Perspectives on eye care access and telemedicine-based glaucoma screening among Latine individuals with limited English proficiency

AJO International Pub Date : 2025-06-01 DOI:10.1016/j.ajoint.2025.100144

Norma E. Del Risco , Mildred Silva Zuccaro , Jade J. Livingston , Michele Heisler , Harry Levine , Maria A. Woodward , Amanda K. Bicket , Angela R. Elam , Denise A. John , Paula Anne Newman-Casey

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Abstract

Purpose

Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program (MI-SIGHT) was developed to facilitate access to glaucoma and eye disease screening and improve attendance at recommended follow-up in underserved communities. MI-SIGHT offered free eye disease screenings, low-cost glasses and for those who screened positive for glaucoma, personalized education, and language-concordant coaching grounded in motivational interviewing. The primary aims of this study were 1) To explore barriers to eye care among Latine participants with limited English proficiency (LEP) who screened positive for glaucoma, 2) to understand whether and how the MI-SIGHT program facilitated access to care and 3) to understand participant experience in MI-SIGHT to inform the development of future interventions.

Design

Qualitative study.

Subjects

21 participants who identified as Latine with low English proficiency (LEP) who screened positive for glaucoma during the MI-SIGHT program and received personalized health education about their screening results, motivational-interviewing based health coaching, and care navigation all in Spanish.

Methods

Participants were recruited from the two MI-SIGHT sites, a Federally Qualified Health Center (FQHC) and a free clinic. Semi-structured interviews were conducted in Spanish by a native Spanish speaker. Interviews were audio-recorded and transcribed verbatim in Spanish. Grounded theory was used to guide qualitative analysis. Thematic saturation was achieved after analyzing 16 interviews.

Main outcome measures

Themes regarding barriers to eye care access and facilitators to eye care access through MI-SIGHT.

Results

Between 7/11/23–12/19/23, 154 MI-SIGHT participants identified as Latine and had LEP, 22 screened positive for glaucoma and 21 agreed to be interviewed. Interviews revealed that the primary obstacles to accessing eye care among Latine participants with LEP were language barriers, financial constraints due to lack of insurance, insufficient social support, and difficulty with transportation. Additional challenges included immigration-related fears and complexities in healthcare system navigation. Participants identified key facilitators of the MI-SIGHT program as language concordance with providers, availability of interpreters, affordable eye care and glasses, and transportation services. Personalized coaching in their native language further enhanced their understanding of their eye disease and participation. High satisfaction was evident, with nearly all participants willing to recommend the program to others.

Conclusions

Eye care access for Latine participants with LEP is shaped by interconnected structural, socioeconomic, and cultural barriers. Language-concordant interventions, like the MI-SIGHT program, improve care engagement with unanimously positive feedback and willingness of participants to recommend the program. Integrated strategies targeting multiple barriers are critical for advancing eye health equity.

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英语水平有限的拉丁裔个体的眼保健获取和基于远程医疗的青光眼筛查的观点

目的：制定密歇根青光眼和眼健康远程医疗筛查和干预计划（MI-SIGHT），以促进青光眼和眼病筛查的可及性，并提高服务不足社区推荐随访的出勤率。MI-SIGHT为青光眼筛查呈阳性的患者提供免费眼病筛查、低成本眼镜、个性化教育和基于动机性访谈的语言协调指导。本研究的主要目的是：1)探索青光眼筛查呈阳性的英语水平有限的拉丁裔参与者的眼保健障碍；2)了解MI-SIGHT项目是否以及如何促进获得护理；3)了解MI-SIGHT项目的参与者经验，为未来干预措施的发展提供信息。DesignQualitative研究。研究对象：21名在MI-SIGHT项目中青光眼筛查呈阳性的英语水平较低的拉丁人，接受了关于筛查结果的个性化健康教育、基于动机性访谈的健康指导和西班牙语护理指导。方法从两个MI-SIGHT站点，一个联邦合格健康中心（FQHC）和一个免费诊所招募参与者。半结构化访谈由西班牙语母语人士用西班牙语进行。采访录音并逐字逐句用西班牙语记录下来。采用扎根理论指导定性分析。在分析了16个访谈后达到主题饱和。主要结局指标：通过MI-SIGHT获得眼科保健的障碍和促进因素。结果在7月11日至23年12月19日期间，154名MI-SIGHT参与者被确定为拉丁裔并患有LEP， 22名青光眼筛查阳性，21名同意接受采访。访谈显示，拉丁裔LEP参与者获得眼科护理的主要障碍是语言障碍、缺乏保险造成的经济限制、社会支持不足和交通困难。其他挑战包括移民相关的担忧和医疗系统导航的复杂性。参与者确定了MI-SIGHT项目的关键促进因素，包括与供应商的语言一致性、口译人员的可用性、可负担的眼科护理和眼镜以及交通服务。以他们的母语进行的个性化指导进一步增强了他们对眼病的了解和参与。非常满意，几乎所有的参与者都愿意向其他人推荐这个项目。结论拉丁裔LEP患者的眼科护理可及性受到相互关联的结构、社会经济和文化障碍的影响。语言协调的干预，如MI-SIGHT项目，通过一致的积极反馈和参与者推荐项目的意愿，提高了护理参与度。针对多种障碍的综合战略对于促进眼保健公平至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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AJO International

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