1
|
Wiley K, Johnson J, Coleman C, Olson C, Chuo J, McSwain D. Translating Value Across Telehealth Stakeholders: A Rapid Review of Telehealth Measurement Evidence and a New Policy Framework to Guide Telehealth Researchers. Telemed J E Health 2024. [PMID: 38563764 DOI: 10.1089/tmj.2023.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Introduction: The surge in virtual care during the pandemic was accompanied by an increase in telehealth data of interest to policy stakeholders and other health care decision makers. However, these data often require substantial preprocessing and targeted analyses to be usable. By deliberately evaluating telehealth services with stakeholder perspectives in mind, telehealth researchers can more effectively inform clinical and policy decision making. Objective: To examine existing literature on telehealth measurement and evaluation and develop a new policy-oriented framework to guide telehealth researchers. Materials and Methods: A systematic rapid review of literature on telehealth measurement and evaluation was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The findings were analyzed and applied to the Supporting Pediatric Research on Outcomes and Utilization of Telehealth Evaluation and Measurement (STEM) Framework through the lens of key health care delivery decision makers to create a STEM Policy Framework Results: An initial search yielded 2,324 peer-reviewed articles and gray literatyre from 2012 to 2022, of which 56 met inclusion criteria. These measured and evaluated telehealth access (41.5%), quality (32.1%), cost (15.1%), experience (5.7%), and utilization (5.7%), consistent with the STEM Framework domains, but there was no universal approach. The STEM Policy Framework focuses this literature by describing data measures for each domain from the perspectives of five stakeholders. Conclusions: Literature describing measurement and evaluation approaches for telehealth is limited and not standardized, with few considering policy stakeholder perspectives. With this proposed STEM Policy Framework, we aim to improve this body of literature and support researchers seeking to inform telehealth policy through their work.
Collapse
Affiliation(s)
- Kevin Wiley
- Department of Health Care Leadership and Management, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jada Johnson
- Department of Health Care Leadership and Management, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christina Coleman
- Department of Pediatrics, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Christina Olson
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - John Chuo
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David McSwain
- Department of Pediatrics, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
2
|
Bennett RJ, Kelsall-Foreman I, Barr C, Campbell E, Coles T, Paton M, Vitkovic J. Barriers and facilitators to tele-audiology service delivery in Australia during the COVID-19 pandemic: perspectives of hearing healthcare clinicians. Int J Audiol 2023; 62:1145-1154. [PMID: 36194040 DOI: 10.1080/14992027.2022.2128446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the utilisation, safety, cost, and patient outcomes of delivering tele-audiology services during the COVID-19 pandemic. DESIGN A national cross-sectional self-report online survey asking participants to reflect on interactions with hearing services between April and October 2020. Data were analysed using descriptive statistics. The COM-B model of behaviour change guided survey creation and the presentation of a subset of the results. STUDY SAMPLE 249 Australia-based hearing healthcare clinicians (age range 23-74 years; 162 female). RESULTS Clinicians reported an increase in the use of tele-audiology services, with key drivers relating to keeping their patients safe and keeping businesses running. Clinicians generally viewed the provision of tele-audiology services as successful and resulting in improved patient outcomes. Overall, clinicians were highly motivated to provide tele-audiology services, and they expressed being confident in their knowledge and understanding of tele-audiology service delivery. Barriers to providing tele-audiology services included concerns about the reliability of the results obtained from remote assessments, as well as concerns around information security and privacy issues. CONCLUSIONS Clinicians' motivations to use tele-audiology services appeared to be driven by their desire to maintain COVID-safe practices during the pandemic and by the COVID-driven increase in availability of funding for tele-audiology services.
