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

为服务不足的老年人提供初级保健听力计划的可行性

• 批准号: 10727976
• 负责人: David R Friedmann
• 金额: $ 16.76万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10727976
• 关键词: Address; Adult; Age Years; Aging; Agreement; American; Audiology; Award; Caring; Cellular Phone; Chronic; Clinic; Collection; Communication; Computer Assisted; Counseling; Data; Devices; Ear; Elderly; Eligibility Determination; Ensure; Equity; Evaluation; Feedback; Future; Goals; Health; Hearing; Hearing Aids; Impaired cognition; Intervention; Learning; Logistics; Measures; Medical; Methods; Modeling; Outcome; Participant; Pathway interactions; Patients; Population; Preparation; Presbycusis; Primary Care; Process; Provider; Public Health; Public Hospitals; Quality of Care; Quality of life; Randomized; Recommendation; Rehabilitation therapy; Reporting; Research; Research Personnel; Self Administration; Site; Social isolation; Specialist; Surveys; Training; United States Preventative Services Task Force; Work; biopsychosocial; care delivery; career; career development; cost; design; efficacy trial; feasibility testing; follow-up; health care disparity; health care service utilization; healthy aging; hearing impairment; hearing screening; implementation science; improved; inattention; innovation; insight; novel; patient oriented; patient screening; primary care clinic; primary care practice; primary care setting; primary care visit; programs; rehabilitation strategy; screening; screening program; self testing; shared decision making

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.

项目摘要 与年龄相关的听力损失是阴险的，常见的，并且通常被误认为是衰老的不可避免的一部分。未经处理 听力损失是一个公共卫生问题，与社会隔离和一系列负面关系密切相关 健康影响，包括认知障碍和生活质量差。考虑到它的阴险，通常 无法识别的发作，解决与听力相关的沟通困难的机会经常被错过 大多数老年人接受医疗服务的初级保健。 鉴于许多成年人 在当前的听力保健交付模型中没有寻求听力治疗，或者曾经有过听证会 筛选。当前听力护理模型缺乏效率和可伸缩性，无法应对 这种慢性病。助听器由于成本和物流限制访问而有限使用，这是 与最需要的人特别相关。更新，更具创新性的途径来提供听力 需要。 该GEMSSTAR应用程序的总体目标是：1）测试听证计划的可行性，包括 在公立医院初级保健诊所的老年人的筛查和替代康复策略 使用收敛的混合方法设计。 2）建立实施科学所需的第一步 从耳端/耳朵专家的角度来听取医疗保健差异的职业，以提高质量 和老年人的听力公平。 在初级保健访问期间，我们将筛选并确定听力损失的参与者，然后随机进行A） 关于无障碍辅助听力设备的咨询或b）仅转介到传统听力学护理途径。 可行性措施将证明我们筛查患者，将他们随机进行干预和 完成后续行动，准备对该计划对听证会的影响进行更大的疗效试验和 沟通。未来的工作将寻求证明影响整体的长期结局的改善 生物心理社会健康。