Evaluation of whether health education using video technology increases the uptake of screening for diabetic retinopathy among individuals with diabetes in a slum population in Hyderabad

A community-based intervention to compare the effectiveness of pamphlets and videos as education material to promote diabetic retinopathy (DR) screening in urban slums of Hyderabad and to identify barriers/facilitators for compliance with DR screening. A cross-sectional survey among people with diabetes (sample of 267) was followed by a health education intervention where patients were allocated into two groups (121 received pamphlets and 102 attended video sessions). The effectiveness of the intervention was assessed based on the uptake of DR screening. The facilitating factors and barriers to DR screening were explored through semi-structured interviews and focus group discussions with participants and health workers. Data analysis included Chi-square test for quantitative data and thematic analysis for qualitative data. Among the 235 people in the health education intervention study, 131 (55.7%) received the pamphlet and 104 (44.3%) watched the educational videos. The uptake of DR screening within 2 months was higher in the group shown the educational video than who received the pamphlet (32.7% vs 11.45%; P < 0.05). Absence of an accompanying person and good vision were barriers that prevented patients from screening. Realization of consequences of DR and proximity of the screening facility were identified as motivators. The major results we found in the initial survey of 267 people were that 74.5% had never had HbA1c test and locals underwent health check-ups more regularly than migrants (62.2% versus 34%; P < 0.05). Educational videos led to greater behavior change than pamphlets in motivating diabetics for DR screening.