Collapse
Affiliation(s)
- Rebecca J Bennett
- Brain and Hearing, University of Western Australia, Crawley, Western Australia, Australia
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, Western Australia, Australia
| | - India Kelsall-Foreman
- Brain and Hearing, University of Western Australia, Crawley, Western Australia, Australia
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, Western Australia, Australia
| | - Caitlin Barr
- Soundfair Australia Ltd, Melbourne, Victoria, Australia
| | | | - Tony Coles
- Audiology Australia, Cremorne, Victoria, Australia
| | - Mark Paton
- Australian College of Audiology (ACAud), Spring Hill, Queensland, Australia
| | | |
Collapse
|
3
|
Ramkumar V, Shankar V, Kumar S. Implementation factors influencing the sustained provision of tele-audiology services: insights from a combined methodology of scoping review and qualitative semistructured interviews. BMJ Open 2023; 13:e075430. [PMID: 37875289 PMCID: PMC10603431 DOI: 10.1136/bmjopen-2023-075430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/28/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVES The objectives of the current study were to (a) identify long-term tele-audiology services reported to be implemented beyond the research phase and determine whether they are sustained, (b) map the implementation process to Standards for Reporting Implementation Studies guidelines and (c) map the factors that influenced its sustainability to the Implementation Outcomes Framework (IOF) to understand the gaps from an implementation research perspective. STUDY DESIGN, SETTING AND PARTICIPANTS This cross-sectional study included a scoping review of articles describing long-term tele-audiology services from around the world to determine the factors influencing the implementation. Six electronic databases (PubMed, Cochrane Library, Web of Science, Scopus, Google Scholar and ProQuest) were searched for literature published between 2010 and 2023. This was followed by semistructured interviews (SSIs), which were guided by the IOF. Six project implementers were interviewed to obtain an in-depth understanding of factors that influenced sustainability of these tele-audiology services. Thematic analysis of the interview transcripts was carried out using a hybrid inductive-deductive approach. RESULTS Data were extracted from 32 tele-audiology studies included in the review, which were then mapped to 21 projects. The findings of the scoping review reveal that tele-audiology services were predominantly provided using synchronous telepractice methods. The 'professional-facilitator-patient' model was most commonly used. None of the studies reported the use of implementation research and/or outcome frameworks. Factors that influenced sustainability of tele-audiology services were identified from the combined results of the scoping review and the SSIs. These factors could be mapped to implementation outcomes of acceptability, adoption, feasibility, implementation cost and sustainability. CONCLUSION Implementation research and/or outcome framework should be used to guide the implementation processes, its evaluation and measurement of outcomes systematically in tele-audiology service delivery. When such frameworks are used, gaps in information regarding the context influencing implementation, reporting of fidelity and adaptability measures can be addressed.
Collapse
Affiliation(s)
- Vidya Ramkumar
- Department of Audiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Varsha Shankar
- Department of Audiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Shuba Kumar
- Social Scientist, Samarth, Non-Government Organisation, Chennai, Tamil Nadu, India
| |
Collapse
|
4
|
Winter N, McMillan K, Finch J, da Silva D, Whitehead A, Harvey D, McBride LJ, Hickson L, Theodoros D, Russell T. Evaluation of a teleaudiology service in regional Australia. Int J Audiol 2023; 62:964-972. [PMID: 35980839 DOI: 10.1080/14992027.2022.2108913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 07/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Evaluate accessibility, effectiveness, acceptability and efficiency of a student- assisted teleaudiology model of care in a regional hospital in Queensland, Australia. DESIGN Prospective mixed method service evaluation study. STUDY SAMPLE Demographic, service and satisfaction data were collected from 233 patients (children aged ≥5 and adults) who received teleaudiology assessment. Satisfaction data was collected from 27 hospital clinic staff (medical, nursing and clinic assistants) and 28 university audiology clinical educator participants. Experience and satisfaction data were collected from 16 teleaudiology clinic university students. Quantitative data was analysed using SPSS software. Qualitative data were analysed using inductive content analysis. RESULTS Following introduction of the teleaudiology service in 2017 and evaluation during the first 6 months, 95% of patients were able to access audiology assessments on the same day as their Ear, Nose and Throat appointments. New referrals to the service were seen within a month. The audiology assessment battery was completed 95% of the time within an average of 33 minutes by the end of the study period. Patients, hospital and university staff and students reported high satisfaction with their experiences of teleaudiology, including its convenience and efficiency. CONCLUSIONS A student-assisted teleaudiology model of care can deliver accessible, effective, and efficient services with high levels of satisfaction by participants.
