# Improving African American glaucoma patient involvement in visits and outcomes

> **NIH AHRQ R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $388,442

## Abstract

ABSTRACT
One of the goals of Healthy People 2020 is to reduce glaucoma-related visual impairment.
Between 9% and 12% of blindness in the United States is attributed to glaucoma and glaucoma
is the leading cause of irreversible blindness in African Americans. African Americans are 5
times more likely to get glaucoma than Caucasians and are 6 times more likely to go blind from
it. Proper use of glaucoma medications can lower intraocular pressure and reduce the
progression of glaucoma. Our prior work found that African Americans were significantly less
likely to be educated about glaucoma by their ophthalmologists and they were significantly less
likely to be adherent to their glaucoma medications than Caucasians. The National Eye Institute,
the Office of Women's Health at the National Institutes of Health, and the Glaucoma Research
Foundation all emphasize the importance of improving African American patients' understanding
of both glaucoma and its treatment to minimize disparities in outcomes. Prior studies have
demonstrated that educational interventions targeted to African Americans can have a positive
effect on the utilization of eye care services and on the beliefs about the importance of annual
eye exams. However, these studies did not target glaucoma. We propose to test a glaucoma
question prompt list with educational video intervention based on Social Cognitive Theory that is
designed to improve African American patient question asking and involvement during visits to
reduce disparities and improve the outcomes of African Americans with glaucoma. African
American patients (N=380) who are on at least one medication for glaucoma and who self-
report being less than 80 percent adherent to their medications will be recruited from three
ophthalmology practices. Patients will be randomized to either receive the intervention or usual
care. During pre-visit wait time, African Americans in the intervention group will watch a brief
educational video on the importance of being actively involved during visits and they will receive
the one-page question prompt list which they will use to check which questions they want to ask
the doctor. Patient visits will be audio-taped and patients will be interviewed at baseline, 6, and
12 months. Patients will use Medication Event Monitoring System (MEMS) caps to measure
their adherence. We hypothesize that African American patients with glaucoma in the
intervention group will have significantly improved communication with their ophthalmologists
and this improved communication will improve (a) glaucoma medication self-efficacy, (b)
adherence, and (c) intraocular pressure when compared to usual care.

## Key facts

- **NIH application ID:** 9920069
- **Project number:** 5R01HS025370-04
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Betsy Lynn Sleath
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $388,442
- **Award type:** 5
- **Project period:** 2017-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9920069

## Citation

> US National Institutes of Health, RePORTER application 9920069, Improving African American glaucoma patient involvement in visits and outcomes (5R01HS025370-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9920069. Licensed CC0.

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