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  • Social Work Program Boosts Adherence to Follow-Up Care

    By Lynda Seminara
    Selected By: Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, July 2021

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    Can social outreach programs bring effective—and low-cost—vision care to children? In a previous study, Chung et al. explored costs and outcomes of the Children’s Eye Care Adherence Pro­gram (CECAP1), a social work inter­vention shown to improve adherence to eye care for underserved children in Philadelphia. After analysis of the flagship program, the authors modified it to reduce costs. In their subsequent study, they investigated the effectiveness of the reduced-cost model (CECAP2) and found that, even when costs were lowered by more than 50%, the pro­gram was just as successful.

    For this CECAP2 study, the authors gathered data from records of children who needed ophthalmic follow-up after participating in community-based vision screening programs. They mod­ified CECAP1 to prioritize the children who, based on that earlier study, were more likely to complete a follow-up visit. Efforts were made to decrease phone calls and scheduling attempts and to constrict the geographic catch­ment area for better accessibility. Costs were based on the social workers’ time devoted to the program. Effectiveness was expressed as the percentage of patients who completed at least one follow-up visit within the recommend­ed time frame.

    Altogether, 462 children were referred to CECAP2 from the vision-screening programs. Of these, 242 (52.4%) com­pleted a recommended follow-up exam. The proportion was nearly identical to that for CECAP1 (52.3%). Children who spoke English at home were more likely to return for follow-up than were children who spoke another language (60.8% vs. 46.8%). In CECAP2, the social workers’ time averaged 0.8 hours per patient—significantly less than previously (2.6 hours per patient). The cost per patient was reduced from $77.20 to $32.73.

    To the authors’ knowledge, this is the first publication of efforts to minimize costs of a social work program aimed at increasing follow-up adherence. Although CECAP2 is more sustainable than CECAP1, the authors do not wish to overlook children who are “lost to follow-up.” Rather, they hope other interventions can be developed to reach those children.

    The original article can be found here.