Related Experiment Video
Updated: Oct 14, 2025
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Factors influencing post-screening visits of students to local vision centres in rural northwest China
Yunyun Zhang1, Tianli Yang2, Hongyu Guan1
1Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China.
Insights
Community vision centers improve student access to vision care in rural China. However, compliance with follow-up visits remains a challenge, with factors like poor vision and distance influencing attendance.
Area of Science:
- Ophthalmology and Public Health
- Pediatric Vision Care
- Health Services Research
Background:
- Uncorrected visual impairment negatively impacts children's motor and cognitive development.
- Community-based vision centers (VCs) are crucial for addressing student vision problems in rural China.
- Compliance with VC services is vital for the model's success, necessitating exploration of influencing factors.
Purpose of the Study:
- To explore factors influencing primary school students' compliance with visitations to community-based vision centers after initial screening.
- To identify barriers and facilitators for seeking vision care services among low-income student populations.
Main Methods:
- A cross-sectional study involving 15,763 students across 228 primary schools in rural China.
- Data collection via questionnaires and vision examinations.
- Logistic regression analysis to identify determinants of student visits to VCs.
Main Results:
- 34% of students had visual impairment; only 18% sought care at baseline.
- Post-referral, only 43.33% of students with visual impairment visited the VC.
- Significant predictors for VC visits included poor uncorrected visual acuity, higher grade level, 'left-behind' status, proximity to VC, and residing in Gansu province.
Conclusions:
- Establishing VCs with free services increases vision care utilization among rural students.
- Compliance rates with VC services require improvement.
- Key factors influencing student compliance with vision care have been identified, informing targeted interventions.
Clinical Relevance:
Children with uncorrected visual impairment have lower scores on a variety of motor and cognitive tests. Exploring the influencing factors of low-income groups seeking vision care services is helpful for identifying relevant barriers and necessary measures to improve the utilization rate of vision care services.
Background:
The community-based vision center (VC) is a popular model for solving vision problem of students in rural China. Compliance is the key factor to the success of the VC model. Factors determining compliance with visitations to VC among primary school students after screening were explored.
Methods:
A cross-sectional study was conducted with 15,763 students from 228 primary schools. Information was collected through questionnaires and vision examinations. The determinants that affect visits of students to the VC were analyzed using logistic regression.
Results:
Among the 15,763 sample, 5,361 (34%) students had a visual impairment. At baseline, only 962 (18%) of students with visual impairment sought vision care services. After a local VC was established, among the 5,163 students who needed to be referred, only 2,237 (43.33%) students visited the VC. Multivariate logistic regression models for predicting students visit the VC revealed that the following characteristics were significant predictors: poor uncorrected visual acuity (P < 0.001), a higher grade level (P = 0.008; P = 0.010), 'left-behind' children (P < 0.001), short living distance between home and the VC (P < 0.001), and the fact that these students lived in Gansu province (P < 0.001).
Conclusions:
Establishing a VC that provides students with vision screening and free vision care services can increase the rate of seeking vision health services for students in rural areas, but the compliance rate still needs to be improved. The influencing factors for student compliance have been identified.
