{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:22:17Z","timestamp":1787775737073,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,2]]},"abstract":"\n Purpose:<\/jats:title>\n The effectiveness of Accredited Social Health Activists (ASHAs) with and without monetary incentive in uptake of diabetic retinopathy (DR) screening at community health center (CHC) was compared in South Gujarat, India.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In this non-randomized controlled trial, ASHAs were incentivized to refer people with diabetes mellitus (PwDM) from their respective villages for DR screening after people were sensitized to DM and DR. The minimum sample size was 63 people in each arm.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 162, 50.6% were females, 80.2% were literate, 56.2% were >50 years, 54.3% had increased random blood sugar (RBS), and 59.9% had diabetes for 5 years. The percentage of screening was significantly higher [relative risk (RR) = 4.37, 95% confidence interval (CI) 2.79, 6.84] in ASHA incentive group and health education (HE) group (RR = 3.67, 95% CI 2.35, 5.75) compared with baseline. Providing incentive to ASHAs was not found to be of extra advantage (RR = 1.19, 95% CI 0.89, 1.57). The likelihood of uptake of screening was higher among uncontrolled PwDM, poor literacy, and higher duration of diabetes in incentive phase (\n P<\/jats:italic>\n < 0.001) compared with HE. The results show that age (\n P<\/jats:italic>\n = 0.017), education (\n P<\/jats:italic>\n = 0.015) and level of RBS (\n P<\/jats:italic>\n = 0.001) of those referred were significantly associated with incentives to ASHAs.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n ASHAs can be used effectively to refer known PwDM for DR screening especially when DR screening program is introduced in population with low awareness and poor accessibility. When incentives are planned, additional burden on resources should be kept in mind before adapting this model of care.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2118_19","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T05:03:16Z","timestamp":1579150996000},"page":"S52-S55","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Effectiveness of health education and monetary incentive on uptake of diabetic retinopathy screening at a community health center in South Gujarat, India"],"prefix":"10.4103","volume":"68","author":[{"given":"Rohan Arvindbhai","family":"Chariwala","sequence":"first","affiliation":[{"name":"Divyajyoti Trust, Tejas Eye Hospital, Mandvi, District-Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajan","family":"Shukla","sequence":"additional","affiliation":[{"name":"South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uday R","family":"Gajiwala","sequence":"additional","affiliation":[{"name":"Divyajyoti Trust, Tejas Eye Hospital, Mandvi, District-Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Pant","sequence":"additional","affiliation":[{"name":"South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa Glenda","family":"Lewis","sequence":"additional","affiliation":[{"name":"South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G V S","family":"Murthy","sequence":"additional","affiliation":[{"name":"South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India"},{"name":"Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,1,17]]},"reference":[{"key":"R3-20250506","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4103\/0301-4738.178144","article-title":"Prevalence of diabetic retinopathy in India: The all India ophthalmological society diabetic retinopathy eye screening study 2014","volume":"64","author":"Gadkari","year":"2016","journal-title":"Indian J Ophthalmol"},{"key":"R4-20250506","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/0301-4738.178152","article-title":"Diabetic care initiatives to prevent blindness from diabetic retinopathy in India","volume":"64","author":"Murthy","year":"2016","journal-title":"Indian J Ophthalmology"},{"key":"R5-20250506","doi-asserted-by":"crossref","first-page":"e000005","DOI":"10.1136\/bmjdrc-2013-000005","article-title":"Prevalence and risk factors for diabetic retinopathy in rural India. 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