Task Sharing in Hearing Care: Putting Principles Into Practice to Advance Access to Hearing Care

Abstract Task sharing, through models such as community health workers (CHWs), is considered an efficacious and cost-effective approach to extending access, addressing disparities, and building capacity. Increasingly, task sharing is recognized as a promising approach within sensory health. This session will share results from an NIH-funded trial of a first-in-kind CHW-delivered intervention along the U.S.-Mexico border. Trained CHWs provided a 5-week group aural rehabilitation program that included education and counseling on age-related hearing loss. A total of 136 Spanish-speaking older adults with hearing loss were randomized. Those in the immediate treatment group reported significantly greater use of communication strategies post-intervention, which was maintained over 1 year. Participants were more likely to report taking action on their hearing at 6 months (OR:1.56, p=0.001) and 1 year (OR:1.82, p=0.001). Building upon lessons learned, including post-intervention focus groups, the presentation will share guiding principles on the application of task sharing to support sensory health.

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Screening for hearing loss in the setting of primary care, and the most common used tests

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214788 ◽

2021 ◽

Author(s):

Ohoud Adel Turkistani ◽

Wjdan Abduljlil Al Arqan ◽

Rania Saad Alkhaibry ◽

Yazan Adnan Ayoub ◽

Rawan Mesfer Alhuthali ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Hearing Loss ◽

Standard Test ◽

Lessons Learned ◽

Early Screening ◽

Age Related ◽

Ear Wax ◽

Age Related Hearing Loss

Hearing loss is considered among the most common chronic disorders affecting people worldwide, especially older adults and geriatrics. More than half of older adults have age-related hearing loss, which worsens with age. The role of public health to estimate and manage the issue is crucial as early screening and management for hearing loss patients can be promising. The symptoms and signs of hearing loss can appear one up to two years before the significant hearing affection. Major lessons learned from this review are that elderly individuals and geriatrics are the most common targeted population for age-related hearing loss, followed by ear wax accumulation. Therefore, routine checkup for people who are 50 years for audiological disorders is a must. Associated disorders secondary to hearing loss include depression and anxiety, which significantly burden productivity over time. To our knowledge, we performed the first complex review regarding the screening for hearing loss within the setting of primary care centers and mentioned the most standard test used to diagnose and detect the issue as early as possible.

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2020 Editor's Choice Articles From JGMS: Focus on Vulnerable Populations

Innovation in Aging ◽

10.1093/geroni/igab046.1325 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 343-344

Author(s):

Lewis Lipsitz ◽

Tamara Baker

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Psychosocial Factor ◽

Lessons Learned ◽

Health Study ◽

Age Related ◽

Hispanic Community ◽

The Uk ◽

Older Populations ◽

Age Related Hearing Loss

Abstract This symposium will present four 2020 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on issues relevant to vulnerable older populations. Justin Golub and colleagues, in their article “Audiometric Age-Related Hearing Loss and Cognition in the Hispanic Community Health Study”, broaden the scope of age-related studies on audiometric hearing loss by using a large Hispanic cohort, a community largely excluded from previous hearing loss studies. By examining audiometrically-defined hearing loss and cognitive measures, Golub found links between hearing loss and lower neurocognition. Janice Atkins and colleagues, in “Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort”, challenge the practice of simple age-based targeting of older adults to prevent severe COVID-19 infections, and show that specific high-risk comorbidities are better indicators of hospitalization and mortality. “Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results from Take Heart”, by Jessica Ramsay and colleagues, examines methods used to recruit older adults of color from primarily low socio-economic households for behavioral and clinical health research. Ryon Cobb and coauthors, in their article “Self-reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation among Older Adults: Evidence from the Health and Retirement Study”, investigate whether self-reported lifetime discrimination is a psychosocial factor influencing inflammation in older adults. Tamara Baker, the discussant, will highlight commonalities and lessons learned from these studies, including links between racial, socio-economic, or disease-related vulnerabilities of older adults and their health status, as well as best practices to account for these factors in future clinical trials.

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Developing Physical Activity Interventions for the School and Home Settings: Lessons Learned from a Community-Academic Partnership

10.21203/rs.3.rs-32129/v1 ◽

2020 ◽

Author(s):

Zachary Ramsey ◽

Karen Northrup ◽

Charlotte Workman ◽

Traci Jarrett ◽

Nancy O’Hara Tompkins ◽

...

