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Zhang L, Yu J, Zhang H, Chen S. Association between the hearing aid and mental health outcomes in people with hearing impairment: A case-control study among 28 European countries. J Affect Disord 2024; 361:536-545. [PMID: 38925313 DOI: 10.1016/j.jad.2024.06.085] [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: 03/29/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Hearing loss affects over 1.5 billion individuals globally, with significant implications for mental health. This study investigates the association between hearing aid use and mental health outcomes, by particularly focusing on depression and unmet mental health needs (UMHN), across a diverse international sample. METHODS Utilizing data from the third wave of the European Health Interview Survey (EHIS), this study involved 17,660 participants with hearing impairment from 28 countries. The study examined the association between hearing aid use and mental health outcomes, including the likelihood of moderate and severe depression and UMHN due to lack of contact with general practitioners (GPs) and mental health specialists. Logistic regression models, adjusted for socio-demographic characteristics, health risk behaviours, and other relevant variables, were employed. Inverse probability weights were used to mitigate potential selection bias. RESULTS Hearing aid usage was associated with significantly lower likelihoods of moderate depression (Odds Ratio [OR] = 0.58, 95%CI = [0.54, 0.63]) and severe depression (OR = 0.61, 95%CI = [0.55, 0.69]), compared to non-usage. Hearing aid usage was also associated with reduced UMHN due to lack of GP contact for moderate (OR = 0.82, 95%CI = [0.75, 0.89]) and severe depression (OR = 0.75, 95%CI = [0.59, 0.95]). The depression risk reductions were greater among females and higher-educated subgroups but lower in individuals aged ≥65 years. Income level and rurality also impacted UMHN due to the lack of GP contact. No associations were found between hearing aids and UMHN due to the lack of mental health specialist contact. CONCLUSIONS Hearing aid adoption showed protective associations against mood disorders and lowered unmet primary mental healthcare needs. Tailoring intervention strategies to vulnerable sociodemographic profiles could optimize mental health benefits among those with hearing loss. Integrating hearing health services within mental healthcare delivery frameworks is vital amidst the rising global burden.
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Affiliation(s)
- Liansheng Zhang
- Department of Otolaryngology, Zhumadian Centre Civil Hospital, Zhumadian 463000, China.
| | - Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
| | - Huanyu Zhang
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China.
| | - Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom.
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Pérez-Herrera LC, Peñaranda D, Moreno-López S, Guerra AM, Montes F, Sanchez-Franco SC, Sarmiento OL, Suetta-Lugo N, Peñaranda A. Extended high-frequency hearing loss among Afro-Colombian adolescents from a rural area in Colombia: a cross-sectional study. BMJ Open 2024; 14:e071445. [PMID: 39025814 PMCID: PMC11261701 DOI: 10.1136/bmjopen-2022-071445] [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: 12/30/2022] [Accepted: 05/28/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES Research trends concerning hearing loss within teen rural populations are limited and current evidence suggests that extended high-frequency audiometry can be a sensitive tool to detect subclinical hearing loss. Moreover, current research emphasises the importance of representing different ethnic populations in science. This study aimed to determine the prevalence of acquired hearing loss through conventional pure-tone (0.25-8 kHz) and extended high frequency (EHF) (9-20 kHz) audiometry in Afro-Colombian adolescents from a rural area in Colombia. DESIGN Observational, cross-sectional study. PARTICIPANTS 230 Afro-Colombian adolescents aged 13-17 years who attended high school in a rural population from Cartagena, Colombia. INTERVENTIONS Otoscopic examination, conventional (0.25-8 kHz) and EHF (9-20 kHz) audiometry tests were performed during February-March 2021. Sociodemographic and associated factor questionnaires were also applied to assess probable factors associated with EHF hearing loss. MAIN OUTCOME MEASURES Prevalence of acquired hearing loss using conventional and EHF audiometry, and factors associated with hearing loss. RESULTS Of 230 adolescents who met the eligibility criteria, 133 (57.82%) were female. The mean age was 15.22 years (SD: 1.62). The prevalence of hearing loss in at least one ear assessed with conventional audiometry was 21.30% and with EHF audiometry 14.78%. The main abnormal otoscopic findings included: neotympanum (1.30%), myringosclerosis (0.87%) and monomeric scars (0.43%). Factors associated with a higher probability of EHF hearing loss found through logistic regression were older age (prevalence ratio (PR): 1.45; 95% CI 1.16 to 1.80), attending the 'Picó' four or more times a month (PR: 6.63; 95% CI 2.16 to 20.30), attending bars more than three times a month (PR: 1.14; 95% CI 1.03 to 1.59) and self-reported hearing difficulties (PR: 1.24; 95% CI 1.22 to 4.05). CONCLUSIONS Our results suggest that acquired hearing loss is already widespread among this young rural population.
