Barriers to Vision and Hearing Screening of School Age Children in Rural Communities

Vision and hearing problems impact children's health and their ability to learn and succeed in school and later life. A 1997 survey of pediatric, family medicine, and general medical providers in seven counties in Ohio found that 27% of respondents didn't perform any vision screening; 36% referred patients for eye exams only in response to parental concern or chance detection of a problem. Lack of compliance with guidelines for well-child care underscores the key role of SNs and public health nurses (PHNs) in vision and hearing screening programs. School nurses' (SNs) roles include providing screening and referral for health conditions; promoting health; serving as a liaison among children, families, school personnel, the community, and health care providers and providing leadership for the provision of health services and health polices. PHNs perform these interventions at the broader community level. These nursing roles assume even greater importance in rural communities that are often health professional shortage areas. This presentation reports results of a survey conducted in Autumn 2006 to identify barriers to hearing and vision screening of school-age children. The population was all providers (N=83) of vision or hearing services in three contiguous rural counties in Ohio (primary care and specialist physicians, optometrists, SNs, PHNs). Respondents (n=42, 48%) identified several barriers to screening, including parental compliance, faulty screening practices, inadequate funding, transportation, and the need for broader policy initiatives to address barriers to screening. Results from SN and PHN respondents (n=11, 25% of responding sample) were similar to those of other providers. The state health department identified increasing the proportion of children receiving age-and risk-appropriate screenings for vision and hearing as a strategic performance measure. This presentation discusses policy initiatives that address providers as well as the knowledge, attitude, and behaviors of parents regarding the importance of vision and hearing (and other) preventive services for children. As providers of interventions such as screening, surveillance, referral and follow-up, advocacy, and policy development, SNs and PHNs have key roles in ensuring the health of children and in achieving state health department goals.