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Coco L, Leon K, Navarro C, Piper R, Carvajal S, Marrone N. "Close to My Community": A Qualitative Study of Community Health Worker-Supported Teleaudiology Hearing Aid Services. Ear Hear 2024; 45:1191-1201. [PMID: 38812073 PMCID: PMC11333189 DOI: 10.1097/aud.0000000000001507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVES Given well-documented disparities in rural and minority communities, alternative service delivery models that help improve access to hearing care are needed. This article reports on a study of older Latino adults with hearing loss who received hearing aid services with Community Health Workers (CHWs) providing support via teleaudiology. The present study used qualitative data to explore perceptions of this novel service delivery model. DESIGN Participants completed semistructured interviews related to their experiences in the intervention approximately 17 weeks after the hearing aid fitting appointment. Two coders independently coded the data, using an iterative deductive and inductive thematic analysis approach. Inter-rater reliability was good (κ = 0.80). RESULTS Of the 28 participants, 19 were interviewed (CHW group: n = 9, 8 females; non-CHW group: n = 10, 9 females). Both groups of participants reported experiencing barriers in access to care and reported positive experiences with teleaudiology and with hearing aids as part of the trial. CHW group participants reported interactions with patient-site facilitators that were indicative of patient-centeredness. CONCLUSIONS Results demonstrate the feasibility and potential effectiveness of trained CHWs as patient-site facilitators in teleaudiology-delivered hearing aid services for adults.
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Affiliation(s)
- Laura Coco
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ
| | - Kimberly Leon
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ
- Department of Psychology, University of Arizona, Tucson, AZ
| | | | - Rosie Piper
- Mariposa Community Health Center, Nogales, AZ
| | - Scott Carvajal
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Nicole Marrone
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ
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Nix EP, Davis AG, Brown KD, Panoncillo SG, Thompson NJ, Overton AB, Dedmon MM, Dillon MT. Demographic Representation in Clinical Research Relative to a Cochlear Implant Patient Population. Laryngoscope 2024; 134:4101-4110. [PMID: 38656740 DOI: 10.1002/lary.31467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Research samples that are representative of patient populations are needed to ensure the generalizability of study findings. The primary aim was to assess the efficacy of a study design and recruitment strategy in obtaining a participant sample that was representative of the broader cochlear implant (CI) patient population at the CI center. A secondary aim was to review whether the CI recipient population was representative of the state population. METHODS Demographic variables were compared for a research participant sample (n = 79) and the CI patient population (n = 338). The participant sample was recruited from the CI patient population. The study design included visits that were at the same location and frequency as the recommended clinical follow-up intervals. The demographics for the combined group (participant sample and patient population) were then compared to the reported demographics for the population in North Carolina. RESULTS There were no significant differences between the participant sample and patient population for biological sex, age at implantation, racial distribution, socioeconomic position, degree of urbanization, or drive time to the CI center (p ≥ 0.086). The combined CI recipient population was significantly different from the North Carolina population for the distributions of race, ethnicity, and degree of urbanization (p < 0.001). CONCLUSION The study design and recruitment strategy allowed for recruitment of a participant sample that was representative of the CI patient population. Disparities in access to cochlear implantation persist, as supported by the significant differences in the combined CI recipient population and the population for our state. LEVEL OF EVIDENCE 3 Laryngoscope, 134:4101-4110, 2024.
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Affiliation(s)
- Evan P Nix
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Amanda G Davis
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Stephanie G Panoncillo
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Nicholas J Thompson
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Andrea B Overton
- Department of Audiology, UNC Health, Chapel Hill, North Carolina, U.S.A
| | - Matthew M Dedmon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Margaret T Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
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Warren SE, Lopez LC, Anthony T, Coco L. Communication Public Health: An Integration of Audiology, Speech-Language Pathology, and Public Health. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-18. [PMID: 39083459 DOI: 10.1044/2024_jslhr-23-00491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE Health care is advancing toward a collaborative and integrative approach that promotes general health and wellness while addressing health inequities through the consideration of broader social and economic factors that influence the well-being of the entire population. Recently, there has been growing evidence of public health concept applications in fields related to speech, language, and hearing. However, there is an outstanding need to explicitly define the intersection of public health, including prevention and health promotion, and the discipline of communication sciences and disorders (CSD) across the areas of education, clinical practice, research, and policy. The authors propose a definition for this intersection using the new term communication public health. METHOD This tutorial provides guidance on how to conceptualize communication public health and invites refinement and expansion of the intersection between public health and CSD. Because readers are experts in CSD, this tutorial aims to supplement existing knowledge with information on public health to achieve three main objectives: (a) increase knowledge of the application of public health concepts among speech, language, hearing, and related professionals (SLHP+); (b) introduce the concept of communication public health; and (c) discuss the relevance of communication public health across domains within CSD. The authors utilize the socioecological model to provide examples of applications. RESULTS The concept of communication public health is proposed as the collaborative area of CSD and public health, which encompasses prevention and promotion of equity in communication health through individual-, community-, and population-level efforts. The goals of communication public health are achieved through applications of public health principles in CSD education, clinical practice, research, and policy. CONCLUSION Communication public health defines an area of collaboration between public health and CSD in which SLHP+ can apply public health concepts to both advance communication health and address health disparities.
