Establishing a screening programme for diabetic retinopathy in Kilimanjaro Region, Tanzania using intervention mapping

Claudette E. Hall; Anthony B. Hall; Joyse Mallya; Paul Courtright; Gerjo Kok

doi:10.1038/s41433-022-02001-w

Establishing a screening programme for diabetic retinopathy in Kilimanjaro Region, Tanzania using intervention mapping

Claudette E. Hall^*, Anthony B. Hall, Joyse Mallya, Paul Courtright, Gerjo Kok

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The Kilimanjaro Diabetic Programme used the Intervention Mapping framework to develop a theory- and evidence-based diabetic retinopathy screening programme. A Working Committee of health care workers and stakeholders ensured community engagement and empowerment of the target audience.

OBJECTIVES: To deliver a culturally appropriate, sustainable, community supported health intervention, promoting eye health behaviour change, to prevent avoidable blindness.

METHODS: The six steps of the Intervention Mapping protocol incorporated eight components: (1) a needs assessment of people with diabetes and health care workers (2) a clinical trial of diabetic retinopathy screening modes, (3) comic strips as a motivational strategy for diabetic retinopathy screening uptake, (4) health care worker education (5) an electronic database of people with diabetes (6) a self-carry diary (7) implementation of mobile diabetic retinopathy retinal screening (8) process and outcome programme evaluation.

RESULTS: The programme eliminated barriers to diabetic retinopathy screening in Kilimanjaro Christian Medical Centre eye and diabetic clinics, placing a digital retinal screening camera in the diabetic clinic and a fast-track screening system in the eye clinic. Two comic strips and a diary provided information about self-management and record of medications, treatment, blood sugar and blood pressure at clinic visits. An annual rural health care worker education programme met requests for knowledge on treatment and care of diabetes, targeting prevention of diabetic retinopathy. Rural digital retinal screening was implemented. Rural diabetes clinics were initiated.

CONCLUSIONS: Intervention Mapping provided a systematic, iterative model to formulate and deliver an urban and rural diabetic retinopathy screening programme.

TRIAL REGISTRATION NUMBER: ISRCTN31439939. Details available at https://www.isrctn.com/.

Original language	English
Pages (from-to)	17-24
Number of pages	8
Journal	Eye
Volume	36
Issue number	Suppl 1
DOIs	https://doi.org/10.1038/s41433-022-02001-w
Publication status	Published - May 2022

Keywords

Blood Glucose
Diabetes Mellitus
Diabetic Retinopathy/diagnosis
Humans
Mass Screening
Needs Assessment
Tanzania

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10.1038/s41433-022-02001-wLicence: CC BY-NC-ND

Cite this

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title = "Establishing a screening programme for diabetic retinopathy in Kilimanjaro Region, Tanzania using intervention mapping",

abstract = "BACKGROUND: The Kilimanjaro Diabetic Programme used the Intervention Mapping framework to develop a theory- and evidence-based diabetic retinopathy screening programme. A Working Committee of health care workers and stakeholders ensured community engagement and empowerment of the target audience.OBJECTIVES: To deliver a culturally appropriate, sustainable, community supported health intervention, promoting eye health behaviour change, to prevent avoidable blindness.METHODS: The six steps of the Intervention Mapping protocol incorporated eight components: (1) a needs assessment of people with diabetes and health care workers (2) a clinical trial of diabetic retinopathy screening modes, (3) comic strips as a motivational strategy for diabetic retinopathy screening uptake, (4) health care worker education (5) an electronic database of people with diabetes (6) a self-carry diary (7) implementation of mobile diabetic retinopathy retinal screening (8) process and outcome programme evaluation.RESULTS: The programme eliminated barriers to diabetic retinopathy screening in Kilimanjaro Christian Medical Centre eye and diabetic clinics, placing a digital retinal screening camera in the diabetic clinic and a fast-track screening system in the eye clinic. Two comic strips and a diary provided information about self-management and record of medications, treatment, blood sugar and blood pressure at clinic visits. An annual rural health care worker education programme met requests for knowledge on treatment and care of diabetes, targeting prevention of diabetic retinopathy. Rural digital retinal screening was implemented. Rural diabetes clinics were initiated.CONCLUSIONS: Intervention Mapping provided a systematic, iterative model to formulate and deliver an urban and rural diabetic retinopathy screening programme.TRIAL REGISTRATION NUMBER: ISRCTN31439939. Details available at https://www.isrctn.com/.",

keywords = "Blood Glucose, Diabetes Mellitus, Diabetic Retinopathy/diagnosis, Humans, Mass Screening, Needs Assessment, Tanzania",

author = "Hall, {Claudette E.} and Hall, {Anthony B.} and Joyse Mallya and Paul Courtright and Gerjo Kok",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

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doi = "10.1038/s41433-022-02001-w",

language = "English",

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T1 - Establishing a screening programme for diabetic retinopathy in Kilimanjaro Region, Tanzania using intervention mapping

AU - Hall, Claudette E.

