KAM-C Model of Myopia Management for School-aged Children

Abstract

Abstract (390words)

Progressive myopia is a significant public health issue among primary school-aged children in Malaysia. Its increasing prevalence is closely linked to unhealthy behaviors, such as prolonged near work, excessive digital device use, and limited outdoor activity. These factors contribute to long-term risks, including high myopia and related ocular complications. Although effective, evidence-based interventions exist, their clinical adoption remains limited, highlighting a gap between research and practice. The significance of this study is to develop a model to enhance myopia control in clinical practice. This study used a qualitative approach; it examined behavioral factors and developed the Parental Awareness–Knowledge, Attitude, and Practice Integrated Model (KAM-C Model) to enhance clinical myopia management. The model translates parental perceptions into structured clinical decision-making, aiming to increase treatment uptake, adherence, and overall effectiveness. The objectives were to (i) assess awareness of myopia control strategies, (ii) evaluate parental knowledge, attitudes, and practices regarding myopia management, and (iii) propose a structured clinical model based on the KAM-C Model. A qualitative methodology was employed, utilizing semi-structured interviews with parents (n=10) of children aged 6–12 years diagnosed with mild-to-moderate myopia (≤ −6.00 diopters). Data was processed utilizing NVivo software, and Braun and Clarke’s six-phase thematic analysis was applied, theoretically underpinned by the Health Belief Model and the Theory of Planned Behavior. Thematic analysis yielded four primary domains: myopia perception, awareness of control strategies, decision-making determinants, and professional influence. Findings indicate that while parental comprehension of myopia is foundational, it remains largely constrained. Treatment decisions were predominantly driven by perceived safety profiles, followed by economic feasibility and convenience, with a marked reliance on optometric recommendations. These empirical insights directly informed the patient-care framework, which systematically integrates clinical assessment, patient education, risk communication, and shared decision-making into a standardized pathway. These findings inform the development of the KAM-C Model, which integrates clinical assessment, patient education, risk communication, and shared decision-making into a standardized and systematic process for myopia management. Adoption of this framework by eye care practitioners can standardize clinical protocols, optimize clinician-parent communication, and facilitate evidence-based myopia management. Ultimately, this framework supports improved long-term visual outcomes in children and aligns with Sustainable Development Goal (SDG) 11—specifically Targets 11.3 (inclusive urban development) and 11.7 (access to safe and supportive environments).