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Qualitative study investigating the perceptions of parents of children who failed vision screening at the age of 4–5 years
  1. Alison Bruce1,
  2. Tom Sanders2,
  3. Trevor A Sheldon3
  1. 1 Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, UK
  2. 2 School of Health and Related Research (ScHARR), Section of Public Health, University of Sheffield, Sheffield, UK
  3. 3 Department of Health Sciences, University of York, York, UK
  1. Correspondence to Dr Alison Bruce; alison.bruce{at}


Objective To explore in depth parents’ experiences and understanding of their children’s eye care in order to better comprehend why there is relatively low uptake of services and variable adherence to treatment.

Design Semistructured interviews, informed by the Health Belief framework, were conducted with parents of children who had failed vision screening at age 4–5 years. Four were parents of children who never attended follow-up, 11 had children who attended but did not adhere to spectacle wear and 5 parents of children who had attended and adhered. Interviews were recorded and transcribed verbatim; thematic analysis based on the constant comparative method was undertaken.

Results Parents’ beliefs led to uncertainty about the benefit of treatment, with parents testing their children to confirm the presence of a vision deficit and seeking advice from other family and community members. The stigma of spectacle wear explained the resistance of some to their child’s treatment with the maintenance of ‘normality’ often more important than clinical advice. The combination of parents’ own health beliefs, stigma and the practicalities of attending appointments together influenced parental decisions. Attendance following vision screening and the decision to adhere to spectacle wear were primarily based on the perceived severity of the visual reduction with the perceived benefit of spectacle wear outweighing any negative consequences.

Conclusions Healthcare professionals require a greater understanding of parents’ decision-making processes in order to provide personalised information. Knowledge of the cues to attendance and adherence provides policy makers a framework with which to review the barriers, develop strategies and redesign children’s eye care pathways.

  • adherence
  • vision screening
  • spectacles
  • candidacy
  • children’s eye services

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  • Contributors AB initiated the project, designed the study, conducted the interviews, analysed the transcripts and drafted and revised the paper. She is guarantor. TS analysed the transcripts and revised the draft paper. TAS initiated the project and revised the draft paper.

  • Funding AB is funded by a National Institute for Health Research Post-Doctoral Fellowship Award (PDF-2013-06-050). The research was funded bythe NIHR Collaboration for Leadership in Applied Health Research and CareYorkshire and Humber (NIHR CLAHRC YH). .The views and opinions expressed are those of the author(s), and notnecessarily those of the NHS, the NIHR or the Department of Health.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethics approval was obtained from the National Research Ethics Committee Yorkshire and the Humber- South Yorkshire UK (Ref 13/YH/0379).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional unpublished data are available.