Community-Based Eye Screening With Structured Referral Tracking for Preventing Avoidable Blindness in Adults in Rawalpindi, Pakistan (SIGHT)
Community-Based Eye Screening With a Structured Referral Tracking Intervention for the Prevention of Avoidable Blindness Among Adults in Rawalpindi District, Pakistan
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Avoidable blindness remains a major public health challenge in low- and middle-income countries, including Pakistan. Community-based eye screening camps are commonly used to identify individuals with visual impairment and eye diseases requiring treatment; however, referral completion to tertiary eye care facilities remains poor. Many patients fail to attend referral hospitals because of limited awareness, lack of follow-up, transportation barriers, and uncertainty regarding treatment procedures.
This study aims to evaluate the effectiveness and implementation of a Structured Referral Tracking (SRT) intervention in improving referral completion among adults identified with avoidable blindness during community-based eye screening camps in Rawalpindi District, Pakistan.
The study will use a cluster randomized controlled trial design. Ten community clusters (union councils) from five tehsils of Rawalpindi District will be selected using multistage random sampling. Clusters will be randomized into intervention and control arms. Participants attending eye screening camps who are diagnosed with eye conditions requiring referral to a tertiary eye hospital will be enrolled after informed consent.
Participants in the intervention arm will receive a multi-component Structured Referral Tracking intervention consisting of referral counseling, weekly reminder calls or mobile messages, visual educational material, and customized referral guidance regarding hospital location, estimated costs, and required documents. Participants in the control arm will receive standard referral procedures consisting of routine counseling and referral slips without structured follow-up.
The primary outcome will be referral completion at the tertiary eye hospital within eight weeks after screening, verified through hospital attendance records. Secondary outcomes will include knowledge regarding avoidable blindness, treatment satisfaction, feasibility and acceptability of the intervention, and barriers influencing referral completion.
The findings of this study are expected to provide evidence regarding the effectiveness and feasibility of structured referral tracking systems for improving eye care service utilization and reducing avoidable blindness in Pakistan.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Khizar Nabeel, PHD (In progress)
- Numéro de téléphone: +923455096776
- E-mail: khizar@hsa.edu.pk
Lieux d'étude
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Punjab Province
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Rawalpindi, Punjab Province, Pakistan, 46600
- ACCO Department, Al-Shifa Trust Eye Hospital, Rawalpindi
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Adults aged 18 years or above
- Individuals diagnosed with visual impairment or eye conditions requiring referral to a tertiary eye care facility
- Permanent residents of Rawalpindi District, Pakistan
- Willing and able to provide informed consent
Exclusion Criteria:
- Individuals already undergoing treatment for the identified eye condition
- Individuals requiring emergency ophthalmic care
- Severe systemic or physical illness limiting follow-up
- Individuals unable to provide informed consent
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Structured Referral Tracking (SRT)
Participants will receive structured referral counseling, weekly reminder calls or messages, visual educational material, and customized referral guidance for eight weeks following community-based eye screening.
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A multi-component referral tracking intervention including referral counseling, weekly reminder calls or mobile messages, visual educational material, and customized referral guidance to improve referral completion after community eye screening.
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Aucune intervention: Standard Referral Procedure
Participants will receive routine referral slips and standard counseling without structured follow-up or reminder communication.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Referral Completion Rate Verified Through Hospital Records
Délai: Within 8 weeks after community eye screening
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Proportion of referred participants who complete referral visits at the tertiary eye hospital, verified through hospital attendance records.
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Within 8 weeks after community eye screening
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Knowledge Score on Avoidable Blindness Questionnaire
Délai: Baseline and 8 weeks after screening
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Participant knowledge regarding avoidable blindness and eye health assessed using a structured questionnaire developed for the study.
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Baseline and 8 weeks after screening
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Participant Acceptability of Structured Referral Tracking Assessed Using Structured Feedback Questionnaire
Délai: Within 8 weeks after screening
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Participant acceptability of the Structured Referral Tracking intervention assessed using a structured feedback questionnaire regarding usefulness and satisfaction with reminder communication.
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Within 8 weeks after screening
|
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Barriers Influencing Referral Completion Assessed Using Structured Barrier Assessment Questionnaire
Délai: Within 8 weeks after screening
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Barriers and facilitators influencing referral completion assessed using a structured questionnaire among referred participants.
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Within 8 weeks after screening
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Participant Treatment Satisfaction Score Using Structured Satisfaction Questionnaire
Délai: Within 8 weeks after screening
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Participant-reported satisfaction regarding referral services and treatment received at the tertiary eye hospital assessed using a structured satisfaction questionnaire.
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Within 8 weeks after screening
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Feasibility of Structured Referral Tracking Assessed by Reminder Delivery and Follow-up Completion Rates
Délai: Within 8 weeks after screening
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Feasibility of the intervention assessed through successful delivery of reminder messages/calls and completion of scheduled follow-up procedures.
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Within 8 weeks after screening
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Collaborateurs et enquêteurs
Collaborateurs
Les enquêteurs
- Directeur d'études: Dr. Ahmad Abdullah, PHD, Shifa International Hospital, Islamabad
Publications et liens utiles
Publications générales
- Harwood M, Cunningham W. Lessons from 2020 for equity in global eye health. Lancet Glob Health. 2021 Apr;9(4):e387-e388. doi: 10.1016/S2214-109X(21)00036-X. Epub 2021 Feb 16. No abstract available.
- World Health Organization. Blindness and visual impairment. Geneva: World Health Organization; 2023
- Khan AA, Talpur KI, Awan Z, Arteaga SL, Bolster NM, Katibeh M, Watts E, Bastawrous A. Improving equity, efficiency and adherence to referral in Pakistan's eye health programmes: Pre- and post-pandemic onset. Front Public Health. 2022 Jul 22;10:873192. doi: 10.3389/fpubh.2022.873192. eCollection 2022.
Liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- hsa2026135
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