Purpose: The aim of this study was to describe the process used to meet the vision needs, as well as other health problems related to eye disease, of individuals in the rural Black Belt region of Alabama. This model includes a multidisciplinary collaborative effort that has developed into a replicable vision care delivery system.
Design: This study was a descriptive research study.
Method: Vision and health evaluations were made available to residents of rural counties with a specific focus on an area in Alabama known as the "Black Belt." The model for the project was designed with input from the collaborative partners who were responsible for each health and vision station. Participants in the Rural Alabama Diabetes and Glaucoma Initiative (RADGI) study involved 1,765 black women, 619 black men, and 315 others.
Results: The study included 2,699 participants in 7 counties. The reported ages of the patients ranged from 5 to 97 years, with a mean age of 44. Of the 2,699 patients, 39% (1,053) were found to have a visual acuity of < or =20/40. Spectacles were prescribed for 56% of the patients who required correction other than reading glasses. There was a 19% (513) referral rate for glaucoma. There was a 2.7% (73) referral rate for diabetic retinopathy. Two hundred sixteen patients presented with cataracts (8%) and were referred to eye care providers for follow-up evaluations. The 9.9% of patients who were known diabetics (267) were referred to either a general physician familiar with the patient history or, if no general physician was reported by the patient, another local physician for evaluation. Because there were no subspecialists in these local communities, the 10% of the patients (270) who were undiagnosed diabetics but showed the risk factor of a hemoglobin A1c greater than 7% were referred to a general physician or local emergency room for follow-up care. One thousand fifty-five patients (35.9%) with a blood pressure of greater than 140/90 mmHg were referred to a physician or to the emergency room as indicated either by systolic less than 140 and diastolic greater than 90.
Conclusions: Based on the success of the RADGI project, the project was found to be a sound design for implementing a vision care delivery system in economically distressed rural areas that will address health disparities, barriers to health care, health care access, and patient clinical and educational follow-up.