METHODS: We identified all population-based cross-sectional surveys reporting the prevalence of objectively measured vision impairment or blindness. Using the PROGRESS + framework to identify underserved groups, we assessed whether each study considered underserved groups within 15 items across the rationale, sampling or recruitment methods, or the reporting of participation and prevalence rates.
RESULTS: 388 eye health surveys were included in this review. Few studies prospectively considered underserved groups during study planning or implementation, for example within their sample size calculations (n = 5, ∼1%) or recruitment strategies (n = 70, 18%). The most common way that studies considered underserved groups was in the reporting of prevalence estimates (n = 374, 96%). We observed a modest increase in the number of distinct PROGRESS + factors considered by a publication over the study period. Gender/sex was considered within at least one item by 95% (n = 367) of studies. Forty-three percent (n = 166) of included studies were conducted primarily on underserved population groups, particularly for subnational studies of people living in rural areas, and we identified examples of robust population-based studies in socially excluded groups.
CONCLUSIONS: More effort is needed to improve the design, implementation, and reporting of surveys to monitor inequality and promote equity in eye health. Ideally, national-level monitoring of vision impairment and service coverage would be supplemented with smaller-scale studies to understand the disparities experienced by the most underserved groups.
方法:我们确定了所有基于人群的横断面调查,这些调查报告了客观测量的视力障碍或失明的患病率。使用PROGRESS+框架来识别服务不足的群体,我们评估了每项研究是否在整个理论基础上考虑了15个项目中服务不足的群体,抽样或招聘方法,或参与和患病率的报告。
结果:本综述纳入了388项眼部健康调查。很少有研究在研究计划或实施期间前瞻性地考虑服务不足的群体,例如,在他们的样本量计算(n=5,≈1%)或招聘策略(n=70,18%)中。研究考虑服务不足群体的最常见方式是报告患病率估计值(n=374,96%)。在研究期间,我们观察到出版物所考虑的不同PROGRESS+因素的数量略有增加。95%(n=267)的研究认为性别/性别在至少一个项目中。43%(n=166)的纳入研究主要针对服务不足的人群,特别是对于居住在农村地区的人们的地方研究,我们确定了在社会排斥群体中进行稳健的基于人群的研究的例子.
结论:需要更多的努力来改进设计,实施,和报告调查,以监测不平等和促进眼睛健康的公平。理想情况下,国家一级对视力损害和服务覆盖面的监测将辅之以小规模研究,以了解服务最不足群体所经历的差距。