KAM-C Model of Myopia Management for School-aged Children
DOI:
https://doi.org/10.21834/e-bpj.v11i37.7979Keywords:
Myopia, Parental Behavior, KAM-C Model; SDG 11, Sustainable Cities and CommunitiesAbstract
Myopia has emerged as a significant public health concern, particularly among children in Malaysia, driven by lifestyle and environmental changes. Despite the availability of effective myopia control strategies, adoption remains inconsistent, largely shaped by parental decision-making. This study employs a qualitative phenomenological approach to explore parental awareness, knowledge, attitudes, and practices in myopia management. Guided by the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), the study proposes the Knowledge–Attitude–Practice Clinical Integration (KAM-C) Model. The model integrates behavioral insights into clinical workflows to enhance treatment uptake, adherence, and long-term visual outcomes.
References
Biswas, S., El Kareh, Q. A., Mei, D., Sun, C.-H., Lam, J. S. H., Saw, S.-M., & Najjar, R. P. (2024). The influence of the environment and lifestyle on myopia. Journal of Physiological Anthropology, 43(1). https://doi.org/10.1186/s40101-024-00354-7 DOI: https://doi.org/10.1186/s40101-024-00354-7
Chang, L., Sun, C., Lee, T., Wang, Y., & Liao, L. (2024). Shared decision-making, treatment decision regret, and vision-related quality of life among parents of children with myopia: An online survey in Taiwan. Contact Lens and Anterior Eye, 47(6), 102283. https://doi.org/10.1016/j.clae.2024.102283 DOI: https://doi.org/10.1016/j.clae.2024.102283
Eppenberger, L. S., Grzybowski, A., Schmetterer, L., & Ang, M. (2024). Myopia control: Are we ready for an evidence-based approach? Ophthalmology and Therapy, 13(6), 1453–1477. https://doi.org/10.1007/s40123-024-00951-w DOI: https://doi.org/10.1007/s40123-024-00951-w
George, D., George, A., & Shahul, A. (2023). The myopia epidemic: A growing public health crisis impacting children worldwide. Zenodo. https://doi.org/10.5281/zenodo.8361064
Haarman, A. E. G., Enthoven, C. A., Tideman, J. W. L., Tedja, M. S., Verhoeven, V. J. M., & Klaver, C. C. W. (2020). The complications of myopia: A review and meta-analysis. Investigative Ophthalmology & Visual Science, 61(4), 49. https://doi.org/10.1167/iovs.61.4.49 DOI: https://doi.org/10.1167/iovs.61.4.49
Holden, B. A., Fricke, T. R., Wilson, D. A., Jong, M., Naidoo, K. S., Sankaridurg, P., Wong, T. Y., Naduvilath, T. J., & Resnikoff, S. (2016). Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology, 123(5), 1036–1042. https://doi.org/10.1016/j.ophtha.2016.01.006 DOI: https://doi.org/10.1016/j.ophtha.2016.01.006
Hung, L., Sun, C., Liao, L., Chang, L., & Chen, H. (2025). A web-based, user-centered decision aid to support parental choices in myopia control: A development and usability study. Digital Health, 11, 20552076251395560. https://doi.org/10.1177/20552076251395560 DOI: https://doi.org/10.1177/20552076251395560
Ismail, L. A., & Sukumaran, S. (2022). Prevalence of refractive errors among school children in Wangsa Maju, Kuala Lumpur, Malaysia. Medical Hypothesis, Discovery & Innovation in Optometry, 3(3), 106–112. https://doi.org/10.51329/mehdioptometry158 DOI: https://doi.org/10.51329/mehdioptometry158
Lanca, C., Pang, C. P., & Grzybowski, A. (2023). Effectiveness of myopia control interventions: A systematic review of 12 randomized controlled trials published between 2019 and 2021. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1125000 DOI: https://doi.org/10.3389/fpubh.2023.1125000
Liu, S. M., Wang, Y. T., Chen, J., Wang, F., & Shih, S. F. (2026). Parent engagement in children's eye care behavior and vision-related quality of life: A cross-sectional study. BMC Public Health, 26(1), 879. https://doi.org/10.1186/s12889-026-26277-9 DOI: https://doi.org/10.1186/s12889-026-26277-9
Maulvi, F. A., Desai, D. T., Kalaiselvan, P., Shah, D. O., & Willcox, M. D. P. (2025). Current and emerging strategies for myopia control: A narrative review of optical, pharmacological, behavioral, and adjunctive therapies. Eye, 39(14), 2635–2644. https://doi.org/10.1038/s41433-025-03949-1 DOI: https://doi.org/10.1038/s41433-025-03949-1
Pan, W., Morgan, I., Flitcroft, I., Rose, K., Ostrin, L. A., Rosenfield, M., Govender-Poonsamy, P., Siu-Villaseñor, D., Kaymak, H., Khew, J. M., Woo, O., Tsubota, K., Shinde, L., Prenat, O., Ma, J., Qu, J., Yang, Z., Wang, Y., Tan, K. O., ... Lan, W. (2025). The need to address the myopia pandemic: Summary report of the Global Myopia Public Health Summit 2024. Global Health Research and Policy, 10(1), 45. https://doi.org/10.1186/s41256-025-00445-7 DOI: https://doi.org/10.1186/s41256-025-00445-7
Pan, Z., Xian, H., Li, F., Wang, Z., Li, Z., Huang, Y., Liu, W., Li, Y., Li, F., Wang, J., Chen, H., Wu, Y., Xu, Y., Wu, G., Zhang, Y., He, L., Zhang, J., Zhang, F., Qian, X., & Zhang, X. (2025). Myopia and high myopia trends in Chinese children and adolescents over 25 years: A nationwide study with projections to 2050. The Lancet Regional Health – Western Pacific, 59, 101577. https://doi.org/10.1016/j.lanwpc.2025.101577 DOI: https://doi.org/10.1016/j.lanwpc.2025.101577
Rashidi, N., Rahim, M. A. S. A., & Yusof, F. (2025). Trend and distribution of refractive errors among children attending a private optometry practice in northern Malaysia. International Journal of Allied Health Sciences. among children attending a private optometry practice in northern Malaysia. https://journals.iium.edu.my/ijahs/index.php/IJAHS/article/view/1099
Tan, E. S. Y., Agarwal, P., & Teng, C. L. (2026). Prevalence of Myopia in Children and Adolescents: A Systematic Review of Malaysian Prevalence Studies. Malaysian Journal of Medical Sciences, 33(1), 14–26. https://doi.org/10.21315/mjms-08-2025-592 DOI: https://doi.org/10.21315/mjms-08-2025-592
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mam Yien Ng, Madhubala Bava Harji, Fakhruddin Shamsheer Barodawala
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
