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Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China: The PRICE (Potentiating Rural Investment in Children's Eyecare) study

Author

Listed:
  • Xiuqin Wang
  • Nathan Congdon
  • Yue Ma
  • Min Hu
  • Yuan Zhou
  • Weiqi Liao
  • Ling Jin
  • Baixiang Xiao
  • Xiaoyi Wu
  • Ming Ni
  • Hongmei Yi
  • Yiwen Huang
  • Beatrice Varga
  • Hong Zhang
  • Yongkang Cun
  • Xianshun Li
  • Luhua Yang
  • Chaoguang Liang
  • Wan Huang
  • Scott Rozelle
  • Xiaochen Ma

Abstract

Background: Offering free glasses can be important to increase children’s wear. We sought to assess whether “Upgrade glasses” could avoid reduced glasses sales when offering free glasses to children in China. Methods: In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA) 6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of $30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization. Results: Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0%) at 27 schools to Free Glasses +$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3%, multiple regression relative risk (RR) 0.90 (0.56–1.43), P = 0.65; Free + $30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69. Conclusions: Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income. Trial registration: ClinicalTrials.gov Identifier: NCT02231606. Registered on 31 August 2014.

Suggested Citation

  • Xiuqin Wang & Nathan Congdon & Yue Ma & Min Hu & Yuan Zhou & Weiqi Liao & Ling Jin & Baixiang Xiao & Xiaoyi Wu & Ming Ni & Hongmei Yi & Yiwen Huang & Beatrice Varga & Hong Zhang & Yongkang Cun & Xians, 2017. "Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China: The PRICE (Potentiating Rural Investment in Children's Eyecare) study," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0187808
    DOI: 10.1371/journal.pone.0187808
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    1. Patrick Royston, 2004. "Multiple imputation of missing values," Stata Journal, StataCorp LP, vol. 4(3), pages 227-241, September.
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    1. Yue Ma & Yujuan Gao & Yue Wang & Haoyang Li & Lina Ma & Jiangchao Jing & Yaojiang Shi & Hongyu Guan & Nathan Congdon, 2018. "Impact of a Local Vision Care Center on Glasses Ownership and Wearing Behavior in Northwestern Rural China: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 15(12), pages 1-12, December.
    2. Jin Zhao & Huan Wang & Hongyu Guan & Kang Du & Yunyun Zhang & Nathan Congdon, 2022. "Impact of Teacher Incentive Intervention on Students’ Vision Healthcare Uptake: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 19(19), pages 1-14, October.

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