Retinopathy screening uptake among diabetic patients in Northern Iraq based on the attitude-social...

Diabetic Retinopathy (DR) is the leading cause of blindness in middle-aged and elderly individuals in Asia. Screening for retinopathy is a cost-effective method to prevent this condition. This study aims to identify the factors that are associated with the uptake of Diabetic Retinopathy Screening (DRS) among patients with type 2 diabetes in northern Iraq, using the attitude-social influence-self-efficacy (ASE) model.

This cross-sectional study was conducted in 2023 in the city of Sulaymaniyah, northern Iraq, and involved 602 patients with type 2 diabetes. The patients were selected using a simple random sampling method from those who referred to the diabetes clinic in Sulaimaniyah city. Data was collected through written questionnaires including background and demographic information, DRS uptake, and ASE determinants based on patient interviews. The collected data was analyzed using SPSS version 16, as well as, STAT-17 and statistical tests including Independent Samples t Test, Pearson correlation coefficient, and univariate and multivariate logistic regression were used.

The mean age of respondents was 53.17 ± 9.38 years, ranged from 30 to 77 years. The mean of diabetes duration was 7.92 ± 4.90 years, ranged from 1 to 24 years. 58.1% (350/602) of the participants had DRS uptake. Social influence (OR: 1.089 and P: 0.039), self-efficacy (OR: 1.502 and P < 0.001), barriers (OR: 0.891 and P: 0.002), and intention (OR: 1.215 and P: 0.012) were found to be significantly associated with the DRS uptake. Goodness of fit model indices included sensitivity, specificity, positive predictive value, negative predictive value and correctly classified were equal to 83.67%, 74.80%, 82.23%, 76.67% and 79.97% respectively.

Our findings suggest that in the development of interventions to promote DRS uptake, it should focus on strategies to promote social influences and self-efficacy, along with reducing barriers to DRS uptake.

The online version contains supplementary material available at 10.1007/s40200-026-01971-y.