Using implementation science to adapt a targeted transportation intervention for patients with diabetic retinopathy (PRONTO-EYE)

PROJECT SUMMARY/ABSTRACT Diabetic retinopathy (DR) is the leading cause of preventable vision loss in the United States and disproportionately affects individuals with limited socioeconomic resources. Timely diagnosis and treatment can prevent up to 90% of vision impairment, underscoring the importance of consistent adherence to ophthalmology appointments. Dr. Scanzera’s prior work identified transportation challenges as a key factor contributing to missed appointments among patients coming from neighborhoods with limited socioeconomic resources. Her K23 research plan aims to design, implement, and evaluate a ride-share transportation intervention adapted from her health system’s existing PROgram for Non-emergency TranspOrtation (PRONTO). This intervention, names PRONTO-EYE, is intended to reduce transportation challenges and improve adherence to scheduled ophthalmology visits for patients with DR and Medicaid insurance. To achieve this, Dr. Scanzera will apply implementation and human-centered design methodologies to (1) co-design and (2) pilot test PRONTO-EYE. She hypothesizes that the intervention will be successfully integrated into the existing healthcare infrastructure and will enhance appointment adherence in the target population. Dr. Scanzera’s long-term goal is to develop and implement evidence-based strategies to reduce preventable blindness in communities with limited resources across the U.S. The K23 Career Development Award will provide her with mentored research experience, as well as didactic and hands-on training, to support her transition to an independent investigator focused on improving eye health outcomes for all. She will benefit from the extensive resources and mentorship available at the University of Illinois Chicago, with advisors whose expertise aligns with her research and career objectives. This proposal also aligned with the National Eye Institute’s 2021 Strategic Plan which emphasizes population health. By developing a transportation intervention tailored to patients with DR with Medicaid insurance, Dr. Scanzera’s research has the potential to significantly improve access to eye care and reduce vision loss. The immediate outcome will be a pilot-tested intervention, which will be evaluated in a larger trial as part of a future R01 grant.