K-HEARS: Hearing Health Equity through Accessible Research and Solutions for Korean Americans

K-HEARS：通过韩裔美国人的无障碍研究和解决方案实现听力健康公平

• 批准号: 10471606
• 负责人: HAE-RA HAN
• 金额: $ 69.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471606
• 关键词: Address; Aging; Asian Americans; Asians; Audiology; Bilateral; Caring; Church; Clinic; Cluster randomized trial; Collaborations; Communication; Communities; Community Health; Community Health Aides; Discipline of Nursing; Dissemination and Implementation; Elderly; Equipment and supply inventories; Ethnic Origin; Face; Family; Family member; Friends; Frustration; Future; Generations; Gerontology; Health; Health Promotion; Health Services Accessibility; Hearing; Hearing Aids; Hispanics; Immigrant; Immigration; Interdisciplinary Study; Intervention; Korean American; Language; Limited English Proficiency; Low income; Measures; Medicare; Modeling; Not Hispanic or Latino; Otolaryngology; Partner Communications; Physical Function; Pilot Projects; Population; Poverty; Prevalence; Public Health; Race; Randomized Controlled Trials; Religion and Spirituality; Research; Research Personnel; Resources; Risk; Role; Sampling; Social Functioning; Socioeconomic Status; Technology; Testing; Uninsured Medical Expense; United States; United States National Institutes of Health; Vulnerable Populations; Withdrawal; aging population; arm; base; bilingualism; cognitive function; community engaged research; cost; cost effective; design; disability; efficacy trial; ethnic minority population; evidence base; experience; health disparity; health equity; health literacy; health related quality of life; hearing impairment; improved; loved ones; meetings; multidisciplinary; peer; post intervention; public health priorities; racial and ethnic; rapid growth; screening; social; social stigma; theories; therapy design; treatment group

PROJECT SUMMARY Hearing loss is highly prevalent, yet few older adults use hearing aids and disparities in hearing care exist. Asian Americans have the lowest prevalence of hearing aid use and are one of the fastest-growing segments of the aging population in the United States. Older Korean Americans (KAs), as predominantly monolingual first-generation immigrants, represent a population, like other ethnic minority and immigrant populations, who face barriers to hearing care related to limited English proficiency, poor health literacy, navigational difficulties, and poverty. The need for affordable, accessible hearing care to meet the needs of more communities is recognized nationally and community health worker models of care serve a key role in extending access and delivering culturally responsive care. The HEARS intervention (Hearing Health Equity through Accessible Research and Solution) is a theory-driven, evidence-based hearing care intervention designed for delivery through a peer educator model of care that uses over-the-counter hearing technology. HEARS was developed in-part by the multiple PI team and has since been adapted for delivery to older KAs through faith-based organizations (K-HEARS). An NIH Stage IB pilot study demonstrated feasibility, acceptability, and preliminary efficacy of a community health worker (CHW)-delivered hearing care intervention specifically designed for dyads, an older adult with hearing loss and their communication partner, delivered through ethnic churches. To build upon these findings, we now propose an NIH Stage III efficacy trial, a 2-arm cluster randomized trial, with 440 dyads of older KAs with hearing loss and their communication partners. Our proposal has the following aims: Aim 1: To test the effect of K-HEARS on improving communication function and health-related quality of life among older KAs with hearing loss in comparison to a 6-month delayed treatment group. The trial is powered to detect a 0.32 effect size or greater score difference on the Hearing Handicap Inventory for the Elderly between the immediate and delayed treatment groups at 6 months. Aim 2: To evaluate the effect of K- HEARS on improving third-party disability (i.e., disability of family or friends due to the health condition of their significant other) and health-related quality of life among communication partners in comparison to a 6-month delayed treatment group. Exploratory Aim 1: To test the effect of K-HEARS on the dyad relationship, as measured by mutuality, 6-months post-intervention. Exploratory Aim 2: To identify the barriers and facilitators of an ethnic church-based CHW model of hearing care to inform future implementation and dissemination. This project leverages a multidisciplinary bilingual team of investigators and community partners with a demonstrated track record. The delivery of hearing care through faith-based organizations has not been done and no prior research has systematically designed and tested a hearing care intervention using CHWs with over-the-counter hearing technology in a dyadic sample. The proposed study will inform how we build local capacity to address the needs of underserved older adults and their loved ones.

项目摘要 听力损失非常普遍，但很少有老年人使用助听器，听力保健存在差异。 亚裔美国人助听器使用率最低，是增长最快的群体之一 美国老龄化人口的一半。老年韩裔美国人（KA），主要是单语 第一代移民代表了一个人口，像其他少数民族和移民人口一样， 面临听力保健的障碍，这些障碍与英语水平有限、健康素养差、导航困难有关， 和贫穷.需要负担得起的，可获得的听力护理，以满足更多社区的需求， 公认的国家和社区卫生工作者护理模式在扩大获得服务方面发挥关键作用， 提供符合文化要求的护理。HEARS干预（通过可扩展的听力健康公平） 研究和解决方案）是一个理论驱动的，以证据为基础的听力保健干预， 通过使用非处方听力技术的同伴教育者护理模式。HEARS开发 部分由多个PI团队提供，并已通过基于信仰的 K-HEARS（英语：K-HEARS）NIH阶段IB试点研究证明了可行性，可接受性和初步 社区卫生工作者（CHW）提供的听力保健干预措施的有效性， 一对夫妇，一个听力损失的老年人和他们的交流伙伴，通过民族教堂提供。到 在这些发现的基础上，我们现在提出了一项NIH III期疗效试验，一项2组随机分组试验， 440对老年听力损失患者及其交流伙伴。我们的建议有以下几点 目的：目的1：检测K-HEARS对改善患者沟通功能和健康相关质量的效果。 与6个月延迟治疗组相比，老年KA听力损失患者的寿命。审判 有能力检测听力障碍量表的0.32效应量或更大的评分差异， 6个月时即刻治疗组和延迟治疗组之间的老年人。目的2：评价K- 关于改善第三方残疾的听证会（即，由于家人或朋友的健康状况， 与6个月前相比， 延迟治疗组。探索性目的1：测试K-HEARS对二分体关系的影响， 通过干预后6个月的相互性来衡量。探索性目标2：确定障碍和促进因素 一个以少数民族教会为基础的CHW听力护理模式，为未来的实施和传播提供信息。这 该项目利用了一个由调查人员和社区合作伙伴组成的多学科双语团队， 一个被证明的记录通过信仰组织提供听力保健还没有得到 之前没有研究系统地设计和测试了使用CHW的听力护理干预 与 非处方听证技术在一个二元样本。拟议的研究将说明如何 我们建设地方能力，以满足得不到充分服务的老年人及其亲人的需求。