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

Lucy Goodman1, Tulio Reis2, Justine H Zhang3

  • 1School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand.

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Summary

Few eye health surveys adequately consider underserved groups in their design and implementation. More effort is needed to ensure equitable eye health monitoring and reporting for all populations.

Keywords:
Cross-sectional studiesHealth equity analysisMeta-epidemiologyMeta-researchMethodological reviewPopulation based eye health surveys

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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.