What is the effect of implementing an adapted standardized vision screening process on the outcome of patient rate of completion? A pilot study focused on an underserved Spanish speaking population of children aged 5 – 17

The purpose of this research study was to address the association between lower socioeconomic status and pediatric eye conditions as it relates to the lack of standardized screening processes. In the United States, there are no national standards to guide or even require that vision screenings are done adequately and utilizing evidence based instruments. Studies have determined that the lack of standardization is a contributing factor to the low rate of screening in school age children. A gap in knowledge exists within the needs of Spanish speaking children and their families, due to the lack of standardization as well as the numerous disparities facing this specific population. A new adapted standardized screening process was implemented at the Salud Para Niños clinic (Health For the Children). This program provides low-cost (sometimes free) primary care and culturally competent community outreach to Spanish and Portuguese speaking children and their families in southwestern PA. Salud Para Niños free clinic program makes use of existing clinical space and depends on donated resources and volunteers; therefore, it is faced with even more obstacles when trying to implement changes in practice. The rate of completion of the old non-standardized screening tool (kindergarten chart), was compared to the new standardized tool (LEA symbol chart). A hand chart was also used to address any language barrier. Eighteen children between the ages of 5 and 17 were asked to attempt both screenings in a randomized order. The primary outcome variable in this study was the completion of the old examination process versus the new examination process. Time to complete the examination, if applicable, was also measured and analyzed to determine clinical efficiency. Our results indicate that a standardized screening tool, such as the LEA symbol chart, is effective at producing more reliable measurements in Spanish speaking children in a shorter period of time. The Center for Children’s Vision and Eye Health recognize this as an evidence – based tool for children who speak English. These results support the idea that this tool can improve quality of vision screenings in primary care settings for populations facing a language barrier