Underserved groups could be better considered within population-based eye health surveys: a methodological study

Area of Science:

• Ophthalmology
• Public Health
• Health Equity Research

Background:

• The World Health Organization advocates for enhanced monitoring of eye health inequalities.
• Population-based eye health surveys are crucial for this monitoring.
• Current practices regarding the inclusion of underserved groups in these surveys are not well understood.

Purpose of the Study:

• To systematically review population-based eye health surveys published since 2000.
• To assess the extent to which underserved groups are considered in survey design, implementation, and reporting.
• To identify gaps and areas for improvement in monitoring eye health equity.

Main Methods:

• Systematic methodological review of population-based cross-sectional surveys.
• Inclusion of surveys reporting objectively measured vision impairment or blindness prevalence.
• Assessment using the PROGRESS+ framework to evaluate consideration of underserved groups across 15 items (rationale, sampling, recruitment, reporting).

Main Results:

• 388 surveys were reviewed; few prospectively considered underserved groups in planning (e.g., sample size calculations, 1%) or recruitment (18%).
• Reporting of prevalence estimates was the most common consideration (96%).
• Gender/sex was considered in 95% of studies; 43% focused primarily on underserved groups (e.g., rural populations).

Conclusions:

• Significant improvements are required in the design, implementation, and reporting of eye health surveys.
• Enhanced survey methodologies are essential for monitoring inequalities and promoting health equity.
• Supplementing national monitoring with smaller-scale studies is vital to understand disparities among the most underserved populations.