Feasibility of a Hearing Program in Primary Care for Underserved Older Adults

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Project Summary Age related hearing loss is insidious, common and often mistaken as an inevitable part of aging. Untreated hearing loss is a public health issue, and is strongly associated with social isolation and an array of negative health effects including cognitive impairment and poor quality of life. Given its insidious and typically unrecognized onset, opportunities to address hearing-related communication difficulties are often missed in primary care where most older persons receive medical care. Primary care settings may be an effective setting to address age-related hearing loss, given that many adults have not sought hearing treatment within the current model of hearing health delivery, or ever had hearing screening. The current model of audiological care lacks efficiency and scalability to address the true burden of this chronic condition. Hearing aids are in limited use due to cost and logistics limiting access and this is particularly relevant to those with the greatest need. Newer, more innovative pathways to deliver hearing care are needed. The overall goals of this GEMSSTAR application are to: 1) test the feasibility of a hearing program including screening and alternative rehabilitation strategies to in older adults in public hospital-based primary care clinic using a convergent mixed method design. 2) establish the first steps needed for an implementation science career in hearing healthcare disparities from the perspective of an otologist/ear specialist to improve the quality and equity of hearing care for older adults. During a primary care visit, we will screen and identify participants with hearing loss and then randomize to a) counseling on accessible assistive listening devices or b) referral to traditional audiology care pathway alone. Feasibility measures will demonstrate our ability to screen patients, randomize them to interventions and complete the follow up in preparation for a larger efficacy trial on the impact of this program on hearing and communication. Future work will seek to demonstrate improvement in longer-term outcomes impacting overall biopsychosocial health.