Grant: Project Grant

Retinopathy is a leading cause of preventable blindness in Canada affecting people with diabetes. Yearly eye screening is recommended and there are treatments that limit vision loss. However, most people with diabetes in Canada don't get their eyes screened annually, and over 30% never have. Newcomers to Canada with diabetes are at greater risk and are even less likely to get screened. We conducted studies to understand why this may be and what can help. We looked into all other previous studies to summarize what is known about barriers to screening and which strategies work for addressing those barriers. We conducted interviews in Mandarin and French with immigrants to Canada with diabetes from China, Africa and the Caribbean about barriers for them getting eye screening. Access is a key barrier, and a promising solution is tele-retina screening, involving bringing portable screening equipment to a community location rather than requiring people to wait for specialist clinic appointments. However, there are many other barriers: language, knowledge, concerns about harms to eyes, misinformation about cost of screening, family influences and remembering. This project will involve two steps: First, we will work with newcomers from China, Africa and the Caribbean and community centres in Ontario and Quebec to co-develop strategies to support eye screening using tele-retina screening. Next we will launch screening programs in community centres on a small scale to test if the strategies we co-develop are acceptable and feasible to community centres and patients, how many patients attend and whether the screening is delivered as we expect. Results will give us the evidence needed to justify a larger study that would randomly allocate people to receive the intervention and then check if more people get their eyes screened. If that works, this may be a way of making sure groups at greater risk of blindness get their eyes screened to reduce the chance of vision loss.