Collapse
Affiliation(s)
- Natalie Winter
- Queensland Department of Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
| | - Katie McMillan
- Queensland Department of Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
| | - Jennifer Finch
- Queensland Department of Health, Allied Health Professions Office of Queensland, Brisbane, Australia
| | - David da Silva
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| | - Andrea Whitehead
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| | - Desley Harvey
- Queensland Department of Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- College of Healthcare Sciences, James Cook University, Cairns, Australia
| | - Liza-Jane McBride
- Queensland Department of Health, Allied Health Professions Office of Queensland, Brisbane, Australia
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| | - Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| |
Collapse
|
5
|
Tucci A, Choi E. Developmental Language Disorder and Writing: A Scoping Review From Childhood to Adulthood. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2900-2920. [PMID: 37459603 DOI: 10.1044/2023_jslhr-22-00583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
PURPOSE The purpose of this study was to conduct a scoping review of literature focused on the effects of developmental language disorder (DLD) on writing skills across the life span to highlight gaps in our knowledge of how to support writing for this population. METHOD We adopted the five-step framework for conducting scoping reviews outlined by Arksey and O'Malley (2005) to identify literature focused on writing outcomes for individuals with DLD in childhood, adolescence, and adulthood. RESULTS Seventy-two studies from 1991 to 2022 met review criteria. Results indicated that spelling may be an area of relative weakness for individuals with DLD across the life span. Children and adolescents with DLD also may have relative difficulty with grammar, organization, cohesion, and length of written output. Research on the writing skills of adults with DLD is too sparse to draw broad conclusions about the writing skills of this subset of the population with DLD. CONCLUSIONS Overall, research into the writing skills of individuals with DLD is limited, and more information is needed to inform functional evidence-based approaches to assessment and intervention of writing for those with DLD from childhood through adulthood. Additionally, more focus on electronic writing in research is needed, as only two studies included in this review examined typed writing in any form. Results of this review also indicate a need for systematic, uniform approaches to defining and measuring writing skills for those who experience language difficulties. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23596797.
Collapse
Affiliation(s)
| | - Elizabeth Choi
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| |
Collapse
|
6
|
Kuschke S, Moodie S, Kirubalingam K, O'Hagan R, Glista D. Parents' Perceptions of the Factors Influencing the Uptake of Remote Pediatric Hearing Aid Support: Development of a Conceptual Framework. JMIR Pediatr Parent 2023; 6:e47358. [PMID: 37279061 DOI: 10.2196/47358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/27/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND To achieve effective integration of virtual care into family-centered audiology practices, participatory research methods, including parents as vital participants in the delivery of pediatric audiology care, should be considered. A better understanding of the barriers and facilitators influencing the adoption of virtual care for families is warranted. OBJECTIVE This study aimed to develop a conceptual framework of the factors perceived to influence the adoption of remote pediatric hearing aid support among the parents of children with hearing loss. METHODS A total of 12 parents of children who wear hearing aids, between the ages of 0-17 years, were recruited to participate in group or individual interviews as part of the 6-step participatory-based concept mapping (CM) process. Data collection was specific to parents in a Canadian context. Analyses included multidimensional scaling and hierarchical cluster analysis. RESULTS The CM process resulted in 6 main themes, displayed in a cluster map according to their order of importance. These themes include access to timely, consistent care; technology considerations; convenience; child engagement; cost; and partnership considerations. Key underlying statements and subthemes are highlighted per theme. CONCLUSIONS Findings from this study demonstrate the use of CM in participatory research with parents and as part of a family-centered care model. Future research should aim to investigate the factors that influence the uptake of remote hearing aid support in different contexts, for example, in low- to middle-income countries versus those in high-income countries.