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Affiliation(s)
- Lucia C Pérez-Herrera
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Daniel Peñaranda
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Department od Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Sergio Moreno-López
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Ana Maria Guerra
- Department of Industrial Engineering, Universidad de los Andes, Bogota, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, Universidad de los Andes, Bogota, Colombia
| | | | | | | | - Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Department of Otolaryngology, Fundacion Santa Fe de Bogota, Bogota, Colombia
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Dillard LK, Der CM, Laplante-Lévesque A, Swanepoel DW, Thorne PR, McPherson B, de Andrade V, Newall J, Ramos HD, Kaspar A, Nieman CL, Clark JL, Chadha S. Service delivery approaches related to hearing aids in low- and middle-income countries or resource-limited settings: A systematic scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002823. [PMID: 38266001 PMCID: PMC10807760 DOI: 10.1371/journal.pgph.0002823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
Hearing loss is an important global public health issue which can be alleviated through treatment with hearing aids. However, most people who would benefit from hearing aids do not receive them, in part due to challenges in accessing hearing aids and related services, which are most salient in low- and middle-income countries (LMIC) and other resource-limited settings. Innovative approaches for hearing aid service delivery can overcome many of the challenges related to access, including that of limited human resources trained to provide ear and hearing care. The purpose of this systematic scoping review is to synthesize evidence on service delivery approaches for hearing aid provision in LMIC and resource-limited settings. We searched 3 databases (PubMed, Scopus, Ovid MEDLINE) for peer-reviewed articles from 2000 to 2022 that focused on service delivery approaches related to hearing aids in LMIC or resource-limited settings. Fifteen peer-reviewed articles were included, which described hospital-based (3 studies), large-scale donation program (1 studies), community-based (7 studies), and remote (telehealth; 4 studies) service delivery approaches. Key findings are that hearing aid services can be successfully delivered in hospital- and community-based settings, and remotely, and that both qualified hearing care providers and trained non-specialists can provide quality hearing aid services. Service delivery approaches focused on community-based and remote care, and task sharing among qualified hearing care providers and trained non-specialists can likely improve access to hearing aids worldwide, thereby reducing the burden of untreated hearing loss.
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Affiliation(s)
- Lauren K. Dillard
- Department of Otolaryngology- Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Carolina M. Der
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Ariane Laplante-Lévesque
- Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology—Head & Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Peter R. Thorne
- Section of Audiology and Eisdell Moore Centre, University of Auckland, Auckland, New Zealand
| | - Bradley McPherson
- Centre for Hearing Research, School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Victor de Andrade
- Department of Speech Pathology and Audiology School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - John Newall
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - Hubert D. Ramos
- Master in Clinical Audiology Program, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | | | - Carrie L. Nieman
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Jackie L. Clark
- University of Texas at Dallas–AuD Program, Dallas, Texas, United States of America
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Waterworth CJ, Marella M, Bhutta MF, Dowell R, Khim K, Annear PL. Access to ear and hearing care services in Cambodia: a qualitative enquiry into experiences of key informants. J Laryngol Otol 2024; 138:22-32. [PMID: 36154944 PMCID: PMC10772024 DOI: 10.1017/s0022215122002158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In Cambodia, little is known about the state of ear and hearing care, or the roles providers or key stakeholders play in delivering services. METHOD This was an exploratory study using semi-structured qualitative interviews and a questionnaire addressed to key stakeholders to explore their perceptions and experiences in providing services to people suffering from ear disease or hearing loss in Cambodia. RESULTS Several challenges were described including a lack of hearing services to meet the demand, especially outside Phnom Penh in primary care and aural rehabilitation. Supply-side challenges include a shortage of trained professionals, facilities and resources, poor co-ordination between providers, unclear referral pathways, and long wait times. CONCLUSION Now is an opportune time to build on the positive trend in providing integrated care for non-communicable diseases in Cambodia, through the integration of effective ear and hearing care into primary care and strengthening the package of activities delivered at government facilities.
