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This study is a community trial that aims to establish and evaluate an mHealth screening and promotional tool for improving eye health in Iran. Sampling frame is a region in Tehran province with around 1 million sub-urban and rural inhabitants. investigators have obtained the list of health centers and their underserved population from the health authorities. In this region, health services are delivered through rural health houses, urban health posts and overhead health centers (221 units in total). investigators choose 27 units using cluster random sampling method with a probability proportional to size strategy, then investigators randomly assign them into three arms (explained below). The interventions will be at community level with the community as the unit of randomization.
Arm 1- Training of the Primary Health Care (PHC) workers + PHC workers will be empowered with the mHealth tool to monitor, screen and promote community members Arm 2- PHC system will be strengthened with health promotion and screening programmes (same content as the mHealth tool) and PHC workers will deliver eye health messages and screening tests by the conventional facilities.
Arm 3: Control group: only observation and registering of routine care
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| routine care | No Intervention | ||
| Screening program including 2 consecutive tests | Active Comparator |
| |
| Screening program with mobile health | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Screening program including 2 consecutive tests | Diagnostic Test | visual acuity test by Snellen chart, fundus imaging by fundus photography (Visucam Pro NM; Carl Zeiss Meditec AG, Germany) |
| Measure | Description | Time Frame |
|---|---|---|
| Eye care utilization: being visited/treated by an eye care professional | Questionnaire based on closed questions | 6-12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Visual acuity | Peek Acuity Software installed on smart phones (Samsung Galaxy S8, based on Logarithm Minimum Angle of Resolution, LogMAR). Visual acuity will be presented in range (minimum to maximum). Higher value of visual acuity represents the worsened outcome. | At baseline |
| fundus imaging |
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Inclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ophthalmic Research Center | Tehran | Iran |
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| ID | Term |
|---|---|
| D014786 | Vision Disorders |
| ID | Term |
|---|---|
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D005128 | Eye Diseases |
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| Screening program with mobile health | Diagnostic Test | Peek Acuity and Peek Retina installed on smart phones (Samsung Galaxy S8) |
|
Peek Retina Software installed on smart phones (Samsung Galaxy S8; based on Logarithm Minimum Angle of Resolution, LogMAR). Higher value of visual acuity represents the worsened outcome. |
| At baseline |
| Based on Logarithm Minimum Angle of Resolution, LogMAR. Visual acuity will be presented in range (minimum to maximum). Higher value of visual acuity represents the worsened outcome. | visual acuity test by Snellen chart | At baseline |
| fundus imaging by fundus photography (Visucam Pro NM; Carl Zeiss Meditec AG, Germany) | fundus photography (Visucam Pro NM; Carl Zeiss Meditec AG, Germany) | At baseline |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |