Does Vision Health Knowledge Matter? A Cross-Sectional Study of Primary School Students in Rural China

Purpose: To estimate the prevalence, consequences of, and factors associated with poor vision health knowledge among students, parents, and teachers in rural China. Methods: This cross-sectional study was conducted with 17,902 students among 251 primary schools in rural China. The primary outcomes were eyeglasses ownership and wear rates, measured by self-reported eyeglasses ownership and wear status. Descriptive and multivariable regression analyses were performed. Results: Students, parents, and teachers had a high prevalence of poor vision health knowledge, with 90% of students, 86% of parents, and 56% of teachers scoring 4 or below on the study's vision knowledge test. Among 2,893 students needing eyeglasses, only 563 (19.46%) owned eyeglasses and 450 (15.55%) wore them. Both student and parental vision health knowledge were positively associated with eyeglasses ownership (p < 0.001 and p < 0.001, respectively). Parental vision health knowledge also showed a positive association with eyeglasses wear (p=0.098). Students with higher parental vision health knowledge and male students had higher vision health knowledge. Parents with higher education levels, at least one family member wearing eyeglasses, medium to high family wealth demonstrated higher levels of vision health knowledge. Conclusion: We found that poor vision health knowledge is prevalent among children, parents, and teachers in rural western China, and that prevalent visual impairment among children is accompanied by low eyeglasses ownership and wear rates. We also found positive and significant correlations between students' and parental vision health knowledge and students' eyeglasses ownership, as well as between parental vision health knowledge and students' eyeglasses wear rates, suggesting that efforts are needed to improve vision health knowledge among students and parents in rural China.