Introduction Evidence suggests that certain groups face substantial barriers to accessing eye care services. This study seeks to explore barriers and potential solutions as perceived by members of the population groups who are least able to access care in the context of four national eye screening programmes. We aim to use rapid yet robust mixed methods that allow us to identify generalisable findings and testable service modifications to improve equitable access to care. Methods and analysis This is a multi-phased exploratory sequential mixed methods study. First, we will conduct interviews with people purposively selected from the sociodemographic subgroups with the lowest odds of accessing care within each screening programme. Taking a phenomenological approach, we will explore their perceptions of barriers and potential service modifications that could boost attendance at eye clinics among people from these "left behind" groups. We will use a deductive analytic matrix to facilitate the rapid analysis of qualitative data. Space will be made for the inductive identification of themes that are not necessarily captured in the framework. Sample size will be determined by thematic saturation. Next we will conduct a survey with a representative sample of non-attenders from the same left behind groups, asking them to rank each suggested service modification by likely impact. Finally, we will convene a multistakeholder workshop to asses each service modification based on ranking, likely impact, feasibility, cost, and potential risks. The most promising service modifications will be implemented and evaluated in a follow-on randomised controlled trial, the methods for which will be reported elsewhere. Ethics and dissemination This project has been approved by independent research ethics committees in Botswana, Kenya, India, Nepal and the UK. We will disseminate our findings through local community advisory boards, national eye screening meetings, in peer-reviewed journals, and at conferences.

中文翻译：

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确定障碍和潜在解决方案，以改善博茨瓦纳、印度、肯尼亚和尼泊尔获得社区眼科服务的公平机会：快速探索性序贯混合方法研究方案

简介 有证据表明，某些群体在获得眼保健服务方面面临巨大障碍。本研究旨在探讨在四个国家眼科筛查计划的背景下最无力获得护理的人群所认为的障碍和潜在的解决方案。我们的目标是使用快速而强大的混合方法，使我们能够确定普遍的发现和可测试的服务修改，以改善公平获得护理的机会。方法和分析这是一项多阶段探索性序贯混合方法研究。首先，我们将有目的地从每个筛查计划中获得护理机会最低的社会人口亚组中选出的人进行访谈。我们将采用现象学方法，探讨他们对障碍的看法以及潜在的服务调整，这些调整可以提高这些“落后”群体的眼科诊所就诊率。我们将使用演绎分析矩阵来促进定性数据的快速分析。将为归纳识别框架中不一定包含的主题留出空间。样本大小将由主题饱和度决定。接下来，我们将对来自同一留下群体的未参加者的代表性样本进行调查，要求他们根据可能的影响对每项建议的服务修改进行排名。最后，我们将召开多利益相关方研讨会，根据排名、可能的影响、可行性、成本和潜在风险评估每个服务修改。最有希望的服务修改将在后续随机对照试验中实施和评估，其方法将在其他地方报告。伦理与传播 该项目已获得博茨瓦纳、肯尼亚、印度、尼泊尔和英国独立研究伦理委员会的批准。我们将通过当地社区咨询委员会、全国眼科筛查会议、同行评审期刊和会议传播我们的研究结果。