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

项目摘要 与年龄相关的听力损失是潜伏的，常见的，经常被误认为是衰老不可避免的一部分。未处理 听力损失是一个公共卫生问题，与社会孤立和一系列负面影响密切相关。 健康影响，包括认知障碍和生活质量差。鉴于其阴险和典型的 未被认识到的发病，解决听力相关的沟通困难的机会往往错过， 初级保健是大多数老年人接受医疗保健的地方。 初级保健环境可能是解决年龄相关性听力损失的有效环境，因为许多成年人 没有在目前的听力健康提供模式下寻求听力治疗，或者曾经有过听力 筛选目前的听力保健模式缺乏效率和可扩展性，以解决真正的负担， 这种慢性病。由于成本和物流限制，助听器的使用有限， 尤其是对那些最需要的人。提供听力保健的更新颖、更创新的途径 是必要的。 GEMSSTAR应用程序的总体目标是：1）测试听力计划的可行性，包括 在公立医院初级保健诊所对老年人进行筛查和替代康复策略 使用收敛混合方法设计。2)建立实施科学所需的第一步 从耳科医生/耳专科医生的角度来看，听力保健的职业差异，以提高质量 和老年人听力保健的公平性。 在初级保健访视期间，我们将筛选和识别听力损失的参与者，然后随机分配到a） 关于无障碍辅助听力设备的咨询或B）仅转介传统听力学护理途径。 可行性措施将证明我们有能力筛选患者，将他们随机分配到干预措施， 完成随访，为更大规模的关于该计划对听力影响的有效性试验做准备， 通信未来的工作将寻求证明长期结果的改善， 生物心理社会健康

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.