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Affiliation(s)
- Sarah E Warren
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Leslie C Lopez
- Department of Communication Disorders, School of Allied Health Professions, Louisiana State University Health Sciences Center, New Orleans
| | - Teresa Anthony
- College of Public Health, University of South Florida, Tampa
| | - Laura Coco
- School of Speech, Language, and Hearing Sciences, College of Health and Human Services, San Diego State University, CA
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Kepper M, L'Hotta A, Shato T, Kwan BM, Glasgow RE, Luke D, Graham AK, Baumann AA, Brownson RC, Morse B. Supporting Teams with Designing for Dissemination and Sustainability: the Design, Development, and Usability of a Digital Interactive Platform. RESEARCH SQUARE 2024:rs.3.rs-4276919. [PMID: 38853949 PMCID: PMC11160915 DOI: 10.21203/rs.3.rs-4276919/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background The use of Designing for Dissemination and Sustainability (D4DS) principles and methods can support the development of research products (interventions, tools, findings) to match well with the needs and context of the intended audience and setting. D4DS principles and methods are not well-known or used during clinical and public health research; research teams would benefit from applying D4DS. This paper presents the development of a new digital platform for teams to learn and apply a D4DS process to their work. Methods A user-centered design (UCD) approach engaged users (n=14) and an expert panel (n=6) in an iterative design process from discovery to prototyping and testing. We led five design sessions using Zoom and Figma software over a 5-month period. Users (71% academics; 29% practitioners) participated in at least 2 sessions. Following design sessions, feedback from users were summarized and discussed to generate design decisions. A prototype was then built and heuristically tested with 11 users who were asked to complete multiple tasks within the platform while verbalizing their decision-making using the 'think aloud' procedure. The System Usability Scale (SUS) was administered at the end of each testing session. After refinements to the platform were made, usability was reassessed with 7 of 11 same users to examine changes. Results The interactive digital platform (the D4DS Planner) has two main components: 1) the Education Hub (e.g., searchable platform with literature, videos, websites) and 2) the Action Planner. The Action Planner includes 7 interactive steps that walk users through a set of activities to generate a downloadable D4DS action plan for their project. Participants reported that the prototype tool was moderately usable (SUS=66) but improved following refinements (SUS=71). Conclusions This is a first of its kind tool that supports research teams in learning about and explicitly applying D4DS to their work. The use of this publicly available tool may increase the adoption, impact, and sustainment of a wide range of research products. The use of UCD yielded a tool that is easy to use. The future use and impact of this tool will be evaluated, and the tool will continue to be refined and improved.
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Affiliation(s)
- Maura Kepper
- Washington University In St Louis: Washington University in St Louis
| | - Allison L'Hotta
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Thembekile Shato
- Washington University In St Louis: Washington University in St Louis
| | - Bethany M Kwan
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Russell E Glasgow
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Douglas Luke
- Washington University In St Louis: Washington University in St Louis
| | | | - Ana A Baumann
- Washington University in St Louis School of Medicine
| | - Ross C Brownson
- Washington University In St Louis: Washington University in St Louis
| | - Brad Morse
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
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Bennett RJ, Bucks RS, Saulsman L, Pachana NA, Eikelboom RH, Meyer CJ. Evaluation of the Ask-Inform-Manage-Encourage-Refer Intervention and Its Implementation Targeting the Provision of Mental Wellbeing Support Within the Audiology Setting. Ear Hear 2024; 45:600-616. [PMID: 38148508 DOI: 10.1097/aud.0000000000001452] [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: 12/28/2023]
Abstract
OBJECTIVES The ask, inform, manage, encourage, refer (AIMER) program is a behavior change intervention designed to increase the frequency with which hearing healthcare clinicians (HHCs) ask about and provide information regarding mental wellbeing within adult audiology services. The objective of this study was to systematically evaluate the first iteration of the AIMER program to determine whether the intervention achieved the changes in HHC behaviors anticipated and to evaluate feasibility of implementing the AIMER program based on the implementation protocol. DESIGN The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide this evaluation. Data were collected from October 2020 to February 2022 and included both quantitative and qualitative measures (i.e., observation reports, staff surveys, clinical diaries, clinical file audits, and interviews). RESULTS Comparison between pre- and post-implementation data showed that the AIMER intervention successfully increased: (i) HHC's skills and confidence for discussing mental wellbeing; (ii) how often HHCs ask about mental wellbeing within audiology consultations; (iii) how often HHCs provide personalized information and support regarding mental wellbeing within audiology consultations; and (iv) how often HHCs use mental wellbeing terms within clinical case notes and general practitioner reports. The factors affecting feasibility of implementing the AIMER program within the clinical setting could be classified into three major categories: (i) the AIMER program itself and its way of delivery to clinical staff; (ii) people working with the AIMER program; and (iii) contextual factors. Key recommendations to improve future implementation of the AIMER program were provided by the participants. CONCLUSIONS The AIMER program was shown to be effective at increasing the frequency with which HHCs ask about and provide information regarding mental wellbeing within routine audiological service delivery. Implementation of the AIMER program was feasible but leaves room for improvement. Use of the reach, effectiveness, adoption, implementation, and maintenance framework facilitated systematic evaluation of multiple indicators providing a broad evaluation of the AIMER program. Our analysis helps to better understand the optimal levels of training and facilitation and provides recommendations to improve future scale-up of the AIMER program. The findings of this study will be used to further adapt and improve the AIMER program and to enhance program implementation strategies before its further dissemination.
