Teachers' influence on purchase and wear of children's glasses in rural China: the PRICE study

Xiuqin Wang, Yue Ma, Min Hu, Ling Jin, Baixiang Xiao, Ming Ni, Hongmei Yi, Xiaochen Ma, Congyao Wang, Beatrice Varga, Yiwen Huang, Scott Rozelle, Nathan Congdon

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IMPORTANCE: Uncorrected refractive error causes 90% of poor vision among Chinese children.

BACKGROUND: Little is known about teachers' influence on children's glasses wear.

DESIGN: Cohort study.

PARTICIPANTS: Children at 138 randomly-selected primary schools in Guangdong and Yunnan provinces, China, with uncorrected visual acuity (VA) ≤6/12 in either eye correctable to >6/12 in both eyes, and their teachers.

METHODS: Teachers and children underwent VA testing and completed questionnaires about spectacles use and attitudes towards children's vision.

MAIN OUTCOME MEASURES: Children's acceptance of free glasses, spectacle purchase and wear.

RESULTS: A total of 882 children (mean age 10.6 years, 45.5% boys) and 276 teachers (mean age 37.9 years, 67.8% female) participated. Among teachers, 20.4% (56/275) believed glasses worsened children's vision, 68.4% (188/275) felt eye exercises prevented myopia, 55.0% (151/275) thought children with modest myopia shouldn't wear glasses, and 93.1% (256/275) encouraged children to obtain glasses. Teacher factors associated with children's glasses-related behavior included believing glasses harm children's vision (decreased purchase, univariate model: relative risk (RR) 0.65, 95% CI 0.43, 0.98, P < 0.05); supporting children's classroom glasses wear (increased glasses wear, univariate model: RR 2.20, 95% CI 1.23, 3.95, P < 0.01); and advising children to obtain glasses (increased free glasses acceptance, multivariate model: RR 2.74, 95% CI 1.29, 5.84, P < 0.01; increased wear, univariate model: RR 2.93, 95% CI 1.45, 5.90, P < 0.01), but not teacher's ownership/wear of glasses.

CONCLUSIONS AND RELEVANCE: Though teachers had limited knowledge about children's vision, they influenced children's glasses acceptance. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalClinical and Experimental Ophthalmology
Early online date16 Aug 2018
Publication statusEarly online date - 16 Aug 2018


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