Translating Public Health Practices: Community-Based Approaches for Addressing Hearing Health Care Disparities

Suen, Jonathan J.; Marrone, Nicole; Han, Hae Ra; Lin, Frank R.; Nieman, Carrie L.

doi:10.1055/s-0038-1676782

Cited by 28 publications

(16 citation statements)

References 50 publications

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“…Through a collaboration involving community members and experts from audiology, public health and translation, 37 – 39 the development of Oyendo Bien was guided by community-based participatory research principles 29 . The main principles of Oyendo Bien include: participation of communication partners, who are typically family members or friends; rehabilitation services facilitated by CHWs and audiologists; training in communication strategies for individuals with hearing loss and their communication partners; and an emphasis on peer support.…”

Section: Innovative Models: Adultsmentioning

confidence: 99%

Hearing care across the life course provided in the community

Suen

Bhatnagar

Emmett

et al. 2019

Bull. World Health Organ.

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Untreated hearing loss is recognized as a growing global health priority because of its prevalence and harmful effects on health and well-being. Until recently, little progress had been made in expanding hearing care beyond traditional clinic-based models to incorporate public health approaches that increase accessibility to and affordability of hearing care. As demonstrated in numerous countries and for many health conditions, sharing health-care tasks with community health workers (CHWs) offers advantages as a complementary approach to expand health-service delivery and improve public health. This paper explores the possibilities of task shifting to provide hearing care across the life course by reviewing several ongoing projects in a variety of settings – Bangladesh, India, South Africa and the United States of America. The selected programmes train CHWs to provide a range of hearing-care services, from childhood hearing screening to management of age-related hearing loss. We discuss lessons learnt from these examples to inform best practices for task shifting within community-delivered hearing care. Preliminary evidence supports the feasibility, acceptability and effectiveness of hearing care delivered by CHWs in these varied settings. To make further progress, community-delivered hearing care must build on established models of CHWs and ensure adequate training and supervision, delineation of the scope of practice, supportive local and national legislation, incorporation of appropriate technology and analysis of programme costs and cost–effectiveness. In view of the growing evidence, community-delivered hearing care may now be a way forward to improve hearing health equity.

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Section: Innovative Models: Adultsmentioning

confidence: 99%

Hearing care across the life course provided in the community

Suen

Bhatnagar

Emmett

et al. 2019

Bull. World Health Organ.

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“…These barriers include unclear eligibility criteria [ 16 ] and the need for continuous upskilling of the hearing aid audiologists [ 17 , 18 ]. Secondly, CI services are usually centralized, offered only in specialized CI units located in metropolitan areas that provide in-clinic services [ 19 , 20 ]. Centralization poses additional barriers to utilization of services for patients, particularly those from rural and remote areas.…”

Section: Introductionmentioning

confidence: 99%

Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements

et al. 2023

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Background This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured. Methods Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories. Results A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test. Conclusion A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients’ experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient’s view CI experience, associated costs and the value of different care models.

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“…To date, to our knowledge, relatively few studies have focused on characterizing the epidemiology of hearing loss and potential differences in hearing health care and associated outcomes among diverse populations . Despite evidence of disparities in health care more broadly by race/ethnicity and socioeconomic position, disparities in hearing health care are relatively unexplored compared with other disciplines . Among the few studies that have examined the epidemiology of hearing loss management by race/ethnicity, the available literature documents differences in hearing aid use between minority and White older adults, with consistently lower prevalence of hearing aid use among minority older adults with hearing loss .…”

Section: Introductionmentioning

confidence: 99%

Racial/Ethnic and Sex Representation in US-Based Clinical Trials of Hearing Loss Management in Adults

Pittman

Roura

Price

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEAlthough the National Institutes of Health (NIH) mandated the inclusion and reporting of women and racial or ethnic minority groups in NIH-funded research in 1993, little is known regarding the representation of women and racial or ethnic minority groups in trials that investigate hearing loss management.OBJECTIVE To assess sex and racial/ethnic representation in US-based clinical trials of hearing loss management in an adult population.DATA SOURCES Pertinent studies were identified using search strategies in PubMed, Embase, and ClinicalTrials.gov.STUDY SELECTION Our search strategy yielded 6196 studies. We included prospective studies that were written in English, performed in the US, and evaluated hearing loss management in adults, including amplification devices, such as hearing aids or assistive listening devices, cochlear implants, aural rehabilitation, and therapeutics. Given its prevalence, only studies that addressed bilateral sensorineural hearing loss were included.DATA EXTRACTION AND SYNTHESIS Data from 125 studies were extracted. The Preferred Reporting Items for Systematic Reviews and Meta-analyses diagram for systematic reviews was used for abstracting data. The guidelines were applied using independent extraction by multiple observers. RESULTS Among 125 clinical studies performed from January 1990 to July 2020 regarding hearing loss management, only 16 (12.8%) reported race/ethnicity, and 88 (70.4%) reported sex. Of the 16 studies that reported race/ethnicity, only 5 included more than 30% non-White representation. Among the 88 articles that reported sex, 44 (35.2%) reported more than 45% female representation. While the mean number of participants included in the observed trials was 80 (range, 7-644), the median number of participants from racial or ethnic minority groups in studies that reported race/ethnicity was 9 (range, 1-77), and a median of 12 female participants were included in studies with a numerical breakdown by sex. A mean of 41% (range, 1.55%-77.5%) of participants were female among studies that reported sex, and a mean of 30% (range, 1.96%-100%) of participants were from racial or ethnic minority groups among the 16 studies that reported race/ethnicity. Reporting of race/ethnicity varied substantially by funding source and journal type, while reporting by sex differed only by journal type.CONCLUSIONS AND RELEVANCE Studies investigating hearing loss management do not adequately reflect the US population. A closer examination of the inclusion of diverse adults in clinical research associated with hearing health may work to ameliorate disparities and contribute to the development of tailored interventions that address the needs of an increasingly diverse US population.

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Translating Public Health Practices: Community-Based Approaches for Addressing Hearing Health Care Disparities

Cited by 28 publications

References 50 publications

Hearing care across the life course provided in the community

Hearing care across the life course provided in the community

Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements

Racial/Ethnic and Sex Representation in US-Based Clinical Trials of Hearing Loss Management in Adults

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