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Affiliation(s)
- C J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M Marella
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - R Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
| | - K Khim
- Monitoring, Evaluation and Learning, Access Program, Phnom Penh, Cambodia
| | - P L Annear
- Nossal Institute for Global Health, University of Melbourne, Australia
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Frisby C, Eikelboom RH, Mahomed-Asmail F, Kuper H, Moore DR, de Kock T, Manchaiah V, Swanepoel DW. Mobile Health Hearing Aid Acclimatization and Support Program in Low-Income Communities: Feasibility Study. JMIR Form Res 2023; 7:e46043. [PMID: 37610802 PMCID: PMC10483300 DOI: 10.2196/46043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use. This study developed an mHealth acclimatization and support program for first-time hearing aid users and subsequently implemented and pilot-tested the feasibility of the program. The program was facilitated by community health workers (CHWs) in low-income communities in South Africa. OBJECTIVE This study aimed to evaluate the feasibility of an mHealth acclimatization and support program supported by CHWs in low-income communities. METHODS An application-based acclimatization and support was adapted and translated for use in low- and middle-income countries. This program was delivered in the form of 20 different voice notes accompanied by graphical illustrations via WhatsApp or 20 different SMS text messages. The program was provided to first-time hearing aid users immediately after a community-based hearing aid fitting in March 2021 in 2 low-income communities in the Western Cape, South Africa. The 20 messages were sent over a period of 45 days. Participants were contacted telephonically on days 8, 20, and 43 of the program and via open-ended paper-based questionnaires translated to isiXhosa 45 days and 6 months after the program started to obtain information on their experiences, perceptions, and accessibility of the program. Their responses were analyzed using inductive thematic analysis. RESULTS A total of 19 participants fitted with hearing aids received the mHealth acclimatization and support program. Most participants (15/19, 79%) received the program via WhatsApp, with 21% (4/19) of them receiving it via SMS text message. Participants described the program as helpful, supportive, informative, sufficient, and clear at both follow-ups. A total of 14 participants reported that they were still using their hearing aids at the 6-month follow-up. Three participants indicated that not all their questions about hearing aids were answered, and 5 others had minor hearing aid issues. This included feedback (n=1), battery performance (n=1), physical fit (n=2), and issues with hearing aid accessories (n=1). However, CHWs successfully addressed all these issues. There were no notable differences in responses between the participants who received the program via WhatsApp compared with those who received it through SMS text message. Most participants receiving WhatsApp messages reported that the voice notes were easier to understand, but the graphical illustrations supplemented the voice notes well. CONCLUSIONS An mHealth acclimatization and support program is feasible and potentially assists hearing aid acclimatization and use for first-time users in low-income communities. Scalable mHealth support options can facilitate increased access and improve outcomes of hearing care.
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Affiliation(s)
- Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
- Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH, United States
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | | | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
- Ear Science Institute Australia, Subiaco, Australia
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
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Peñaranda D, Pérez-Herrera LC, Moreno-López S, Noguera L, Hernández D, Martínez D, Peñaranda A. Audiological benefit, quality of life, and factors associated with functional gain in elderly hearing aid users in a developing country between 2017 and 2020: a pre-post-study. BMC Geriatr 2023; 23:376. [PMID: 37337203 DOI: 10.1186/s12877-023-04051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/19/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Sensorineural hearing loss (SNHL) is the most common auditory deficit in older adults and may lead to quality-of-life deterioration. However, few studies have been performed in low/middle-income countries, particularly in Latin America. This study aimed to assess the audiological benefit, quality of life, and factors associated with functional gain in elderly hearing aid users in the Fundación Santa Fe de Bogotá and UNIMEQ-ORL, two otology referral centers in Colombia. DESIGN Pre-post study that included hearing aid users at the otology consult of the Fundación Santa Fe de Bogotá and UNIMEQ-ORL between June 2017 and December 2020. Glasgow Benefit Inventory (GBI) and Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaires were applied. Audiometric (0,5 kHz to 4 kHz) and speech audiometry results were collected. RESULTS A total of 75 participants (132 ears) were included. The mean age was 70.73 years (SD: 12.66). The median hearing aid use in years was 0.71 (IQR: 0.64-0.90). Mean change in speech audiometry was - 26.53dB (95%CI: -28.09, -24.97; p < 0.001), in functional gain was - 21.75dB (-23.81, -19.68; p < 0.001). The mean changes in the APHAB domains were Ease of Communication: -37.85 (95%CI: -43.01; -32.7), Background Noise: -3.51 (-6.06; -0.95), and Aversiveness of Sounds: -6.9 (-2.04; 11.77). The GBI assessment of quality of life showed improvement in 100% of the population after the use of hearing aids. The number of years of hearing aids use was associated with functional gain. CONCLUSION The number of years of hearing aids use may impact on the functional gain in these populations. A significant clinical benefit was found in terms of quality of life, communication, and reverberation related to the use of hearing aids. Access to hearing aids should be granted, and public health strategies are needed to grant the access to hearing rehabilitation in these populations. TRIAL REGISTRATION Fundación Santa Fe de Bogotá (Protocol Number: CCEI-12666-2020).
