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. 2022 Aug 10:16:2505-2511.
doi: 10.2147/OPTH.S375405. eCollection 2022.

Parental Keratoconus Literacy: A Socioeconomic Perspective

Tessnim R Ahmad  1 , Marcus L Turner  2 , Charis Hoppe  2 , Alan W Kong  2 , Jackson S Barnett  2 , Gurbani Kaur  2 , Neel D Pasricha  1 , Maanasa Indaram  1
Affiliations

Parental Keratoconus Literacy: A Socioeconomic Perspective

Tessnim R Ahmad et al. Clin Ophthalmol. .

Abstract

Purpose: To assess the impact of parental socioeconomic status and keratoconus literacy on pediatric eye rubbing and keratoconus severity.

Methods: In this mixed-methods study, pediatric keratoconus patients (age ≤ 18 years) were retrospectively identified. Sociodemographic and clinical characteristics were extracted from the electronic medical record (EMR). Telephone surveys were subsequently conducted to assess parental keratoconus literacy, receipt of counseling on keratoconus prevention, eye rubbing, and household socioeconomic factors not available in the EMR. Parents reporting poor keratoconus literacy were probed via semi-structured interview to explore barriers to their understanding.

Results: Forty-eight patients met inclusion criteria, 22 (46%) of whom were reached by telephone. Most patients were insured by Medicaid (73%) and current eye rubbers (82%). Few parents reported good or excellent keratoconus literacy now (32%) or at the time of diagnosis (18%). Parents with a high-school education, limited English proficiency, lower income level, and Medicaid insurance tended to have lower keratoconus literacy, though this was not statistically significant. Parental keratoconus literacy was not correlated with disease severity. High-school education, limited English proficiency, lower income level, and Medicaid insurance were correlated with steeper keratometry readings, which was statistically significant for high-school education. In-depth interviews revealed parents felt unconfident with eye health in general and perceived a personal responsibility for learning more.

Conclusion: This is the first study exploring keratoconus literacy from a socioeconomic perspective, demonstrating lower literacy among socioeconomically marginalized parents and a tendency toward more severe disease in their children.

Keywords: disparities; health literacy; keratoconus; social determinants of health.

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Conflict of interest statement

Dr Neel D Pasricha reports personal fees from iota Biosciences, outside the submitted work. No conflicting relationship exists for any author.

Figures

Figure 1
Figure 1
Percentage of parents, stratified by socioeconomic status, endorsing good or excellent current knowledge of keratoconus. Factor levels are not paired and the maximum percentage for each column is 100%. For example, 60% of patients with a household income ≥$100,000 reported good or excellent knowledge compared to 27% of patients with a household income <$100,000.
Figure 2
Figure 2
Percentage of parents, stratified by socioeconomic status, who reported receiving education on keratoconus progression. Asterisks (*) indicate statistical significance at P < 0.05. Factor levels are not paired and the maximum percentage for each column is 100%.
Figure 3
Figure 3
Mean steep keratometry (in diopters) by socioeconomic status.
See this image and copyright information in PMC

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