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

ABSTRACT

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 should not wear glasses and 93.1% (256/275) encouraged children to obtain glasses. Teacher factors associated with children's glasses-related behaviour 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.