Collapse
Affiliation(s)
| | - Sheila Moodie
- School of Communication Sciences and Disorders, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
- National Centre for Audiology, The University of Western Ontario, London, ON, Canada
| | - Keshinisuthan Kirubalingam
- Department of Otolaryngology - Head & Neck Surgery, The University of Western Ontario, London, ON, Canada
| | - Robin O'Hagan
- National Centre for Audiology, The University of Western Ontario, London, ON, Canada
| | - Danielle Glista
- School of Communication Sciences and Disorders, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
- National Centre for Audiology, The University of Western Ontario, London, ON, Canada
| |
Collapse
|
7
|
Ramkumar V, Krumm M. Tele-audiology diagnostic testing services for children with disabilities in a school setting: A pilot study. Int J Pediatr Otorhinolaryngol 2023; 165:111426. [PMID: 36587539 DOI: 10.1016/j.ijporl.2022.111426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Children with disabilities (CWDs) having comorbidities face challenges in accessing and completing diagnostic hearing evaluations. This study was conducted to determine whether a tele-audiology diagnostic test battery can be administered to school-aged CWDs having comorbidities in a school-setting. DESIGN A proof-of-concept pilot study using a cross-sectional design. STUDY SAMPLE Ten typically developing children between 3 years 9 months and 10 years 9 months of age; mean age of 8 years 3 months (pilot-norm group) and seven CWDs having comorbidities between 3 years and 8 years and 1 month of age; mean age of 5 years and 2 months (CWD group) participated in the study. A diagnostic test protocol delivered via tele-audiology was first administered to the pilot-norm group to ensure its efficiency and suitability for use in the CWD group. Following modifications, the diagnostic test protocol was delivered for CWDs. RESULTS We identified key aspects, including the role of the facilitator in conducting a diagnostic test battery using tele-audiology on CWDs, the usefulness of having co-facilitators to support child-friendly testing, as well as technology-related requirements. With respect to tele-audiology diagnostic testing, it was possible to quickly assess peripheral hearing using synchronous tele video-otoscopy, tympanometry, and DPOAEs. We identified limitations in conducting behavioral audiometry and completing tone-burst ABRs in CWDs. CONCLUSION Evidence was obtained from this exploratory pilot study that a tele-audiology diagnostic test battery can be administered in a school setting to school-aged CWDs having comorbidities. Tele-audiology can be considered to provide hearing healthcare services to school-aged CWDs who may otherwise not receive these services.
Collapse
Affiliation(s)
- Vidya Ramkumar
- Faculty of Audiology and Speech, Language Pathology, Sri Ramachandra Institute for Higher Education and Research, Chennai, India.
| | - Mark Krumm
- Department of Speech Pathology and Audiology, School of Health Sciences, Kent State University, Kent, OH, USA
| |
Collapse
|
8
|
Coco L, Carvajal S, Navarro C, Piper R, Marrone N. Community Health Workers as Patient-Site Facilitators in Adult Hearing Aid Services via Synchronous Teleaudiology: Feasibility Results from the Conexiones Randomized Controlled Trial. Ear Hear 2023; 44:28-42. [PMID: 36253920 PMCID: PMC9780168 DOI: 10.1097/aud.0000000000001281] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the feasibility of Community Health Workers (CHWs) as patient-site facilitators in teleaudiology-facilitated hearing aid services to improve hearing aid rehabilitation outcomes for older Hispanic/Latino adults in a medically underserved, rural, US-Mexico border community. DESIGN A total of 28 adults (aged 55 to 89) with bilateral hearing loss participated in this study. Individuals were randomized to one of two teleaudiology intervention arms that differed at the level of the patient-site facilitator. Participants in the experimental group were assisted locally by trained CHW facilitators. Participants in the control group were assisted locally by trained university student facilitators. Synchronous (real-time) teleaudiology hearing aid services took place with participants located at a rural community health center and the clinician located a university 70 miles away. The results of this feasibility study are presented within the reach, effectiveness, adoption, implementation fidelity, and maintenance implementation framework. RESULTS Regarding reach, the participants in this study population are historically under-represented in research (primarily low-income Hispanic/Latino older adults). A total of 57 individuals were recruited, 47 were consented and assessed for eligibility and 28 individuals met inclusion criteria and were randomized. The average age of participants was 73.9 years, (range: 55 to 89 years) and most individuals were female (75%). Most participants (86%) reported having incomes less than $20,000 annually. Effectiveness results (via the Self Efficacy for Situational Communication Management Questionnaire) showed that both groups (CHW and control) significantly improved listening self-efficacy from pre-fitting baseline and no difference between groups was observed. Regarding datalogging, at the short-term follow-up, participants in the CHW group wore their hearing aids for more hours/day on average compared with participants in the control group. Implementation fidelity was high for both groups. Long-term maintenance of CHW-supported teleaudiology appears feasible given that training and institutional support is in place. CONCLUSIONS Teleaudiology-delivered hearing aid services were feasible when facilitated locally by trained CHWs. Future efficacy and effectiveness research is warranted with CHWs and teleaudiology, potentially leading to a significant reduction in barriers for rural and medically under-resourced communities.
