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Impact of Community-Based Colour Vision Screening on Colour Vision Deficiency Detection among Adolescents in Nigeria

Abstract

Colour vision deficiency is an important visual health concern that may affect adolescents' educational participation, career choices, safety, and daily activities in Nigeria. Individuals with colour vision deficiency may experience difficulty distinguishing certain colours, which can affect tasks involving colour-coded learning materials, laboratory activities, electrical wiring, transportation signals, occupational requirements, and other everyday situations. However, colour vision deficiency may remain undetected when affected adolescents adapt to their visual limitations or when routine vision assessment does not include specific colour vision testing. Limited awareness, inadequate access to eye-care services, financial barriers, and insufficient community-based vision screening programmes may further contribute to delayed identification. Community-based colour vision screening provides an opportunity to identify adolescents with possible colour vision deficiency through community outreach programmes, primary healthcare centres, schools, youth organizations, and other accessible platforms. Early detection can facilitate appropriate eye assessment, counselling, educational support, career guidance, and safety-related interventions. Against this background, this study investigates the impact of community-based colour vision screening on colour vision deficiency detection among adolescents in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Promotion Model. The Health Belief Model explains how adolescents' perceptions of susceptibility to visual problems, perceived consequences of colour vision deficiency, perceived benefits of screening, perceived barriers, and cues to action may influence participation in community-based colour vision screening. The Social Ecological Model emphasizes the influence of individual, family, school, community, socioeconomic, and healthcare-system factors on visual health and access to eye-care services. The Health Promotion Model emphasizes individual knowledge, perceived benefits, interpersonal influences, and health-promoting behaviours that may encourage adolescents to participate in preventive visual health assessment. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based colour vision screening may influence colour vision deficiency detection among adolescents in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adolescents aged approximately 10 to 19 years residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, primary healthcare centres, schools, youth organizations, and eligible adolescents. Community-based colour vision screening will be measured using indicators such as availability of screening programmes, screening coverage, frequency of screening activities, use of standardized colour vision screening tests, availability of trained screening personnel, assessment procedures, privacy arrangements, eye-health education, awareness activities, and referral pathways. Colour vision deficiency detection will be assessed using indicators such as positive colour vision screening results, identification of red-green colour vision deficiency, identification of other colour discrimination abnormalities where applicable, adolescents requiring comprehensive eye examination, newly detected colour vision deficiency, referrals to eye-care professionals, and documented diagnoses following appropriate clinical evaluation. Data will be collected using structured questionnaires, standardized colour vision screening instruments such as appropriate colour-dot or colour-arrangement tests, community eye-health assessment forms, screening registers, and referral documentation. Descriptive statistics will be used to summarize participants' demographic characteristics, screening coverage, screening results, and colour vision deficiency detection rates. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the impact of community-based colour vision screening on colour vision deficiency detection. Where appropriate, detection rates before and after implementation of community-based screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based colour vision screening has a significant positive impact on colour vision deficiency detection among adolescents in Nigeria. Adolescents who participate in systematic community-based colour vision screening are expected to have a higher likelihood of previously unrecognized colour vision deficiency being identified than adolescents without access to such screening. Routine screening may facilitate early recognition of colour discrimination difficulties that adolescents may not recognize or report independently. Early detection may provide opportunities for comprehensive eye assessment, appropriate counselling, classroom accommodations, educational guidance, career counselling, and safety education. Community-based screening may also reduce geographical, financial, and access barriers and reach adolescents who may not routinely visit eye-care facilities. Increased awareness among adolescents, parents, teachers, and community members may further encourage appropriate referral and support for affected individuals. Conversely, limited availability of trained eye-care personnel, inadequate screening equipment, financial constraints, low awareness, cultural misconceptions, and weak referral and follow-up systems may reduce the effectiveness of community-based colour vision screening. The study therefore expects accessible, standardized, and systematically implemented community-based colour vision screening to contribute significantly to improved detection and early support for adolescents with colour vision deficiency in Nigeria. The study is expected to contribute to the literature on community-based colour vision screening, colour vision deficiency detection, adolescent eye health, visual health, school health, preventive eye care, educational participation, career guidance, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, ophthalmologists, optometrists, opticians, primary healthcare workers, schools, youth organizations, parents, development partners, and policymakers regarding strategies for improving early identification of colour vision deficiency. The study will also provide evidence-based recommendations for expanding community-based colour vision screening, strengthening adolescent eye-health education, increasing access to trained eye-care personnel, improving referral and follow-up systems, promoting appropriate educational accommodations, supporting informed career guidance, and integrating colour vision assessment into appropriate community-based adolescent and preventive eye-health programmes across Nigeria.

Keywords: Community-based colour vision screening, colour vision deficiency detection, adolescents, colour blindness, adolescent eye health, visual health, eye screening, preventive eye care, educational support, career guidance, Nigeria, public health.