Hearing Healthcare Assessment in Rural Communities (HHARC)

农村社区听力保健评估 (HHARC)

• 批准号: 10844668
• 负责人: Matthew Lee Bush
• 金额: $ 48.65万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-04 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10844668
• 关键词: Address; Administrator; Adult; Advisory Committees; Affect; Appalachian Region; Area; Certification; Chronic; Communication impairment; Communities; Country; County; Depressed mood; Development; Diagnosis; Diagnostic; Disease; Education; Elderly; Employment; Enabling Factors; Enrollment; Environmental Risk Factor; Epidemiology; Evaluation; Face; Geographic state; Goals; Health; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Hearing; Hearing Tests; Intervention; Kentucky; Life; Measurable; Medical; Medical Economics; Methods; Morbidity - disease rate; Occupational; Outcome; Patients; Phase; Population; Positioning Attribute; Precede-Proceed Model; Predisposing Factor; Prevalence; Prevention; Primary Care; Protocols documentation; Provider; Public Health; Reinforcing Factor; Research; Resources; Rural; Rural Appalachia; Rural Community; United States; Vulnerable Populations; Well in self; barrier to care; care delivery; experience; health care availability; health care delivery; health care service; health care service utilization; hearing impairment; hearing loss treatment; improved; innovation; medical specialties; medically underserved; mortality; novel; patient navigation; pilot test; practice-based research network; preference; prevent; primary care practice; primary care services; programs; rural area; rural health clinic; rural patients; rural underserved; screening; social; therapy development; treatment comparison; underserved community; urban setting; virtual; young adult; Address; Administrator; Adult; Advisory Committees; Affect; Appalachian Region; Area; Certification; Chronic; Communication impairment; Communities; Country; County; Depressed mood; Development; Diagnosis; Diagnostic; Disease; Education; Elderly; Employment; Enabling Factors; Enrollment; Environmental Risk Factor; Epidemiology; Evaluation; Face; Geographic state; Goals; Health; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Hearing; Hearing Tests; Intervention; Kentucky; Life; Measurable; Medical; Medical Economics; Methods; Morbidity - disease rate; Occupational; Outcome; Patients; Phase; Population; Positioning Attribute; Precede-Proceed Model; Predisposing Factor; Prevalence; Prevention; Primary Care; Protocols documentation; Provider; Public Health; Reinforcing Factor; Research; Resources; Rural; Rural Appalachia; Rural Community; United States; Vulnerable Populations; Well in self; barrier to care; care delivery; experience; health care availability; health care delivery; health care service; health care service utilization; hearing impairment; hearing loss treatment; improved; innovation; medical specialties; medically underserved; mortality; novel; patient navigation; pilot test; practice-based research network; preference; prevent; primary care practice; primary care services; programs; rural area; rural health clinic; rural patients; rural underserved; screening; social; therapy development; treatment comparison; underserved community; urban setting; virtual; young adult

