SWISH: Randomized Trial Providing Free Glasses to Secondary School Children With Myopia to Increase Academic High School Attendance in Rural Communities

What this Trial Is About

Researchers are investigating whether providing free glasses to myopic children in rural northern China, along with teacher support to encourage wearing them, can increase the rate at which these children attend academic high school instead of vocational schools. This cluster-randomized trial involves 111 middle schools, aiming to provide strong evidence for government programs to distribute free glasses nationally. Previous studies have shown that giving glasses improves grades more than factors like parents' education or family income, and this trial seeks to assess the impact on high school attendance as well as mental health and vision progression. Children in Year 1 at selected middle schools will be randomly assigned by school to either receive free glasses with teacher incentives to promote their use (Intervention group) or to receive only their glasses prescriptions (Control group). Intervention participants will receive their spectacles in December 2024 and will be followed for 32 months until July 2027, which covers the period through Year 3 of middle school when high school attendance is determined. Researchers will also observe how often children wear their glasses and whether they use blackboards or textbooks in class to understand how vision correction affects learning. Throughout the study, children will be monitored for academic progress, including attendance at academic high schools after middle school, observed spectacle wear at unannounced school visits, and mental health outcomes after one year of intervention. Data on the cost-effectiveness of the glasses program and local attitudes toward myopia and spectacle use will also be collected. The main outcome is measured in July following completion of Year 3, after 32 months of follow-up from the start of treatment.

Correcting Myopia Among Secondary School Children to Increase Academic High School Attendance Rates in Rural Communities