AU - Hall, Anthony B.

AU - Mallya, Joyse

AU - Courtright, Paul

AU - Kok, Gerjo

PY - 2022/5

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N2 - BACKGROUND: The Kilimanjaro Diabetic Programme used the Intervention Mapping framework to develop a theory- and evidence-based diabetic retinopathy screening programme. A Working Committee of health care workers and stakeholders ensured community engagement and empowerment of the target audience.OBJECTIVES: To deliver a culturally appropriate, sustainable, community supported health intervention, promoting eye health behaviour change, to prevent avoidable blindness.METHODS: The six steps of the Intervention Mapping protocol incorporated eight components: (1) a needs assessment of people with diabetes and health care workers (2) a clinical trial of diabetic retinopathy screening modes, (3) comic strips as a motivational strategy for diabetic retinopathy screening uptake, (4) health care worker education (5) an electronic database of people with diabetes (6) a self-carry diary (7) implementation of mobile diabetic retinopathy retinal screening (8) process and outcome programme evaluation.RESULTS: The programme eliminated barriers to diabetic retinopathy screening in Kilimanjaro Christian Medical Centre eye and diabetic clinics, placing a digital retinal screening camera in the diabetic clinic and a fast-track screening system in the eye clinic. Two comic strips and a diary provided information about self-management and record of medications, treatment, blood sugar and blood pressure at clinic visits. An annual rural health care worker education programme met requests for knowledge on treatment and care of diabetes, targeting prevention of diabetic retinopathy. Rural digital retinal screening was implemented. Rural diabetes clinics were initiated.CONCLUSIONS: Intervention Mapping provided a systematic, iterative model to formulate and deliver an urban and rural diabetic retinopathy screening programme.TRIAL REGISTRATION NUMBER: ISRCTN31439939. Details available at https://www.isrctn.com/.

AB - BACKGROUND: The Kilimanjaro Diabetic Programme used the Intervention Mapping framework to develop a theory- and evidence-based diabetic retinopathy screening programme. A Working Committee of health care workers and stakeholders ensured community engagement and empowerment of the target audience.OBJECTIVES: To deliver a culturally appropriate, sustainable, community supported health intervention, promoting eye health behaviour change, to prevent avoidable blindness.METHODS: The six steps of the Intervention Mapping protocol incorporated eight components: (1) a needs assessment of people with diabetes and health care workers (2) a clinical trial of diabetic retinopathy screening modes, (3) comic strips as a motivational strategy for diabetic retinopathy screening uptake, (4) health care worker education (5) an electronic database of people with diabetes (6) a self-carry diary (7) implementation of mobile diabetic retinopathy retinal screening (8) process and outcome programme evaluation.RESULTS: The programme eliminated barriers to diabetic retinopathy screening in Kilimanjaro Christian Medical Centre eye and diabetic clinics, placing a digital retinal screening camera in the diabetic clinic and a fast-track screening system in the eye clinic. Two comic strips and a diary provided information about self-management and record of medications, treatment, blood sugar and blood pressure at clinic visits. An annual rural health care worker education programme met requests for knowledge on treatment and care of diabetes, targeting prevention of diabetic retinopathy. Rural digital retinal screening was implemented. Rural diabetes clinics were initiated.CONCLUSIONS: Intervention Mapping provided a systematic, iterative model to formulate and deliver an urban and rural diabetic retinopathy screening programme.TRIAL REGISTRATION NUMBER: ISRCTN31439939. Details available at https://www.isrctn.com/.

KW - Blood Glucose

KW - Diabetes Mellitus

KW - Diabetic Retinopathy/diagnosis

KW - Humans

KW - Mass Screening

KW - Needs Assessment

KW - Tanzania

U2 - 10.1038/s41433-022-02001-w

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SN - 0950-222X

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SP - 17

EP - 24

JO - Eye

JF - Eye

IS - Suppl 1

ER -