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Affiliation(s)
- Rebecca J Bennett
- National Acoustic Laboratories, Sydney, Australia
- Ear Science Institute Australia, Subiaco, Australia
- Centre for Ear Sciences, The University of Western Australia, Perth, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Romola S Bucks
- The Raine Study, School of Population and Global Health, The University of Western Australia, Perth, Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia
- Centre for Ear Sciences, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Carly J Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Ogungbe O, Longenecker CT, Beaton A, de Loizaga S, Brant LCC, Turkson Ocran RN, Bastani P, Sarfo FS, Commodore‐Mensah Y. Advancing Cardiovascular Health Equity Globally Through Digital Technologies. J Am Heart Assoc 2024; 13:e031237. [PMID: 38226506 PMCID: PMC10926780 DOI: 10.1161/jaha.123.031237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/30/2023] [Indexed: 01/17/2024]
Abstract
Cardiovascular diseases (CVDs) remain the leading cause of death and disability worldwide. Digital health technologies are important public health interventions for addressing the burden of cardiovascular disease. In this article, we discuss the importance of translating digital innovations in research-funded projects to low-resource settings globally to advance global cardiovascular health equity. We also discuss current global cardiovascular health inequities and the digital health divide within and between countries. We present various considerations for translating digital innovations across different settings across the globe, including reciprocal innovation, a "bidirectional, co-constituted, and iterative exchange of ideas, resources, and innovations to address shared health challenges across diverse global settings." In this case, afferent reciprocal innovations may flow from high-income countries toward low- and middle-income countries, and efferent reciprocal innovations may be exported to high-income countries from low- and middle-income countries with adaptation. Finally, we discuss opportunities for bidirectional learning between local and global institutions and highlight examples of projects funded through the American Heart Association Health and Innovation Strategically Funded Research Network that have been adapted to lower-resource settings or have the potential to be adapted to lower-resource settings.
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Affiliation(s)
| | - Chris T. Longenecker
- Division of Cardiology and Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Andrea Beaton
- Heart Institute, Cincinnati Children’s Hospital Medical CenterCincinnatiOHUSA
| | - Sarah de Loizaga
- Heart Institute, Cincinnati Children’s Hospital Medical CenterCincinnatiOHUSA
- University of Cincinnati College of MedicineCincinnatiOHUSA
| | - Luisa Campos Caldeira Brant
- Faculty of Medicine and Telehealth Center, Hospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Ruth‐Alma N. Turkson Ocran
- Beth Israel Deaconess Medical Center, Division of General MedicineBostonMAUSA
- Havard Medical SchoolBostonMAUSA
| | - Pouya Bastani
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Fred Stephen Sarfo
- Division of Neurology, Department of MedicineKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Yvonne Commodore‐Mensah
- Johns Hopkins School of NursingBaltimoreMDUSA
- Department of EpidemiologyBloomberg School of Public HealthBaltimoreMDUSA
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Luigi-Bravo G, Maria Ramirez A, Gerdts C, Gill R. Lessons learned from developing and implementing digital health tools for self-managed abortion and sexual and reproductive healthcare in Canada, the United States, and Venezuela. Sex Reprod Health Matters 2023; 31:2266305. [PMID: 37870150 PMCID: PMC10595388 DOI: 10.1080/26410397.2023.2266305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Affiliation(s)
| | | | - Caitlin Gerdts
- Vice President for Research, Ibis Reproductive Health, Oakland, CA, USA
| | - Roopan Gill
- Executive Director and Co-founder, Vitala Global Foundation, Vancouver, Canada
- Clinician Investigator, Assistant Professor, Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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Reavis KM, Bisgaard N, Canlon B, Dubno JR, Frisina RD, Hertzano R, Humes LE, Mick P, Phillips NA, Pichora-Fuller MK, Shuster B, Singh G. Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health. Ear Hear 2023; 44:10-27. [PMID: 36384870 PMCID: PMC10234332 DOI: 10.1097/aud.0000000000001291] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.
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Affiliation(s)
- Kelly M Reavis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA.,OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Barbara Canlon
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert D Frisina
- Department of Medical Engineering and Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Ronna Hertzano
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Institute for Genome Science, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
| | - Paul Mick
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | | | - Benjamin Shuster
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
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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.
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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
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11
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Abstract
In this Viewpoint from officials at NIH and FDA, the authors discuss research collaborations between federal agencies and the private sector, using new regulations for over-the-counter hearing aids as an illustration.
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Affiliation(s)
- Debara L Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
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