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Affiliation(s)
- Daniel Peñaranda
- Otolaryngology Section, Fundación Universitaria de Ciencias de la Salud, Cra. 19 # 8 A - 32, Bogotá, Colombia
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia
| | - Lucia C Pérez-Herrera
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia
- School of medicine, Universidad de Los Andes, Cra. 1 Nº 18A - 12, Bogotá, Colombia
| | - Sergio Moreno-López
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia
- School of medicine, Universidad de Los Andes, Cra. 1 Nº 18A - 12, Bogotá, Colombia
| | - Lucia Noguera
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia
| | - Diana Hernández
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia
- Otolaryngology Department, Universidad Nacional de Colombia, Av. Cra. 30 #45- 03, Bogotá, Colombia
| | - Daniel Martínez
- School of medicine, Universidad de Los Andes, Cra. 1 Nº 18A - 12, Bogotá, Colombia
| | - Augusto Peñaranda
- Otolaryngology and Allergy Research groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Av. 9 # 116-20, Bogotá, Colombia.
- School of medicine, Universidad de Los Andes, Cra. 1 Nº 18A - 12, Bogotá, Colombia.
- Otolaryngology Department, Fundación Santa Fe de Bogotá, Cra. 7 #117 - 15, Bogotá, Colombia.
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Frisby C, Eikelboom RH, Mahomed-Asmail F, Kuper H, de Kock T, Manchaiah V, Swanepoel DW. Community-based adult hearing care provided by community healthcare workers using mHealth technologies. Glob Health Action 2022; 15:2095784. [PMID: 35960191 PMCID: PMC9377258 DOI: 10.1080/16549716.2022.2095784] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The rising prevalence of hearing loss is a global health concern. Professional hearing services are largely absent within low- and middle-income countries where appropriate skills are lacking. Task-shifting to community healthcare workers (CHWs) supported by mHealth technologies is an important strategy to address the problem. OBJECTIVE To evaluate the feasibility of a community-based rehabilitation model providing hearing aids to adults in low-income communities using CHWs supported by mHealth technologies. METHOD Between September 2020 and October 2021, hearing aid assessments and fittings were implemented for adults aged 18 and above in two low-income communities in the Western Cape, South Africa, using trained CHWs. A quantitative approach with illustrative open-ended questions was utilised to measure and analyse hearing aid outcomes. Data were collected through initial face-to-face interviews, telephone interviews, and face-to-face visits post-fitting. Responses to open-ended questions were analysed using inductive thematic analysis. The International Outcome Inventory - Hearing Aids questionnaire determined standardised hearing aid outcomes. RESULTS Of the 152 adults in the community who self-reported hearing difficulties, 148 were successfully tested by CHWs during home visits. Most had normal hearing (39.9%), 24.3% had bilateral sensorineural hearing loss, 20.9% had suspected conductive hearing loss, and 14.9% had unilateral hearing loss, of which 5.4% had suspected conductive loss. Forty adults met the inclusion criteria to be fitted with hearing aids. Nineteen of these were fitted bilaterally. Positive hearing aid outcomes and minimal device handling challenges were reported 45 days post-fitting and were maintained at six months. The majority (73.7%) of participants fitted were still making use of their hearing aids at the six-month follow-up. CONCLUSIONS Implementing a hearing healthcare service-delivery model facilitated by CHWs in low-income communities is feasible. mHealth technologies used by CHWs can support scalable service-delivery models with the potential for improved access and affordability in low-income settings.
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Affiliation(s)
- Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado and the University of Pretoria, Aurora, CO, USA
| | - Robert H. Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, WA, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, WA, Australia
- Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado and the University of Pretoria, Aurora, CO, USA
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado and the University of Pretoria, Aurora, CO, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, USA
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado and the University of Pretoria, Aurora, CO, USA
- Ear Science Institute Australia, Subiaco, WA, Australia
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