{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:06Z","timestamp":1792787286133,"version":"4.5.0"},"reference-count":24,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Livelihood Impact Fund Eyeglasses Initiative","award":["GR0126407"],"award-info":[{"award-number":["GR0126407"]}],"id":[{"id":"https:\/\/ror.org\/00jb20j87","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Presbyopia, an age-related loss of near vision, affects approximately 80% of adults over 40 and 100% of adults over 60. Although correctable with inexpensive reading glasses, fewer than 20% of those affected in low- and middle-income countries have access to appropriate correction. Uncorrected presbyopia impairs daily functioning and productivity. The impact of presbyopia on health workforce performance remains unexplored, despite the impact of data accuracy on patient safety and the increasing reliance on mobile data entry and digital tools. This study assesses whether near-vision correction improves community health worker (CHW) data accuracy and entry speed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a mixed-methods, within-subject crossover study among 400 CHWs in Dowa district, Malawi. Participants (n=105) with screened presbyopia completed two simulated data entry tasks in Dimagi\u2019s CommCare mobile application, once with and once without reading glasses in random order. Task accuracy and completion time were assessed, adjusting for age and testing order. Post-task surveys explored perceptions of ease, accuracy and work impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Wearing appropriate reading glasses nearly doubled the odds of accurate data entry (OR=1.92, 95%\u2009CI 1.71 to 2.16; p&lt;0.001). No statistically significant effect was observed on task speed, although 84% of participants reported glasses made data entry easier and 81% perceived themselves as faster. Nearly all (93%) believed reading glasses could increase their impact and were willing to pay for them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Providing low-cost reading glasses improved data entry accuracy among CHWs with presbyopia. As digital health systems expand, addressing uncorrected near-vision loss may reduce medical errors and improve care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2026-004932","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:40:22Z","timestamp":1786023622000},"page":"e004932","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Does near-vision correction improve digital data entry accuracy? A simulated within-subject crossover study among community health workers in Malawi"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6448-437X","authenticated-orcid":false,"given":"Julie","family":"Rosenberg","sequence":"first","affiliation":[{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"The Global Health Delivery Project, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3241-1088","authenticated-orcid":false,"given":"Safia","family":"Abou-Zamzam","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"The Global Health Delivery Project, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aubrey","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Dimagi Inc, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarvesh","family":"Tewari","sequence":"additional","affiliation":[{"name":"Dimagi Inc, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Lesh","sequence":"additional","affiliation":[{"name":"Dimagi Inc, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"The Global Health Delivery Project, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026093023400596000_4.3.e004932.1","unstructured":"World Health Organization . World report on vision. 2019. Available: https:\/\/www.who.int\/docs\/default-source\/documents\/publications\/world-vision-report-accessible.pdf"},{"key":"2026093023400596000_4.3.e004932.2","first-page":"27","article-title":"The Lancet Global Health Commission on Global Eye Health: key findings","volume":"34","author":"Bassett","year":"2021","journal-title":"Community Eye Health"},{"key":"2026093023400596000_4.3.e004932.3","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.983423","article-title":"Potential productivity loss from uncorrected and under-corrected presbyopia in low- and middle-income countries: A life table modeling study","volume":"10","author":"Ma","year":"2022","journal-title":"Front Public Health"},{"key":"2026093023400596000_4.3.e004932.4","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6353"},{"key":"2026093023400596000_4.3.e004932.5","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.08-3154"},{"key":"2026093023400596000_4.3.e004932.