As we age, changes in vision are common. For millions of older adults, however, vision changes can be profound, going far beyond needing glasses. Low vision is distinct from total blindness and brings a different set of challenges as people with low vision try to maintain their daily routines. With the aging population in the United States growing rapidly, the number of older adults with vision loss due to diseases and disorders is projected to increase 1. Many of these older adults will experience varying levels of low vision with issues that cannot be corrected with reading glasses, contact lenses, medical treatment, or surgery 2. Therefore, having access to the right tools and support systems can be crucial for maintaining independence and adapting to their changing vision.

Braille Institute of America (Braille Institute) is a nonprofit organization based in Southern California that has been providing free programs for people with blindness and low vision for over 100 years. Braille Institute partnered with Vital Research, LLC (Vital) to help chart a more defined roadmap to guide expanding services for adults with low vision. Vital conducted a comprehensive needs assessment to uncover unmet needs not currently addressed by Braille Institute’s services, identify barriers to accessing services, and explore innovative strategies to engage individuals with low vision, both virtually and in-person. We used a daily diary method to gain deeper insight into the everyday realities of adults with low vision and captured the voices, routines, adjustments, and challenges of participants in real time.

Using Daily Diaries to Capture Lived Experiences

For the needs assessment, Vital considered using various research methods including secondary data analysis, surveys, focus groups, and interviews to answer Braille Institute’s questions. Vital decided to use a comprehensive daily diary method 3 to capture the breadth and nuances of daily challenges experienced by older adults with low vision. Unlike surveys or interviews that provide only a single snapshot in time, daily diaries allowed us to observe how needs and barriers shifted for participants across multiple days in varied, real-world contexts.

Thirty-one participants were asked to reflect on their day and answer a set of structured questions in English or Spanish for five consecutive days, either using an online form or talking to a researcher by phone. To enrich the findings, we included a culminating interview that gave each participant the opportunity to review their own diary data, reflect on the experiences they recorded, and provide additional context about how representative those experiences were of their daily lives.

Key Advantages of the Daily Diary Method

We found that the daily diary method revealed insights that a single interview or survey would likely have missed. The daily diary method had the following advantages for understanding the experiences of adults with low vision:

  • Increased participant awareness of vision issues: The daily diary method helped participants become more aware of their vision needs over time. Participants mentioned they thought about some daily diary questions during the day, which helped them notice how they were adapting their lifestyle to their vision. By the end of the five days, several participants were surprised to realize how much they were already adjusting for their vision concerns.
  • Increased variability in the data: The period of five days also helped to increase the variability of the data as participants tended to engage in different activities across the five days. For example, for working participants, having a mix of weekday and weekend days was important to capture work-related challenges as well as challenges related to hobbies, recreation, and socializing.
  • Ability to detect patterns in data: By collecting information for several consecutive days patterns in some issues were revealed. For example, participants recorded consistent challenges with vision in certain types of lighting across several days due to the time of day or weather.

Layering Research Methods for a Deeper Understanding

After participants completed the daily diary protocol, we analyzed individual results and used those findings to frame in-depth interviews with each participant. While the daily diary method helped to capture challenges faced, interviews gave participants the opportunity to describe the impact of vision challenges on their lives while sharing more detail on strategies they used to adapt to changes in their vision. Interview data in conjunction with daily diary data provided a comprehensive view of challenges, unmet needs, and access to resources.

Vital concluded the study by conducting focus groups to test out ideas for new programming to improve Braille Institute’s reach and better meet the needs of adults with low vision. This sequential approach to data collection enabled us to ask relevant and targeted questions during the focus groups that then translated into clear recommendations for Braille Institute’s strategic next steps.

Innovative Methods to Answer Pressing Questions

The strength of our needs assessment approach came from selecting the appropriate methods for our guiding research questions and layering them sequentially. Daily diaries over five consecutive days captured immediate and varied experiences while interviews and focus groups added context and nuance. Together, they answered the study’s key questions, validated existing thinking at Braille Institute, and surfaced promising directions to explore.

Vital presented synthesized findings and representative quotes with the Board, leadership, and program teams at Braille Institute to align implications and next steps. Braille Institute is now using the needs assessment findings to guide strategic outreach and expansion so they can better serve people with low vision.

Looking to conduct a needs assessment or use research to inform your strategic planning? Interested in learning more about the research and evaluation services Vital offers? Please contact our Partner working in this area, Cathy Coddington, PhD.


1DeMott, K. (2016, May 19). Visual impairment, blindness cases in U.S. expected to double by 2050. National Eye Institute. https://www.nei.nih.gov/about/news-and-events/news/visual-impairment-blindness-cases-us-expected-double-2050

2 National Eye Institute. (2024, December). Low Vision. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/low-vision

3 Gunthert, K. C., & Wenze, S. J. (2012). Daily diary methods. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 144–159). The Guilford Press.