"I want to see everything": A community-based participatory research framework to identify eye health and vision care knowledge, perceptions, values, and barriers.

Abstract

Introduction: Vision impairment disproportionately affects individuals from low-income and African American communities, yet underutilization of preventive eye care persists. We conducted a community-based participatory research (CBPR) study to explore perceptions, values, and barriers related to vision care in an underserved urban neighborhood.

Methods: In partnership with University Settlement, a trusted community center in Cleveland, Ohio, and a study-specific Community Advisory Board (CAB), we conducted semi-structured interviews with 60 adult residents of the Broadway-Slavic Village neighborhood. Thematic analysis identified key facilitators and barriers to accessing vision care.

Results: Participants across racial groups described vision as highly important and often endorsed more frequent preventive eye care than they reported receiving. Barriers to eye care utilization included cost, inadequate insurance coverage, transportation challenges, fear of diagnosis, and limited awareness of preventive benefits. Distinct differences emerged in insurance type and visit frequency between African American and White participants despite comparable socioeconomic status. Participants identified community-specific solutions such as free or low-cost exams, mobile clinics, transportation support, and increased education.

Conclusions: Our findings demonstrate that underutilization of eye care reflects structural and systemic barriers rather than lack of motivation. System-level interventions that integrate screenings into clinical and community settings, streamline referral pathways, and reduce logistical burdens are needed to facilitate equitable access to vision care. Embedding data collection in a trusted community setting surfaced perspectives from individuals who may be absent from clinic-based or online research and provides a model for translational research addressing health disparities.