Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China: The PRICE (Potentiating Rural Investment in Children's Eyecare) study

Xiuqin Wang, Nathan Congdon, Yue Ma, Min Hu, Yuan Zhou, Weiqi Liao, Ling Jin, Baixiang Xiao, Xiaoyi Wu, Ming Ni, Hongmei Yi, Yiwen Huang, Beatrice Varga, Hong Zhang, Yongkang Cun, Xianshun Li, Luhua Yang, Chaoguang Liang, Wan Huang, Scott RozelleXiaochen Ma

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Abstract

BACKGROUND: Offering free glasses can be important to increase children's wear. We sought to assess whether "Upgrade glasses" could avoid reduced glasses sales when offering free glasses to children in China.

METHODS: In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA)< = 6/12 in either eye correctable to >6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of $30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization.

RESULTS: Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0%) at 27 schools to Free Glasses +$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3%, multiple regression relative risk (RR) 0.90 (0.56-1.43), P = 0.65; Free + $30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69.

CONCLUSIONS: Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02231606. Registered on 31 August 2014.

Original languageEnglish
Pages (from-to)e0187808
JournalPloS one
Volume12
Issue number11
DOIs
Publication statusPublished - 21 Nov 2017

Keywords

  • Child
  • China
  • Commerce
  • Eyeglasses
  • Female
  • Humans
  • Investments
  • Male
  • Prescriptions
  • Refractive Errors
  • Rural Population
  • Schools
  • Visual Acuity
  • Journal Article
  • Randomized Controlled Trial

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