Stakeholders' perspectives on a digital myopia screening program in children: a qualitative analysis

PURPOSE: This study was aimed at identifying barriers and opportunities to use a self-administered online refractive eye test by various stakeholders of a pediatric vision screening program.

METHODS: This qualitative study performed semi-structured interviews with myopic children and their parents, eye care professionals, and policymakers. Three topic lists were developed, delineating themes to identify gaps, barriers, and opportunities. Interviews were anonymously recorded, transcribed, and coded using thematic analysis. Quantitative data was acquired from a concomitant clinical validation study.

RESULTS: In total, 14 interviews were conducted, of which seven were with children and their parents, four with eye care professionals, and three with policymakers. The patients and parents were positive about the instructions and age appropriateness. They noted that the test could be designed as more child-friendly and preferred receiving feedback during the test. Eye care professionals and policymakers saw potential for using the test in children aged ≥12 without high refractive errors, yet they also underlined the false-positives rates, impacting care demand and costs. The population refraining from participation was expected to have higher health gains, yet including them was expected to be challenging without facilitating awareness.

CONCLUSIONS: This qualitative study shows the perspectives for an online pediatric refractive screening. The patients and parents were open to self-administered screening and suggested improvements. The eye care professionals and policymakers were receptive to screening but also cautious, highlighting costs and scientific reliability. For better implementation, the policymakers underlined the relevance of the screening criteria, while the eye care professionals recommended targeting a specific population at risk that benefits most rather than screening the whole population.