Development and Assessment of a Spanish-Language Toolkit for Hearing Loss Self-Management

在西班牙裔/拉美裔成年人和非拉美裔/拉美裔白人之间，听力保健(HHC)方面的差异仍然存在， 尽管听力损失的患病率相似。英语水平(LEP)明显有限，负面- 对一般医疗保健的获取和利用产生影响，但考虑到首选的干预措施 患者的语言和文化已被证明可以减少或消除医疗保健许多领域的差异。 然而，目前的理解存在一个根本性的差距，即解决LEP是否会缓解差异-- 西班牙裔/拉美裔老年人的HHC领带。因为未经治疗的听力损失与昂贵的 对于健康结果，迫切需要改善卫生保健服务的提供，特别是向弱势人群提供服务 比如那些患有LEP的人。申请人的长期目标是开发听力损失干预措施，以解决 美国弱势群体的需求。当前提案的总体目标，这是下一步 为了实现申请人的长期目标，是开发和评估可打印的西班牙语- 语言听力损失自我管理患者教育材料。中心假设是参与者 将更好地了解他们的听力损失困难，并将能够更好地确定选择 在提供文化和语言上合适的患者教育材料后进行自我管理。这个 拟议研究的基本原理是，研究结果将有助于开发和测试新的互联网 旨在增加弱势人群获得和利用HHC的技术。在初步数据的指导下， 这一假设将通过追求两个具体目标来检验：1)使用迭代方法，成员来自 目标受众，培养一种文化和语言上合适的西班牙语听力损失自我- 考虑到不同的健康素养背景的管理计划；以及2)评估 说西班牙语的成年听力损失患者的HHC知识和管理听力的自我效能 损失，在交付西班牙语听力损失自我管理程序后。目标1将得到解决 通过利用由目标受众代表组成的焦点小组来发展教育宣传。 毛地砖。目标2将通过比较单一组在治疗前后听力损失方面的自我效能来解决 设计对象为53名患有耳聋的西班牙裔/拉丁裔成年人。这些目标与推进 NIDCD的总体使命是“帮助预防、检测、诊断和治疗疾病和残疾”，以及 NIDCD的2017-2022年战略计划，以解决听力健康差距。这一贡献预计将是 意义重大，因为它降低了拉美裔/拉丁裔美国成年人经历的HHC的语言障碍 有LEP背景。这项拟议的研究具有创新性，因为它代表了与 通过提供听力损失干预，解决LEP和健康素养的交叉问题，改善现状。 预计结果将提供令人信服的数据，以包括在未来旨在减少 美国脆弱人群获取和利用六氯乙烯的结构性和临床障碍。

Disparities in hearing healthcare (HHC) persist between Hispanic/Latino adults and non-Hispanic/Latino Whites, despite similar hearing loss prevalence rates. Limited English language proficiency (LEP) significantly and neg- atively impacts general healthcare access and utilization, but interventions that take into account the preferred language and culture of patients have been shown to reduce or eliminate disparities in many areas of healthcare. Yet there is a fundamental gap in the current understanding as to whether addressing LEP will alleviate dispari- ties in HHC for Hispanic/Latino older adults. As untreated hearing loss is associated with increased risks of costly health outcomes, there is an urgent need to improve HHC service delivery, particularly to vulnerable populations such as those with LEP. The applicant's long-term goal is to develop hearing loss interventions that address the needs of vulnerable populations in the US. The overall objective of the current proposal, which is the next step toward attainment of the applicant's long-term goal, is to develop and assess the benefits of printable, Spanish- language hearing loss self-management patient education materials. The central hypothesis is that participants will demonstrate better understanding of their hearing loss difficulties, and will be better able to identify options for self-management following delivery of culturally and linguistically appropriate patient education materials. The rationale for the proposed research is that findings will contribute to the development and testing of novel inter- ventions aimed at increasing HHC access and utilization in vulnerable populations. Guided by preliminary data, this hypothesis will be tested by pursuing two specific aims: 1) Using an iterative approach with members from the target audience, develop a culturally and linguistically appropriate Spanish-language hearing loss self-man- agement program that takes into account varying health literacy backgrounds; and 2) Assess the benefits for Spanish-speaking adults with hearing loss, in terms of HHC knowledge and self-efficacy for managing hearing loss, following delivery of a Spanish-language hearing loss self-management program. Aim #1 will be addressed through utilizing focus groups consisting of representatives of the target audience to develop the education ma- terials. Aim #2 will be addressed by comparing self-efficacy for managing hearing loss in a single-group, pre/post design with 53 Hispanic/Latino adults with hearing loss who have LEP. These aims in line with advancing the overall mission of the NIDCD to “help prevent, detect, diagnose, and treat disease and disability”, as well as NIDCD's 2017-2022 Strategic Plan to address hearing health disparities. This contribution is expected to be significant because it poses to reduce language barriers to HHC experienced by US adults from Hispanic/Latino background with LEP. The proposed research is innovative because it represents a substantive departure from the status quo by delivering a hearing loss intervention that addresses the intersection of LEP and health literacy. It is expected that results will provide compelling data to include in a future R01 application aimed at reducing structural and clinical barriers to HHC access and utilization for vulnerable populations in the US.