Social Risk Factors of Referral Non-Adherence to Eye Care Referrals for Children: A Scoping Review

Abstract BackgroundDespite the importance and benefits of vision screening and comprehensive eye examinations, up to 60% of children with abnormal vision screenings do not attend recommended appointments with eye care providers. The purpose of this study is to identify social risk factors of and strategies to address referral non-adherence to eye care referrals following abnormal vision screening tests.Methods A scoping review was conducted following the Joanna Briggs Institute methodology. Bibliographic databases and gray literature were searched from their inception to July 2023, with an updated search in November 2024. The review protocol was registered with Open Science Framework. Four reviewers screened and extracted data from the included studies. Social risk factors were synthesized and thematically mapped using the Penchansky and Thomas's model of access, extended by Saurman.ResultsSeventeen studies reported social risk factors of referral nonadherence, and 16 studies assessed strategies to overcome social risk factors. The most frequently cited Penchansky and Thomas dimension was affordability (n = 14) and awareness (n = 14), while accessibility was the least cited (n = 5) in the data. None (n = 0) of the studies indicated the use of a conceptual framework to inform the organization of their extracted data. Most of the included studies targeted populations in high-income (as compared to low, lower-middle, upper-middle income) countries. Strategies to address social risk factors are reported in a separate manuscript.ConclusionAffordability and awareness are the most frequent social risk factors of non-adherence to eye care referrals for children following abnormal vision screening tests. Significant gaps remain in understanding social risk factors in resource-limited settings with high needs.