Rebecca N Dudovitz1, Myung Shin Sim2, David Elashoff2, Joshua Klarin3, Wendelin Slusser4, Paul J Chung5. 1. Department of Pediatrics and Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children's Hospital (RN Dudovitz, W Slusser, and PJ Chung). Electronic address: rdudovitz@mednet.ucla.edu. 2. General Internal Medicine and Health Services Research, UCLA (MS Sim and D Elashoff). 3. Los Angeles Unified School District (J Klarin). 4. Department of Pediatrics and Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children's Hospital (RN Dudovitz, W Slusser, and PJ Chung); UCLA Fielding School of Public Health (W Slusser and PJ Chung); UCLA Chancellor's Office-Semel Healthy Campus Initiative Center at UCLA (W Slusser), Los Angeles, Calif. 5. Department of Pediatrics and Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children's Hospital (RN Dudovitz, W Slusser, and PJ Chung); UCLA Fielding School of Public Health (W Slusser and PJ Chung); RAND Health, RAND Corporation (PJ Chung), Santa Monica, Calif. Dr Chung is now with the Health Systems Science, Kaiser Permanente School of Medicine and Pediatrics and Health Policy & Management, UCLA, Los Angeles, Calif.
Abstract
OBJECTIVE: Untreated vision problems are associated with poor school performance. Whether providing glasses alone improves performance, however, remains unknown. We sought to test whether receiving glasses was associated with improved school performance for low-income minority students in Los Angeles. METHODS: From 2017 to 2018, we analyzed achievement marks in mathematics and language arts from 406 first to fifth grade students attending 24 public elementary schools who received glasses through a free school-based vision program between February and May 2014, and 23,393 of their nonparticipating same-school, same-grade peers. We calculated students' percentile rank during each grading period in 1 year before and 2 years since they received glasses. Multilevel linear regressions tested whether percentile rank differed from baseline at each subsequent grading period. Models accounted for clustering at the school level and controlled for gender, grade level, and baseline class rank. Interaction terms tested whether associations differed by gender and class rank. RESULTS: Students increased 4.5 percentile points (P = .02) in language arts in the second year after receiving glasses. There was no change in math achievement overall; however, those with baseline performance in the bottom tercile had an immediate and sustained improvement of 10 to 24 percentile points from baseline (interaction term P < .001). Class rank for behavior marks decreased during the fourth grading period after receiving glasses but subsequently returned to baseline. There were no significant changes in work habits and no variation in results by gender. CONCLUSIONS: Ensuring access to vision care may be a simple, scalable strategy to improve language arts performance for low-income minority children.
OBJECTIVE: Untreated vision problems are associated with poor school performance. Whether providing glasses alone improves performance, however, remains unknown. We sought to test whether receiving glasses was associated with improved school performance for low-income minority students in Los Angeles. METHODS: From 2017 to 2018, we analyzed achievement marks in mathematics and language arts from 406 first to fifth grade students attending 24 public elementary schools who received glasses through a free school-based vision program between February and May 2014, and 23,393 of their nonparticipating same-school, same-grade peers. We calculated students' percentile rank during each grading period in 1 year before and 2 years since they received glasses. Multilevel linear regressions tested whether percentile rank differed from baseline at each subsequent grading period. Models accounted for clustering at the school level and controlled for gender, grade level, and baseline class rank. Interaction terms tested whether associations differed by gender and class rank. RESULTS: Students increased 4.5 percentile points (P = .02) in language arts in the second year after receiving glasses. There was no change in math achievement overall; however, those with baseline performance in the bottom tercile had an immediate and sustained improvement of 10 to 24 percentile points from baseline (interaction term P < .001). Class rank for behavior marks decreased during the fourth grading period after receiving glasses but subsequently returned to baseline. There were no significant changes in work habits and no variation in results by gender. CONCLUSIONS: Ensuring access to vision care may be a simple, scalable strategy to improve language arts performance for low-income minority children.