ASPPH logo


Member Research & Reports

Member Research & Reports

UAB Researchers Team to Analyze Impact of EQUALITY on Patient Knowledge and Attitude

A study by University of Alabama at Birmingham researchers suggests that having access to information about glaucoma—as well as a patient’s determination to pursue regular eye care—leads to greater chances of early detection of the condition, which brings with it a lowered risk for developing blindness.




[Photo: (top to bottom) Ms. Carrie Huisingh, Dr. Gerald McGwin, Jr., and Dr. Stephen T. Mennemeyer]

Ms. Carrie Huisingh, doctoral student in UAB’s department of epidemiology and statistician in the department of ophthalmology; Dr. Gerald McGwin, Jr., professor and vice chair in the department of epidemiology and associate director of UAB’s Clinical Research Unit; and Dr. Stephen T. Mennemeyer, professor in the department of health care organization and policy—in collaboration with lead author Dr. Lindsay A. Rhodes, assistant professor in UAB’s department of ophthalmology (who will be starting the MPH program at UAB in Fall 2016), and her department colleagues Drs. Cynthia Owsley and Christopher A. Girkin—recently examined the influence of Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) on at-risk patients’ understanding of glaucoma as well as on their attitudes toward eye care and the program. (EQUALITY is a telemedicine program designed to educate the public in addition to giving health care professionals the ability to assess, diagnose, and then treat patients who might not otherwise have access to care.)

A total of 651 patients seeking a comprehensive eye exam (CEE) were enrolled in the study after having met the criteria for being at risk for developing glaucoma: being African American and age 40 or above; being White and age 50 or above; having diabetes; and having a family history of glaucoma and/or having been previously diagnosed with the condition. Subjects answered a questionnaire before being given the CEE or any eye health education information; two to four weeks later a follow-up survey was administered to them by phone.

When patients’ knowledge regarding glaucoma and their attitudes toward eye care were then assessed, the investigators discovered that at follow-up “all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions). Those who were unemployed (odds ratio =0.63, 95 percent confidence interval [CI] =0.42–0.95, P=0.026) or had lower education (odds ratio =0.55, 95 percent CI =0.29–1.02, P=0.058) were less likely to improve their knowledge after adjusting for age, sex, race, and prior glaucoma diagnosis. This association was attenuated after further adjustment for other patient-level characteristics. Ninety-eight percent (n=501) of patients reported being likely to have a CEE within the next two years, whereas 63 percent (n=326) had had a CEE in the previous two years. Patient satisfaction with EQUALITY was high (99 percent).”

“Eye Care Quality and Accessibility Improvement in the Community (EQUALITY): Impact of an Eye Health Education Program on Patient Knowledge about Glaucoma and Attitudes about Eye Care” was published in May 2016 in the journal Patient Related Outcome Measures.

Journal article: