of the TDF/ CFIR coding. Domain importance will be identified using prespecified criteria: “frequency” and “expressed importance”. Variations in perceived barriers and enablers between demographic groups (e.g., socio-economic, ethnic) will be explored. Discussion : This review will identify important barriers and enablers likely to influence attendance for diabetic retinopathy screening. The results will be used to assess the extent to which existing interventions targeting attendance address the theoretical determinants of attendance behaviour. Findings will inform recommendations for future intervention design. Systematic review registration : PROSPERO CRD42016032990
dc.relation.ispartofSystematic Reviewsen
dc.rights© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.en
dc.subjectDiabetic retinopathyen
dc.subjectTheoretical Domains Frameworken
dc.subjectConsolidated Framework for Implementation Researchen
dc.subjectThematic analysisen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleBarriers and enablers to diabetic retinopathy screening attendance : protocol for a systematic reviewen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.description.statusPeer revieweden

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