A theory- and evidence-based holistic intervention to enhance the uptake of preventive eye examination among the elderly centre members

Abstract

Objective: To develop a theory-driven and evidence-based intervention to enhance the uptake of preventive eye examinations of older adults in Hong Kong. Study design: A cross-sectional study to inform the development of intervention. Methods: Intervention development was informed by the Capability-Opportunity-Motivation Behaviour (COM-B) Model and the Behaviour Change Wheel through an eight-step approach. Key stages included identifying the missing behavioural drivers and considering the intervention options and implementation options to improve service uptake. Findings were evaluated against APEASE criteria and supplemented by the feedback from advisory group consultations. Results: The barriers deterring preventive eye examination uptakes reflected deficits in psychological capability, social opportunity, physical opportunity, reflective motivation, and automatic motivation. An intervention requires seven intervention functions to address these deficits, including Education, Persuasion, Incentivisation, Training, Environmental Restructuring, Modelling and Enablement. The intervention aims to create a supportive environment in the elderly centre and lay referral networks to empower older adults to access health-related and service-related information, allowing access to appropriate social support. Better health communication of service-related information, more effective communication of appointment booking, and mobile service provision modes were proposed to enable older adults to attend future appointments. Conclusions: Informed by the Behaviour Change Wheel framework, a holistic intervention to address the multiple barriers to preventive eye examination uptake was developed. The findings indicated that strategies beyond health education and service provision should be considered. A multi-component intervention, including service providers, service recipients and community social workers, should be considered to effectively address the barriers to service uptake.