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0296115","article-title":"The effect on income of providing near vision correction to workers in Bangladesh: The THRIVE (Tradespeople and Hand-workers Rural Initiative for a Vision-enhanced Economy) randomized controlled trial","volume":"19","author":"Sehrin","year":"2024","journal-title":"PLoS ONE"},{"key":"2026093023400596000_4.3.e004932.7","unstructured":"Singh P , Zeppieri M , Tripathy K . Presbyopia. In: StatPearls. Treasure Island, FL: StatPearls Publishing, 2025."},{"key":"2026093023400596000_4.3.e004932.8","doi-asserted-by":"crossref","first-page":"e1019","DOI":"10.1016\/S2214-109X(18)30329-2","article-title":"Effect of providing near glasses on productivity among rural Indian tea workers with presbyopia (PROSPER): a randomised trial","volume":"6","author":"Reddy","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2026093023400596000_4.3.e004932.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-071203","article-title":"Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review","volume":"13","author":"Cohen","year":"2023","journal-title":"BMJ Open"},{"key":"2026093023400596000_4.3.e004932.10","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czu126"},{"key":"2026093023400596000_4.3.e004932.11","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-63828-9","article-title":"Quality of life and associated factors for community health workers in the context of the COVID-19 pandemic in northeastern Brazil","volume":"14","author":"Forte","year":"2024","journal-title":"Sci Rep"},{"key":"2026093023400596000_4.3.e004932.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-021-00689-7","article-title":"Association between supportive supervision and performance of community health workers in India: a longitudinal multi-level analysis","volume":"19","author":"Gopalakrishnan","year":"2021","journal-title":"Hum Resour Health"},{"key":"2026093023400596000_4.3.e004932.13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw625"},{"key":"2026093023400596000_4.3.e004932.14","first-page":"41018794","article-title":"Community health workers\u2019 knowledge and attitudes toward advance directives in China: a cross-sectional study","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Public Health"},{"key":"2026093023400596000_4.3.e004932.15","unstructured":"Community health worker advancing diversity in community health. National Association of Community Health Workers; 2022. Available: https:\/\/nachw.org\/wp-content\/uploads\/2022\/08\/chw_diversity_2.pdf"},{"key":"2026093023400596000_4.3.e004932.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-021-06652-5","article-title":"The burden of recording and reporting health data in primary health care facilities in five low- and lower-middle income countries","volume":"21","author":"Siyam","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"2026093023400596000_4.3.e004932.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-023-00839-z","article-title":"A time-motion study of community health workers delivering community-based primary health care in Neno District, Malawi","volume":"21","author":"Aron","year":"2023","journal-title":"Hum Resour Health"},{"key":"2026093023400596000_4.3.e004932.18","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1733909"},{"key":"2026093023400596000_4.3.e004932.19","doi-asserted-by":"crossref","DOI":"10.2196\/42615","article-title":"Digital Health Data Quality Issues: Systematic Review","volume":"25","author":"Syed","year":"2023","journal-title":"J Med Internet Res"},{"key":"2026093023400596000_4.3.e004932.20","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.2147\/JMDH.S516383","article-title":"Global Trends and Evidence Gaps in Medical Errors Research: A Mixed-Methods Scientometrics Study","volume":"18","author":"Angarita-Pacheco","year":"2025","journal-title":"J Multidiscip Healthc"},{"key":"2026093023400596000_4.3.e004932.21","unstructured":"World Health Organization . Patient safety. 2023. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/patient-safety"},{"key":"2026093023400596000_4.3.e004932.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-020-01774-9","article-title":"Preventable medication harm across health care settings: a systematic review and meta-analysis","volume":"18","author":"Hodkinson","year":"2020","journal-title":"BMC Med"},{"key":"2026093023400596000_4.3.e004932.23","unstructured":"CommCare evidence base overview. Dimagi; 2025. Available: https:\/\/dimagi.com\/wp-content\/uploads\/2024\/02\/Evidence-Base-2024-Jan.pdf"},{"key":"2026093023400596000_4.3.e004932.24","unstructured":"Davies L , Goodman D , et al . SQUIRE 2.0 (standards for quality improvement reporting excellence): revised publication guidelines from a detailed consensus process."}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2026-004932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:40:53Z","timestamp":1790836853000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2026-004932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2026-004932"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2026-004932","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}