Primary Care Intervention Promoting Hearing Health Care Service Access and Use

初级保健干预促进听力保健服务的获取和使用

• 批准号: 8607610
• 负责人: Margaret Ingrid Wallhagen
• 金额: $ 61.81万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2016-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8607610
• 关键词: Address; Age-Years; Belief; Budgets; Clinic; Communication; Communication impairment; Communities; Cost Effectiveness Analysis; Development; Devices; Early Diagnosis; Educational Intervention; Elderly; Eligibility Determination; Evaluation; Family; Goals; Health; Health Services; Health Services Accessibility; Health education; Healthy People 2010; Hearing; Hearing Aids; Human Resources; Impaired cognition; Individual; Intervention; Mission; National Institute on Deafness and Other Communication Disorders; Outcome; Pamphlets; Personal Satisfaction; Persons; Phase; Presbycusis; Primary Health Care; Protocols documentation; Quality of life; Randomized Controlled Trials; Rehabilitation therapy; Resources; Risk; Self-Help Devices; Sensitivity and Specificity; Services; Societies; Technology; Testing; Time; base; comparative effectiveness; cost; cost effective; cost utility analysis; design; effective intervention; expectation; experience; follow-up; health economics; health literacy; healthy aging; hearing impairment; improved; improved functioning; prevent; primary care setting; programs; public health relevance; screening; social; standard care; time use

DESCRIPTION (provided by applicant): The purpose of this proposal is to develop, pilot (R21), and then (R33) utilize a randomized controlled trial to test the comparative effectiveness within a primary care setting of three protocols for older adults e 60 years of age who are not currently wearing hearing aids and who screen positive as at risk for hearing loss on subsequent effective access to and use of hearing health care services. The three protocols include: 1) screening for hearing loss only followed by a statement that the person has possible hearing loss and should obtain a follow-up evaluation (standard care control); 2) standard care plus the provision of an illustrated brochure on hearing loss, hearing aids, and assistive listening devices; and 3) standard care plus the provision of an illustrated brochure on hearing loss, hearing aids, and assistive listening devices and an in- person brief educational program on hearing loss, hearing aids and assistive listening devices. The goal is to develop an intervention that: 1) can be easily integrated into primary care settings that serve a range of individuals with varying levels of financial and social resources; 2) can be implemented by office or clinic personnel with a wide range of backgrounds; and 3) will promote the effective subsequent access to and use of hearing health care services. Congruent with the mission of the NIDCD to "improve the function and quality of life of individuals with communication disorders," the ultimate goal is to maximize healthy aging and quality of life and minimize cognitive decline by facilitating the ability of older adults to remain socially engaged and highly functional. Many older adults will not raise the issue of hearing loss with their practitioners, partly because it comes on slowly and is not appreciated for its significance. If referred, they often do not accept recommended interventions or do not successfully adapt to the use of hearing aids, often because of poor understanding of age related hearing loss, unrealistic and uninformed expectations about hearing aids, and beliefs that hearing loss is not an important issue and that hearing aids are stigmatizing. Given poor follow-up or subsequent successful use of hearing services, screening in the primary care setting is often not viewed as an effective use of time. To address these issues, the development of a time-efficient, cost-effective, and outcome-effective intervention is needed so that assessment and hearing health education can be integrated into primary care settings with acknowledgment of the constraints of time and cost. This project is designed to develop and test such an intervention and brings together a multi-disciplinary team with expertise in hearing loss, primary care, health literacy and economics that is essential to the successful implementation of the project.

描述（由申请人提供）：该提案的目的是开发，试点（R21），然后（R33）利用随机对照试验来测试30岁老年人的初级保健设置中的比较有效性，他们目前未佩戴助听器的年龄较高的老年人，他们当前佩戴助听器的效果以及对随后有效访问有效访问和使用听力医疗服务的障碍的风险，并具有筛查正面的效果。这三个方案包括：1）筛查听力损失仅此后，声明该人可能有听力损失并应获得后续评估（标准护理控制）； 2）标准护理以及提供听力损失，助听器和辅助听力设备的插图小册子； 3）标准护理以及提供有关听力损失，助听器和辅助聆听设备的插图小册子，以及有关听力损失，助听器和辅助听力设备的知名度简短教育计划。目的是开发一种干预措施：1）可以轻松地集成到为具有不同金融和社会资源水平的个人服务的初级保健环境中； 2）可以由具有广泛背景的办公室或诊所人员实施； 3）将促进随后的有效访问和使用听力医疗服务。与NIDCD的使命一致，其使命“改善了沟通障碍的人的生活和生活质量”，最终目标是通过促进老年人保持社会参与和高度功能的能力来最大程度地提高健康的衰老和生活质量，并最大程度地减少认知能力下降。许多老年人不会与从业人员一起引起听力损失的问题，部分原因是它出现了缓慢的，并且不因其意义而受到赞赏。如果被提及，他们通常不接受建议的干预措施或不成功适应助听器的使用，这通常是因为对年龄相关的听力损失，对助听器的不现实和不明智期望的理解不足，并且相信听力损失并不是一个重要问题，并且听力辅助是污名化的。鉴于随后或随后成功使用听力服务，在初级保健环境中进行筛查通常不会被视为有效利用时间。为了解决这些问题，需要开发时间效率，具有成本效益和结果有效的干预措施，以便在确认时间和成本的限制下，可以将评估和听力健康教育整合到初级保健环境中。该项目旨在开发和测试这种干预措施，并汇集了一个具有听力损失，初级保健，健康素养和经济学专业知识的多学科团队，这对于成功实施该项目至关重要。