Optometry Outreach in Indigenous Communities in British Columbia, Saskatchewan, and Manitoba
Bibliographic record
Abstract
Introduction: Inuit, Métis, and First Nations, the three main Indigenous groups within Canada, face disproportionate barriers to access for primary eye and vision care. Optometrists visit rural and remote Indigenous communities to provide outreach care to areas without a local optometrist; however, the approach is fragmented and not well represented. The purpose of this project is to assess the current state of outreach optometry within Indigenous communities by surveying optometrists who provide outreach care. \n \n \nMethods: In collaboration with the provincial optometry regulatory bodies, eligible participants were identified as optometrists who travel outside of their primary clinics to provide care within non-urban Indigenous communities. A questionnaire was developed through iterative stakeholder review for phase I of the study. The online questionnaire captured the delivery of care across one year (2022). The process of planning logistics, distances travelled, patient care provided and associated expenses were queried. A Semi-structured interview guide was developed for phase II of the study. One-on-one interviews expanded on questionnaire themes, providing insight into individual experiences. Data was collated through descriptive statistics and thematic coding for case and cross-case analysis. \n \n \nResults: The overall response rate was 50% (18/36) for the questionnaire and 30.5% (11/36) for the interview. Total questionnaire responses represent 96 outreach visits, 312.5 optometry clinic days, and 8,386 patient encounters across 64 communities in the three provinces. Optometrists coordinate with health center employees and school contacts to plan outreach visits, travelling primarily north to some of the most remote areas within each province. Overall Euclidean distances between participants primary clinic locations and communities visited ranged from 65 to 1405 kilometers (kms) (median: 438 kms). Costs per clinic day were highly variable ($174.44 - $3,800, mean: $765 per clinic day). Challenges reported were related to logistics, economic burden, and organizational challenges. Complementary enablers were identified, and recommendations are provided. \n \n \nConclusions: This study is the first to provide visibility to the current state of outreach optometry care to Indigenous communities in British Columbia, Saskatchewan, and Manitoba. The process of planning outreach visits was variable for individual optometrists and between provinces. High variability in reported costs associated with outreach visits requires additional investigation. Multi-stakeholder collaboration to support optometry outreach programming would encourage outreach participation and improve services towards reducing eye and vision health inequity experienced by non-urban Indigenous populations. \n \n \nAcknowledgements: Project supported by Anonymous Philanthropic Foundation, Canadian Institute for Health Research Canadian Graduate Scholarship, and Canadian Optometric Education Trust Fund. No conflicts to declare.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.011 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".