Introduction
diabetes, diabetic-related retinopathy, anxiety, blindness
DIABETES, BLINDNESS
Over 80 million people around the world suffer from diabetic-related retinopathy (DR), the leading cause of blindness for people between the ages of 25 and 74 years [Various factors affect the probability of patients getting screened, including environmental factors (eg, accessibility of the clinic, time, and financial concerns), social influences (eg, doctor-patient communication and family influences), knowledge (eg, lack of knowledge about the illness or screening), memory, attention and decision processes (eg, forgetting, absence of symptoms, and competing health issues), beliefs about consequences (eg, perceived necessity and negative short-term effects of the procedure), and emotions (eg, fear, anxiety, and emotional burden) [Another strategy to improve access to DR screening is a teleophthalmology program [Past studies have demonstrated the effectiveness of patient engagement strategies, such as providing patients with instructions and giving reminders and prompts; however, no studies to date have examined the effectiveness of these methods for engaging patients in teleophthalmology programs. The goal of this study was to evaluate the effectiveness of such patient engagement strategies (eg, calling, mailing letters, or both) in improving diabetes screening care in an urban, team-based primary care setting.