{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:16:24Z","timestamp":1783016184596,"version":"3.54.6"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001868","name":"National Science Council","doi-asserted-by":"publisher","award":["NSCT 114\u20102314\u2010B\u2010A49\u2010032\u2010MY3"],"award-info":[{"award-number":["NSCT 114\u20102314\u2010B\u2010A49\u2010032\u2010MY3"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001868","name":"National Science Council","doi-asserted-by":"publisher","award":["NSCT 112\u20102314\u2010B\u2010A49\u2010052\u2010MY3"],"award-info":[{"award-number":["NSCT 112\u20102314\u2010B\u2010A49\u2010052\u2010MY3"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001868","name":"National Science Council","doi-asserted-by":"publisher","award":["NSTC 114\u20102423\u2010H\u2010468\u2010001"],"award-info":[{"award-number":["NSTC 114\u20102423\u2010H\u2010468\u2010001"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with intellectual disabilities (IDs) are more likely to experience vision\u2010related impairments, yet they face many barriers to accessing eye care. Although previous studies have described these barriers, few have compared barriers reported by families who have and have not accessed ophthalmologic care, which may provide insight into barriers interpreted as anticipated or experienced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study objectives are to compare barriers to ophthalmologic care reported by family caregivers of users and non\u2010users and to interpret these differences as anticipated or experienced barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional survey was conducted with 657 primary family caregivers in Taichung City and Hualien County, Taiwan, between August and October 2023. Caregivers selected from a list of 13 predefined barriers. Participants were classified as \u2018users\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009261) if they had taken their family member with IDs for an eye examination and \u2018non\u2010users\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009396) otherwise. For interpretation, barriers reported significantly more often by non\u2010users were labelled as \u2018anticipated\u2019, whereas those reported significantly more often by users were labelled as \u2018experienced\u2019; these labels were based on service use status rather than direct temporal measurement. Logistic regression with marginal effects was used to identify predictors of the most common anticipated barrier.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A clinic environment perceived as unwelcoming or inaccessible was reported by 17.6% of non\u2010users and 4.5% of users (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Users more frequently reported difficulty participating during appointments or examinations (9.95% vs. 4.25%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), equipment that could not be adapted (8.0% vs. 4.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), limited availability of accessible assessment tools (7.1% vs. 3.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) and limited provider experience in delivering accessible care for people with IDs (7.6% vs. 2.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Higher caregiver strain and having \u2265\u20092 vision\u2010related conditions were associated with reporting the environmental barrier.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Barriers reported by non\u2010users suggest that perceptions of clinics as unwelcoming or inaccessible may discourage families from seeking a first eye examination for people with IDs. Improving accessibility and the care environment, alongside staff training and adaptable equipment and assessment tools, may reduce barriers reported by both non\u2010users and users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jir.70123","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:49:01Z","timestamp":1780393741000},"page":"845-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers to Ophthalmologic Care Reported by Family Caregivers of Users and Non\u2010Users With Intellectual Disabilities"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2441-039X","authenticated-orcid":false,"given":"Chiun\u2010Ho","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Ophthalmology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-3617","authenticated-orcid":false,"given":"Yueh\u2010Ching","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Social Work Asia University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Fang","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Health Administration, College of Health Professions Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4605-0893","authenticated-orcid":false,"given":"Christy","family":"Pu","sequence":"additional","affiliation":[{"name":"Institute of Public Health National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070855"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/41.5.652"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.13220"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2007.00958.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212733"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckx064"},{"key":"e_1_2_10_8_1","first-page":"13","article-title":"Reaching out to Patients With Intellectual Disabilities","volume":"26","author":"Ellison E.","year":"2013","journal-title":"Community Eye Health"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2008.01114.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.2001.00350.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2008.01057.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.13210"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.13258"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-014-0505-5"},{"issue":"3","key":"e_1_2_10_15_1","first-page":"109","article-title":"Visual Impairment and Blindness in People With Intellectual Disabilities: A Systematic Review","volume":"8","author":"Kroezen M.","year":"2020","journal-title":"Optometry and Visual Performance"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01590.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-18"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12304"},{"key":"e_1_2_10_19_1","first-page":"61","article-title":"Functional Evaluation: The Barthel Index: A Simple Index of Independence Useful in Scoring Improvement in the Rehabilitation of the Chronically Ill","volume":"14","author":"Mahoney F. 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