Vision is precious: a successful behavioral intervention to increase the rate of screening for diabetic retinopathy for inner-city adults.

Purpose: This purpose of this report is to describe a successful telephone intervention to increase the rate of diabetic retinopathy screening, its implementation with English and Spanish speakers, and the characteristics of those who benefited most from the intervention.

Methods: Participants in the telephone group (N = 305) received a tailored intervention from trained health educators who were ethnically diverse and representative of the community. The main outcome for the randomized controlled study was documented receipt of a dilated fundus examination (DFE) within the 6-month study window. Exploratory analyses focused on examining the factors that contribute to receiving a DFE within 6 months for participants in the tailored telephone intervention using Pearson chi(2) and logistic regression analysis.

Results: Participants in the telephone intervention who did not receive a DFE had significantly more documented steps in the behavioral process than those who did receive a DFE, and ethnic concordance of the health educator was not significantly associated with a positive outcome in the DFE group. There was a negative association between the time spent building rapport and receipt of DFE. As time spent engaging in educational activities by telephone increased, the likelihood of receiving a DFE increased.

Conclusions: Although the telephone intervention was highly successful compared with the print intervention, these process results demonstrate the difficulties and challenges of conducting a tailored telephone intervention to improve rates of screening in an underserved, diverse urban community.