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

项目总结

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.