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

项目总结 听力损失非常普遍，但老年人很少使用助听器，听力护理方面也存在差异。 亚裔美国人的助听器使用率最低，是增长最快的群体之一 美国老龄化人口的比例。年长的韩裔美国人(KA)，主要是单一语言 第一代移民，与其他少数民族和移民人口一样，代表着这样一个群体，他们 听力护理面临障碍，与英语水平有限、健康素养差、导航困难、 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的护理模式在扩大获得和 提供符合文化需求的关怀。听力干预(通过无障碍获得听力健康公平 研究和解决方案)是一种理论驱动、以证据为基础的听力护理干预措施，旨在提供 通过使用非处方听力技术的同伴教育护理模式。希尔斯公司开发了 部分由多PI团队提供，此后已调整为通过基于信仰的方式交付给较老的KA 组织(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)提供的听力护理干预措施的疗效 双胞胎是一名患有听力损失的老年人和他们的沟通伙伴，通过少数民族教堂递送。至 在这些发现的基础上，我们现在建议进行NIH第三阶段疗效试验，这是一项双臂随机试验， 440例听力损失的老年KA及其通讯伙伴。我们的建议有以下几点 目的：目的1：检验K-HARS对改善老年人沟通功能和健康相关素质的作用 与6个月延迟治疗组相比，听力损失的老年KA患者的生活状况。审判是 有能力在听力障碍清单上检测0.32效果大小或更大的分数差异 老年患者6个月后立即治疗组与延迟治疗组比较。目的2：评价卡介苗的药效。 听取关于改善第三方残疾(即家人或朋友因健康状况而致残)的意见 与6个月相比，沟通伙伴的生活质量和健康相关 延迟治疗组。探索性目标1：检验K-HARS对二联体关系的影响 以干预后6个月的相互性来衡量。探索性目标2：确定障碍和促进者 以少数民族教会为基础的CHW听力护理模式，为今后的实施和传播提供信息。这 项目利用了由调查人员和社区合作伙伴组成的多学科双语团队， 有良好的业绩记录。通过以信仰为基础的组织提供听力护理尚未得到 已经完成，之前没有研究系统地设计和测试使用CHWS的听力护理干预 使用 二元样本中的场外听力技术。拟议的研究将告诉我们如何 我们建设地方能力，以满足服务不足的老年人及其亲人的需求。

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.