Collapse
Affiliation(s)
- Laura Coco
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA
| | - Scott Carvajal
- Health Behavior Health Promotion, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - Rosie Piper
- Mariposa Community Health Center, Nogales, AZ
| | - Nicole Marrone
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
| |
Collapse
|
9
|
DiFabio D, Moodie S, O’Hagan R, Pardal S, Glista D. Barriers and facilitators to paediatric caregivers' participation in virtual speech, language, and hearing services: A scoping review. Digit Health 2023; 9:20552076231216684. [PMID: 38033515 PMCID: PMC10687955 DOI: 10.1177/20552076231216684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Virtual care-related technologies are transforming the way in which health services are delivered. A growing number of studies support the use of virtual care in the field of audiology and speech-language pathology; however, there remains a need to identify and understand what influences caregiver participation within the care that is virtual and family-focused. This review aimed to identify, synthesize, and summarize the literature around the reported barriers and facilitators to caregiver participation in virtual speech/hearing assessment and/or intervention appointments for their child. Methods A scoping review was conducted following the Joanna Briggs Institute manual for evidence synthesis. A search was conducted using six databases including MEDLINE, CINAHL, SCOPUS, ERIC, Nursing and Allied Health, and Web of Science to collect peer-reviewed studies of interest. Data was extracted according to a protocol published on Figshare, outlining a predefined data extraction form and search strategy. Results A variety of service delivery models and technology requirements were identified across the 48 included studies. Caregiver participation was found to vary across levels of attendance and involvement according to eight categories: Attitudes, child behavioral considerations, environment, opportunities, provider-family relationship, role in care process, support, and technology. Conclusions This review presents a description of the key categories reported to influence caregiver participation in virtual care appointments. Future research is needed to explore how the findings can be used within family-centered care models to provide strategic support benefiting the use and outcomes of virtual care.
Collapse
Affiliation(s)
- Danielle DiFabio
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Sheila Moodie
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
| | - Robin O’Hagan
- The National Centre for Audiology, Western University, London, ON, Canada
| | - Simrin Pardal
- School of Health Studies, Western University, London, ON, Canada
| | - Danielle Glista
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
| |
Collapse
|
10
|
Robler SK, Coco L, Krumm M. Telehealth solutions for assessing auditory outcomes related to noise and ototoxic exposures in clinic and research. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:1737. [PMID: 36182272 DOI: 10.1121/10.0013706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/04/2022] [Indexed: 06/16/2023]
Abstract
Nearly 1.5 billion people globally have some decline in hearing ability throughout their lifetime. Many causes for hearing loss are preventable, such as that from exposure to noise and chemicals. According to the World Health Organization, nearly 50% of individuals 12-25 years old are at risk of hearing loss due to recreational noise exposure. In the occupational setting, an estimated 16% of disabling hearing loss is related to occupational noise exposure, highest in developing countries. Ototoxicity is another cause of acquired hearing loss. Audiologic assessment is essential for monitoring hearing health and for the diagnosis and management of hearing loss and related disorders (e.g., tinnitus). However, 44% of the world's population is considered rural and, consequently, lacks access to quality hearing healthcare. Therefore, serving individuals living in rural and under-resourced areas requires creative solutions. Conducting hearing assessments via telehealth is one such solution. Telehealth can be used in a variety of contexts, including noise and ototoxic exposure monitoring, field testing in rural and low-resource settings, and evaluating auditory outcomes in large-scale clinical trials. This overview summarizes current telehealth applications and practices for the audiometric assessment, identification, and monitoring of hearing loss.
