Examination compliance and screening for diabetic retinopathy: a 2-year follow-up study

Early detection and timely treatment of diabetic retinopathy can preserve vision, yet many people with diabetes do not have their eyes examined regularly. The purpose of this study was to examine eye care practices of people with diabetes who had not previously accessed eye care services on a regular basis. Screening with non-mydriatic retinal photography for diabetic retinopathy was initiated in 1996, and targeted people with diabetes who did not access eye care services on a regular basis. Each test area was revisited 2 years after the initial screening. Patients that did not attend the biennial screening were followed up by mail survey. Although none of the participants in this study had been previously accessing eye care services on a regular basis, 87% did so after attending the screening. These results indicate that mobile screening with non-mydriatic photography, as an adjunct to current eye care services, has the potential to increase examination compliance for diabetic retinopathy and to achieve sustained behaviour change.

Recruitment methods for community-based screening for diabetic retinopathy

Regular screening of all people with diabetes is the most efficient and cost-effective way to detect early stages of diabetic retinopathy so that laser treatment can be performed at the optimal time. A major aim of the Program for the Early Detection of Diabetic Retinopathy was to increase compliance with guidelines for screening for diabetic retinopathy. This community-based screening program used non-mydriatic retinal photography and was initiated in four areas of Victoria, Australia from 1996-1998. Recruitment strategies included targeted mail-outs, provision of the program brochure in English and the main languages spoken in the areas and media promotion in ethnic newspapers and on ethnic radio stations. In Victoria, only 55% of the population with diabetes currently access eye care services at the recommended intervals. This program was able to increase compliance with guidelines to 70% among people with diabetes that had not had a recent eye examination. A total of 1,197 people with diabetes were screened for diabetic retinopathy. Of the 1,197 people who were screened, 620 (15% of the estimated number of people with diabetes) had not had their eyes examined in the past two years. This pilot study identified strategies to encourage people with diabetes to have their eyes examined at the recommended intervals.

A critical analysis of screening for skin cancer: participation among older males

 This thesis was a critical examination of participation in skin cancer screening for men over the age of 50 years. This research explored subjective experiences of skin cancer screening, participation in the process, perceptions of skin cancer and factors that influence men’s willingness to undergo skin cancer screening.

Cardiovascular risk screening of volunteer firefighters

Background: The work demands involved in firefighting place significant stress on the cardiovascular system. This study investigated the application of the AHA/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire in volunteer Country Fire Brigade (CFA) firefighters. Methods: Cardiovascular disease (CVD) risk factors were measured in 3777 CFA firefighters and entered into a modified version of the American Heart Association (AHA)/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire to stratify individuals as low, moderate or high risk. Results: Just over half (50.8%) of female and more than two thirds (68.2%) of male CFA firefighters were classified as moderate risk. The questionnaire further stratified 2.6% of female and 5.2% of male CFA firefighters as high risk while the remaining 46.6% and 26.6% of female and male firefighters, respectively, were classified as low risk. Conclusion: The majority of firefighters screened were at moderate risk and therefore, would be advised by AHA/ACSM guidelines to undertake and pass a detailed medical examination and a medically supervised exercise test prior to initiating vigorous intensity physical activity. However, considering the financial and practical implications (e.g., reduced emergency response capacity) the introduction of mandatory screening may cause, fire agencies should focus screening for high risk personnel only, while promoting agency wide CVD health education.