Hearing Healthcare Assessment in Rural Communities (HHARC)

农村社区听力保健评估 (HHARC)

• 批准号: 10273379
• 负责人: Matthew Lee Bush
• 金额: $ 21.19万
• 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 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10273379
• 关键词: Address; Administrator; Adult; Affect; Appalachian Region; Area; 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; Lead; Life; Measurable; Medical; Methods; Morbidity - disease rate; Occupational; Outcome; Patients; Phase; Population; Positioning Attribute; Precede-Proceed Model; Predisposing Factor; Prevalence; Prevention; Primary Health Care; Protocols documentation; Provider; Public Health; Reinforcing Factor; Research; Resources; Rural; Rural Appalachia; Rural Community; Rural Health Centers; Testing; Time; United States; Vulnerable Populations; Well in self; barrier to care; base; 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; practice-based research network; preference; prevent; primary care services; programs; rural area; 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.

项目概要 成人听力损失是美国第三大常见慢性健康状况，患病率 年轻人中超过20%，老年人中超过40%。未经治疗的听力损失会造成可衡量的影响 关于成年人的健康以及社会、职业和情感福祉。只有 26% 的成年人接受过诊断 过去5年内进行过听力测试且延迟听力损失诊断和治疗可能会导致沟通 对教育、就业和整体健康产生深远影响的损害。听力损失的患病率 与城市环境中的成年人相比，居住在农村社区的成年人的比例更高；此外，农村 与听力损失的成年人相比，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 (RHC) 代表联邦政府指定的卫生系统护理服务，提供 农村服务欠缺社区的初级保健；然而，听力保健服务尚未成为 RHC 护理服务的重要组成部分。 RHC 处于与农村社区合作的理想位置， 制定一项干预措施，帮助农村成年人应对听力保健的不同方面，例如 教育、预防、筛查、诊断和治疗。本研究的目的是评估 通过 RHC 和该计划的 R21 阶段，为农村成年人提供听力保健服务，然后制定一个 具有文化响应性的 RHC 患者导航计划 (PNP)，以促进听力保健的利用。到 进行这项研究时，我们将与阿巴拉契亚农村县内 10 个资源匮乏的高需求 RHC 合作 在肯塔基州利用 PRECEDE-PROCEED 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，为干预措施的制定提供信息。 R21阶段 我们将 1) 对农村成人听力保健进行社会和流行病学评估，2) 评估 影响 RHC 听力保健利用的组织和环境因素。的里程碑 R21 包括确定农村地区听力损失的患病率和听力保健利用情况 成人、确定农村成人听力保健优先事项以及建立社区咨询委员会 和一个农村提供者工作组。在 R33 阶段，我们将 1) 开发基于社区的听力保健服务 RHC 患者导航计划和 2) 试点农村听力保健导航计划。这 R33 阶段的里程碑包括制定 PNP 协议、评估 农村成年人获取诊断听力图的导航器，以及 PNP 可行性、可接受性和评估的评估 适当性。这项研究意义重大，因为它旨在减少获得及时诊断的护理障碍 对农村成年人进行听力测试，以防止负面后果。这项研究在开发上具有创新性 对之前未在 RHC 环境中的成人听力保健中进行评估的新型干预措施进行试点测试。 我们的成果将通过与社区合作来影响该领域，为开发和交付提供信息 创新的患者支持干预措施，以改善农村听力保健的可及性。