Collapse
Affiliation(s)
- Samantha Kleindienst Robler
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
| | - Laura Coco
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California 92182, USA
| | - Mark Krumm
- Department of Hearing Sciences, Kent State University, Kent, Ohio 44240, USA
| |
Collapse
|
11
|
DiFabio DL, O'Hagan R, Glista D. A Scoping Review of Technology and Infrastructure Needs in the Delivery of Virtual Hearing Aid Services. Am J Audiol 2022; 31:411-426. [PMID: 35580238 DOI: 10.1044/2022_aja-21-00247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The digital health revolution has brought forward integral technological advancements enabling virtual care as a readily accessible delivery model. Despite this forward momentum, the field of audiology still faces barriers that impede the uptake of virtual services into routine clinical practice. The aim of this study was to gather, synthesize, and summarize the literature around virtual hearing aid intervention studies and the related technology and infrastructure requirements. METHOD A scoping review was conducted using MEDLINE, CINAHL, Scopus, Nursing and Allied Health, and Web of Science databases. Objectives, inclusion criteria, and scoping review methods were specified in advance and documented in a protocol. RESULTS The 11 studies identified through this review related to virtual hearing aid services delivered by a licensed health care provider and/or facilitator(s) specific to hearing aid management, programming, verification, and validation services. Service delivery models varied according to patient population, technology experience, type(s) and time course of care, type of remote location, and technology/support requirements. Barriers and facilitators to implementation-related themes including technology access and function, client sociotechnical, convenience, education and training, interaction quality, service delivery, and technology innovation. CONCLUSIONS This scoping review provides evidence around the technology and infrastructure required for full integration of virtual hearing aid services into practice and according to care type. Low-tech versus high-tech requirements may be used to guide virtual service delivery triaging efforts. Research and development efforts in the areas of pediatrics, clinical support tools, and hearing aid/app-based solutions will support further uptake of virtual service delivery in audiology.
Collapse
Affiliation(s)
- Danielle L. DiFabio
- National Centre for Audiology, University of Western Ontario, London, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Canada
| | - Robin O'Hagan
- National Centre for Audiology, University of Western Ontario, London, Canada
| | - Danielle Glista
- National Centre for Audiology, University of Western Ontario, London, Canada
- School of Communication Sciences and Disorders, Faculty of Health Sciences, University of Western Ontario, London, Canada
| |
Collapse
|
12
|
M R NN, Seethapathy J. Tele-Audiology in India: Current and Future Trends in Knowledge, Attitude, and Practice Among Audiologists. J Audiol Otol 2022; 26:130-141. [PMID: 35538867 PMCID: PMC9271733 DOI: 10.7874/jao.2021.00584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/18/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives The COVID-19 pandemic has led to widespread use of telepractice in hearing health care services. In this study, we investigated the knowledge, attitude, and practice (KAP) of tele-audiology among Indian audiologists. The current study is based on tele-practice guidelines recommended by the Indian Speech and Hearing Association for tele-audiology services in India. Subjects and Methods An internet-based KAP questionnaire survey was performed among 108 audiologists. The questionnaire included 33 items categorized under the following domains: demographic information and KAP of tele-audiology. Of the 108 audiologists included in the study, 38 admitted to the practice of tele-audiology previously and during the COVID-19 pandemic (tele-practitioners), and 70 respondents had no experience of tele-audiology (non-telepractitioners). Results Overall higher scores were observed with regard to the knowledge domain, and a mixed attitude regarding tele-practice was observed among audiologists. Most respondents acknowledged the advantages of tele-audiology in clinical practice. However, audiologists were hesitant to utilize this technology owing to the challenges associated with tele-practice. Conclusions Despite adequate awareness and a positive attitude, a gap is observed between available knowledge and its actual application/utilization in tele-audiology. Tele-audiology practice was limited to counseling, hearing impairment treatment, and troubleshooting tips for hearing aids. Evidence-based practices to perform diagnostic test battery in tele-mode, hands-on training to run diagnostic test battery/rehabilitation using a tele-mode approach, and greater understanding of the technical requirements for tele-practice may result in a positive perception and encourage tele-audiology practice among audiologists. Specialized training and regular continuing education programmes are important to promote tele-audiology services in clinical practice.
