Please select the eligibility criteria that correspond to the clinical trial below.
Title: Confronting Unequal Eye Care in Pennsylvania
Brief Summary: Pt. 1 Diabetic retinopathy is a common eye condition among diabetic adults and can lead to severe vision impairment and even blindness. African Americans are more likely to have vision loss from diabetic retinopathy due to a variety of factors, including cultural barriers to care. The investigators aim to increase the rates of eye exams in diabetic African American adults by providing culturally relevant home-based interventions. These interventions will increase the knowledge about diabetes and the eyes and the awareness of ocular risks due to diabetes.

206 African American adults, over the age of 65, with diabetes will be recruited from primary care clinics at Thomas Jefferson and Temple University. Eligible patients who consent to participate will have baseline information taken about medical and ocular history, understanding of diabetes and a hemoglobin A1C level obtained. The subjects will then be randomized to one of two treatment conditions: Behavioral Activation or Supportive Therapy, each of which will be delivered over 4 sessions. Behavioral Activation will consist of educational materials, referral assistance for eye clinics, and addressing patient specific barriers to care. Supportive Therapy will consist of supportive but non-directional interaction with the patient exploring the impact of aging and diabetes on the patient's life. The investigators hypothesize that more patients who receive Behavioral Activation will have a dilated fundus exam (the primary outcome variable), understand the risks of diabetic complications and feel less depression then subjects who receive Supportive Therapy.


Options:
A: Inclusion Criteria:

* diabetic, at least 18 years old, patient at a participating health clinic
B: Inclusion Criteria:

* Provision of informed Consent
* Patients suffering from diabetes type II, insulin dependent or not insulin dependent.

Exclusion Criteria:

* Type I diabetes
* Pregnancy diabetes
* Hospitalisation, as this is a primary care study
* Patients who are member of the Belgian Diabetes Convention
C: Pt. 1

Inclusion Criteria:

* African-American race (self-identified)
* Age ≥ 65 years
* Type II Diabetes Mellitus (physician diagnosis) for at least 1 year
* No medical documentation of a DFE by an ophthalmologist or an optometrist within the past 12 months
* Self-report of no DFE within the past 12 months

Exclusion Criteria:

* Cognitive Impairment (Mini-Mental Status Examination ≤ 24)
* Current clinically significant psychiatric disorder other than depression
* Current medical disorder that limits life expectancy (≤ 12 months) or need for dialysis
* Hearing impairment that precludes research participation

Pt. 2

Inclusion Criteria:

* Glaucoma (physician diagnosis)
* Scheduled for a follow-up appointment that meets the American Academy of Ophthalmology (AAO) follow-up guidelines
* Attended the Wills Eye Glaucoma Clinic from September 1, 2012 to October 31, 2013
* Age ≥ 21 years old
* Able to understand and speak English

Exclusion Criteria:

* Diagnosed with a pre-existing medical condition that would preclude the subject from providing reliable and valid data
* Individual was asked to follow-up in less than a month.
D: Inclusion Criteria:

* Patient with diagnosed diabetes
* Seen in the office of a participating family physician at least once between July 2009 and April 2010
* At high risk for cardiovascular events:

  * Previous cardiovascular disease (including AMI, angina, stroke, TIA, claudication); or
  * Men aged \>= 45 years, women aged \>= 50 years; or
  * Men aged \< 45 years, women aged \< 50 years with at least one of the following:

    1. Macrovascular disease (silent myocardial infarction, or evidence of peripheral arterial, carotid or cerebrovascular disease)
    2. Microvascular disease (nephropathy or retinopathy)
    3. Family history of premature coronary or cerebrovascular disease in a first-degree relative
    4. Duration of diabetes \> 15 years with age \> 30 years

Answer: C