This cluster randomized controlled trial aims to evaluate the effectiveness of a Structured Referral Tracking (SRT) intervention in improving referral completion among adults identified with avoidable blindness during community-based eye screening camps in Rawalpindi District, Pakistan. Ten community clusters will be randomized into intervention and control groups. Participants in the intervention group will receive structured referral counseling, weekly reminder calls or messages, and customized referral guidance for eight weeks, while the control group will receive standard referral procedures. The primary outcome is referral completion at a tertiary eye hospital within eight weeks after screening. Secondary outcomes include knowledge regarding avoidable blindness, treatment satisfaction, feasibility, acceptability, and barriers influencing referral completion.
Adults aged 18 years or above
Individuals diagnosed with visual impairment or eye conditions requiring referral to a tertiary eye care facility
Permanent residents of Rawalpindi District, Pakistan
Willing and able to provide informed consent
Individuals already undergoing treatment for the identified eye condition
Individuals requiring emergency ophthalmic care
Severe systemic or physical illness limiting follow-up
Individuals unable to provide informed consent
Parallel
Structured Referral Tracking (SRT)
BehavioralA multi-component referral tracking intervention including referral counseling, weekly reminder calls or mobile messages, visual educational material, and customized referral guidance to improve referral completion after community eye screening.
Referral Completion Rate Verified Through Hospital Records
Proportion of referred participants who complete referral visits at the tertiary eye hospital, verified through hospital attendance records.
Knowledge Score on Avoidable Blindness Questionnaire
Participant knowledge regarding avoidable blindness and eye health assessed using a structured questionnaire developed for the study.
Participant Acceptability of Structured Referral Tracking Assessed Using Structured Feedback Questionnaire
Participant acceptability of the Structured Referral Tracking intervention assessed using a structured feedback questionnaire regarding usefulness and satisfaction with reminder communication.
Barriers Influencing Referral Completion Assessed Using Structured Barrier Assessment Questionnaire
Barriers and facilitators influencing referral completion assessed using a structured questionnaire among referred participants.
Participant Treatment Satisfaction Score Using Structured Satisfaction Questionnaire
Participant-reported satisfaction regarding referral services and treatment received at the tertiary eye hospital assessed using a structured satisfaction questionnaire.
Feasibility of Structured Referral Tracking Assessed by Reminder Delivery and Follow-up Completion Rates
Feasibility of the intervention assessed through successful delivery of reminder messages/calls and completion of scheduled follow-up procedures.
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Health Services Academy, Islamabad, Pakistan
Lead sponsor
Al-Shifa Trust Eye Hospital
Collaborator
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