Collapse
Affiliation(s)
- Nazreen Nihara M R
- Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | | |
Collapse
|
13
|
Bondy C, Chen L, Grover P, Hanson V, Li R, Shi P. Evaluating Technology-Mediated Collaborative Workflows for Telehealth. IEEE J Biomed Health Inform 2021; 25:4308-4316. [PMID: 34637386 DOI: 10.1109/jbhi.2021.3119458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
GOALS This paper discusses the need for a predictable method to evaluate gains and gaps of collaborative technology-mediated workflows and introduces an evaluation framework to address this need. METHODS The Collaborative Space Analysis Framework (CS-AF), introduced in this research, is a cross-disciplinary evaluation method designed to evaluate technology-mediated collaborative workflows. The 5-step CS-AF approach includes: (1) current-state workflow definition, (2) current-state (baseline) workflow assessment, (3) technology-mediated workflow development and deployment, (4) technology-mediated workflow assessment, (5) analysis, and conclusions. For this research, a comprehensive, empirical study of hypertension exam workflow for telehealth was conducted using the CS-AF approach. RESULTS The CS-AF systemized approach reveals critical cross-disciplinary evaluation data concerning gains and gaps of collaborative workflows when technology-mediated enhancements are characterized and compared with a baseline workflow for the goal of continuous workflow improvement. CONCLUSION The CS-AF is an effective approach that can be adapted for use in multiple domains.
Collapse
|
14
|
Coco L, Piper R, Marrone N. Feasibility of community health workers as teleaudiology patient-site facilitators: a multilevel training study. Int J Audiol 2021; 60:663-676. [PMID: 33403874 PMCID: PMC8628855 DOI: 10.1080/14992027.2020.1864487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We evaluated the feasibility of a multi-level teleaudiology patient-site facilitator training program for Community Health Workers (CHWs) at a partnering health centre in southern Arizona. DESIGN Three levels were offered: Introductory, with basic information on hearing loss and teleaudiology; Intermediate, on technology, team roles, and access issues; and Facilitator, on further knowledge and hands-on skills to serve as patient-site facilitators in synchronous hearing aid service delivery. Six domains of feasibility were addressed using a mixed-methods design. Quantitative data included survey responses and observation of hands-on skills. Qualitative data included field notes from group discussion and open-ended survey questions, and were analysed using CHW core competencies. STUDY SAMPLE Twelve CHWs participated in the introductory training, ten moved on to intermediate, and three continued to the facilitator. RESULTS Quantitative outcomes indicated that the trainings were feasible according to each of the six domains. CHWs in the facilitator training passed the practical hands-on skill assessment. Qualitative analyses revealed CHWs comments addressed eight of the ten possible CHW core competencies, and focussed on service coordination/navigation, and capacity building. CONCLUSIONS Teleaudiology trainings for CHWs were feasible, increasing service capacity for a potential pathway to improve access to hearing health care in low-resource areas.
