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

基本信息

批准号：
8230652
负责人：
Margaret Ingrid Wallhagen
金额：
$ 23.13万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-01 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8230652
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 Screening procedure 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 social standard care time use

项目摘要

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. PUBLIC HEALTH RELEVANCE: Hearing loss is one of the most common problems experienced by older adults, significantly impacts the well-being of these older adults and their families, and impacts society by preventing them from continuing to remain engaged in community activities and potentially contributing to cognitive decline. Still, many older adults are not screened for hearing loss and do not have appropriate information about hearing loss and assistive technology that would promote their access to and use of hearing health care services. This minimizes their potential to effectively adapt to hearing aids or obtain other nonmedical treatment appropriate to their hearing health needs. This project specifically addresses these issues and thus one of the key goals of Healthy People 2010, to improve the hearing health of the nation through early detection, treatment and rehabilitation, by developing, refining and testing a time-efficient, effective, primary care based screening and educational intervention protocol that will promote subsequent access to and successful use of hearing health care services.

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。公共卫生相关性：听力损失是老年人最常见的问题之一，会对这些老年人及其家庭的福祉产生重大影响，并通过阻止他们继续从事社区活动并可能导致认知能力下降来影响社会。尽管如此，许多老年人仍未因听力损失而受到筛查，并且没有有关听力损失和辅助技术的适当信息，这些信息将促进其访问和使用听力医疗服务。这最大程度地减少了他们有效适应助听器或获得适合其听力健康需求的其他非医学治疗的潜力。该项目专门解决了这些问题，因此，通过早期发现，治疗和康复，通过开发，完善和测试一种时间效率，有效，基于初级保健的筛查和教育干预方案，通过早期检测，治疗和康复来改善国家的听力健康，以改善国家的听力健康，从而提高国家的关键目标之一，从而特别解决了这些项目，该项目专门解决了这些项目，该项目专门解决了该项目，该项目专门解决了该项目，该项目是通过开发和测试，该项目专门解决这些问题，从而通过开发和测试将促进后续的访问权和成功使用听力保健服务的利用。