PROJECT SUMMARY Hearing loss in adults is the third most common chronic health condition in the United States with a prevalence of over 20% in younger adults and over 40% in older adults. Untreated hearing loss causes a measurable impact on health and social, occupational, and emotional well-being of adults. Only 26% of adults have had a diagnostic hearing test within the past 5 years and delayed hearing loss diagnosis and treatment may lead to communication impairment with profound effects on education, employment, and overall health. The prevalence of hearing loss is higher among adults living in rural communities compared with those in urban settings; furthermore, rural adults with hearing loss may never receive treatment or may be delayed in diagnosis and/or treatment compared with urban adults. Rural health clinics (RHCs) represent a federally designated health system care that provides primary care within rural underserved communities; however, hearing healthcare services have not been a significant component of RHC care delivery. RHCs are ideally positioned to partner with rural communities to develop an intervention that can help rural adults navigate different aspects of hearing healthcare such as education, prevention, screening, diagnosis, and treatment. The goal of this study is to assess the utilization of hearing healthcare among rural adults through RHCs with the R21 phase of the program and then develop a culturally responsive RHC patient navigation program (PNP) to promote utilization of hearing healthcare. To conduct this study, we will partner with 10 high-need under-resourced RHCs within rural Appalachian counties in Kentucky and utilize the PRECEDE-PROCEED model (PPM) to systematically assess the rural adult hearing health and healthcare priorities, needs, and resources to inform intervention development. During the R21 phase we will 1) conduct a social and epidemiological assessment of rural adult hearing healthcare and 2) assess the organizational and environmental factors influencing hearing healthcare utilization in RHCs. The milestones of the R21 include the determination of the prevalence of hearing loss and hearing healthcare utilization in rural adults, establishment of rural adult hearing healthcare priorities, and development of a community advisory board and a rural provider taskforce. During the R33 phase we will 1) develop of a community-based hearing healthcare patient navigation program for RHCs and 2) pilot test the rural hearing healthcare navigation program. The milestones of the R33 phase include the development of a PNP protocol, assessment of the impact of the navigator on rural adults obtaining diagnostic audiogram, and evaluation of the PNP feasibility, acceptability, and appropriateness. This study is significant because it aims to reduce access to care barriers to timely diagnostic hearing testing for rural adults to prevent negative consequences. This research is innovative in development and pilot testing of a novel intervention not previously assessed in adult hearing healthcare within an RHC setting. Our results will impact the field by partnering with communities to inform the development and delivery of innovative patient supportive interventions to improve rural hearing healthcare access.

项目摘要 成人的听力损失是美国第三大常见的慢性健康状况 年轻人超过20％，老年人超过40％。未经处理的听力损失会引起可衡量的影响 关于成人的健康和社会，职业和情感福祉。只有26％的成年人患有诊断 在过去的5年内听力测试以及听力损失诊断和治疗的延迟可能导致沟通 损害对教育，就业和整体健康产生深远影响。听力损失的流行 与城市环境相比，居住在农村社区的成年人中的成年人更高；此外，农村 听力损失的成年人可能永远不会接受治疗，或者可能会延迟诊断和/或治疗。 与城市成年人。农村卫生诊所（RHCS）代表联邦指定的卫生系统护理 农村服务不足的社区内的初级保健；但是，听力医疗服务不是 RHC护理交付的重要组成部分。 RHC是与农村社区合作的理想位置 开发一种干预措施，可以帮助农村成年人在听力医疗的不同方面导航，例如 教育，预防，筛查，诊断和治疗。这项研究的目的是评估 通过该计划的R21阶段，农村成年人在农村成年人中听到医疗保健，然后开发 具有文化响应的RHC患者导航计划（PNP），以促进听力医疗保健的利用。到 进行这项研究，我们将与阿巴拉契亚农村县的10个高需求的资源不足的RHC合作 在肯塔基州并利用先前的模型（PPM）系统评估农村成人听力 健康和医疗保健优先事项，需求和资源，以告知干预开发。在R21阶段 我们将1）对农村成人听力医疗保健进行社会和流行病学评估，2）评估 影响RHC中听力医疗保健利用的组织和环境因素。的里程碑 R21包括确定农村听力损失的患病率和听力医疗保健利用率 成人，建立农村成人听力医疗保健重点以及建立社区顾问委员会 和农村提供商工作人员。在R33阶段，我们将1）开发基于社区的听力医疗保健 RHCS的患者导航计划和2）试验测试农村听力医疗保健导航计划。这 R33阶段的里程碑包括开发PNP协议，评估的影响 农村成年人获得诊断听力图的导航员，以及对PNP的可行性，可接受性和 适当性。这项研究很重要，因为它旨在减少及时诊断的护理障碍 农村成年人的听力测试以防止负面后果。这项研究在开发方面具有创新性 以及先前未在RHC环境中在成人听力医疗保健中评估的新型干预措施的试点测试。 我们的结果将通过与社区合作以告知开发和交付的结果，从而影响该领域 创新的患者支持干预措施，以改善农村听力医疗保健的访问。