Collapse
Affiliation(s)
- Laura Coco
- University of Arizona, College of Science, Department of Speech, Language, and Hearing Sciences, Tucson, Arizona, USA
| | - Rosie Piper
- Mariposa Community Health Center, Nogales, Arizona, USA
| | - Nicole Marrone
- University of Arizona, College of Science, Department of Speech, Language, and Hearing Sciences, Tucson, Arizona, USA
| |
Collapse
|
15
|
Douglass H, Lowman JJ, Angadi V. Defining Roles and Responsibilities for School-Based Tele-Facilitators: Intraclass Correlation Coefficient (ICC) Ratings Of Proposed Competencies. Int J Telerehabil 2021; 13:e6351. [PMID: 34345338 PMCID: PMC8287710 DOI: 10.5195/ijt.2021.6351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The primary purpose of this study was to craft and validate a set of core competencies necessary for a tele-facilitator to possess in the school setting. Competencies were created through literature review and qualitative analysis. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) speech-language pathologists (SLPs) experienced in telepractice within a school setting; (c) current tele-facilitators, and (d) scholars experienced in telepractice. Fifty-seven percent (20 out of 35) of the competencies were rated as “Essential Skills.” The remaining competencies could be more or less important depending on workplace requirements.
Collapse
|
16
|
Tao KFM, Moreira TDC, Jayakody DMP, Swanepoel DW, Brennan-Jones CG, Coetzee L, Eikelboom RH. Teleaudiology hearing aid fitting follow-up consultations for adults: single blinded crossover randomised control trial and cohort studies. Int J Audiol 2020; 60:S49-S60. [PMID: 32964773 DOI: 10.1080/14992027.2020.1805804] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate and compare the effectiveness and quality of standard face-to-face and teleaudiology hearing aid fitting follow-up consultations and blended services for adult hearing aid users. DESIGN AND STUDY SAMPLE Fifty-six participants were randomly allocated to two equal groups, with equal numbers of new and experienced users. One standard and one teleaudiology follow-up consultation were delivered by an audiologist, the latter assisted by a facilitator. The order was reversed for the second group. Outcome measurement tools were applied to assess aspects of participants' communication, fitting (physical, sensorial), quality of life, and service. Cross-sectional and longitudinal outcomes were analysed. RESULTS Most participants presented with moderate, sloping, and symmetrical sensorineural hearing loss. The duration of teleaudiology (42.96 ± 2.73 min) was equivalent to face-to-face consultations (41.25 ± 2.61 min). All modes of service delivery significantly improved outcomes for communication, fitting, and quality of life (p > 0.05). Satisfaction for both consultation modes was high, although significantly greater with standard consultations. The mode and order of delivery of the consultations did not influence the outcomes. CONCLUSION Teleaudiology hearing aid follow-up consultations can deliver significant improvements, and do not differ from standard consultations. Blended services also deliver significant improvements. Satisfaction can be negatively impacted by technical or human-related issues.
Collapse
Affiliation(s)
- Karina F M Tao
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia.,Ear Science Institute Australia, Perth, Australia.,Ear Health Team, Telethon Kids Institute, The University of Western Australia, Perth, Australia.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.,Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Tais de C Moreira
- Department of Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Dona M P Jayakody
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia.,Ear Science Institute Australia, Perth, Australia
| | - De Wet Swanepoel
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia.,Ear Science Institute Australia, Perth, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Christopher G Brennan-Jones
- Ear Health Team, Telethon Kids Institute, The University of Western Australia, Perth, Australia.,Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.,Department of Audiology, Perth Children's Hospital, Perth, Australia
| | - Lize Coetzee
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia.,Ear Science Institute Australia, Perth, Australia
| | - Robert H Eikelboom
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia.,Ear Science Institute Australia, Perth, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
17
|
Saunders GH, Preminger JE. Introduction for the 4th International Meeting on Internet and Audiology Special Issue of the American Journal of Audiology. Am J Audiol 2020; 29:535-537. [PMID: 32852229 DOI: 10.1044/2020_aja-20-00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Gabrielle H. Saunders
- The Manchester Center for Audiology and Deafness (ManCAD), The University of Manchester Faculty of Biology Medicine and Health, United Kingdom
| | | |
Collapse
|