Keyword(s):

Physical Activity ◽

Health Workers ◽

School Personnel ◽

Cost Effective ◽

Lessons Learned ◽

Rural Setting ◽

Intervention Package ◽

Community Members ◽

Home Environments ◽

Physical Activity Interventions

Abstract Background Physical activity interventions designed for children living in the rural setting, particularly those that are cost effective and utilize common resources, are increasingly requested. Interventions for school and home settings are available but can be complicated and expensive to deliver. Methods In this study, we developed two physical activity interventions to be implemented in the school and home environments within rural settings of varying sizes and resources. This study, Activate!, was based on the socioecological model (SEM) and informed by local school personnel, families, and community health workers. Community members contributed to the development and implementation of the program. Results The resulting intervention package included several resources that were either already available in the school or home settings or could be easily collected by facilitators. Recommendations for frequency of use, capturing whether it is working, and methods for encouraging children and families were included in the packaging. Conclusions In this project, we successfully incorporated community (school and home) needs from a largely rural state within Appalachia to develop physical activity interventions for children. The Activate! interventions were designed for easy implementation by community members directly in both the school and home environments using common materials and easily reviewed packaging and guidance.

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Delivering the Same Intervention to Hispanic/Latinos With Pre-diabetes and Diabetes. Early Evidence of Success in a Longitudinal Mixed Method Study

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211055595 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110555

Author(s):

Maud Joachim-Célestin ◽

Thelma Gamboa-Maldonado ◽

Hildemar Dos Santos ◽

Susanne B Montgomery

Keyword(s):

Low Income ◽

Mixed Method ◽

Health Workers ◽

Glycosylated Hemoglobin ◽

Diabetes Prevention Program ◽

Cost Effective ◽

Post Intervention ◽

Management Intervention ◽

Quasi Experimental ◽

Hispanic Latinos

Background Despite nationwide efforts to address the diabetes epidemic and reduce prevalence disparities, higher rates persist among the poor, especially those with limited literacy. Currently, individuals with abnormal glycemia who have pre-diabetes and diabetes qualify for different programs. However, evidence suggests that, for low-income Hispanic/Latinos, offering a single intervention to all those with abnormal glycemia may provide a more culturally acceptable and effective approach. Our objective was to explore the feasibility of such an intervention led by community health workers (CHWs) among low-income Hispanic/Latinos with diabetes and at risk for diabetes. Methods Using a quasi-experimental mixed method design, we assessed weight, glycosylated hemoglobin, diabetes knowledge, and behavior changes of Hispanic/Latinos participants with pre-diabetes and diabetes living in Southern California. Biometric measurements, blood tests, and surveys were collected at baseline and 3 months post-intervention. Interviews and focus group discussions provided qualitative data. Results Although the program was less costly, results exceeded those reported for low-income H/L attending the National Diabetes Prevention Program and did not differ between pre-diabetes and diabetes groups. Instead, including individuals at different stages of the dysglycemic spectrum seemed to have enhanced the intervention. Physician referral and attendance of family/friends were associated with better outcomes. Conclusion Our findings indicate that a joint prevention/self-management intervention led by CHWs for low-income Hispanic/Latinos with diabetes and with pre-diabetes is feasible and cost-effective, providing results that could help reduce the success gap. Incorporating suggestions and replicating this study on a larger scale could help determine whether or not results are reproducible.

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Efficacy of Online Goal Management Training for Age-Associated Executive Impairment

Innovation in Aging ◽

10.1093/geroni/igab046.1670 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 431-432

Author(s):

Lynn Zhu ◽

Danielle D'Amico ◽

Susan Vandermorris ◽

Yushu Wang ◽

Laryssa Levesque ◽

...

Keyword(s):

Cognitive Rehabilitation ◽

Controlled Trial ◽

Management Training ◽

Rehabilitation Program ◽

Brain Training ◽

Post Intervention ◽

Goal Management ◽

Age Related ◽

Executive Impairment ◽

Goal Management Training

Abstract Goal Management Training® (GMT) is a standardized cognitive rehabilitation program that enhances individuals’ awareness of executive function impairments and trains them to regularly monitor and manage their goals. In-person GMT is well-validated among numerous subpopulations, including people experiencing age-related cognitive impairment or acquired brain injury, and people with psychiatric disorders. The goal of this study was to evaluate the efficacy and usability of online GMT relative to computerized “brain training” in a registered randomized controlled trial (protocol NCT03602768 at Trials.gov). Both interventions were administered in a self-paced format, with background therapist support provided for GMT. Primary outcomes were measured as self-reported executive impairment on standardized measures (the Dysexecutive Questionnaire and the Cognitive Failures Questionnaire) at pre-, immediate post-, and 6 weeks post-intervention. 62 older adults without psychiatric or neurological diagnoses completed the trial (online GMT: n = 37, age[mean] = 69 years; computerized brain training: n = 25, age[mean] = 64 years; both groups: 76% female). Improvements on the primary outcomes were observed post-intervention and were maintained at follow-up. GMT and computerized brain training groups could not be differentiated statistically, possibly due to restriction of range in the outcome measures at baseline. Additionally, the self-paced format prolonged the intervention beyond the recommended duration, which may have diluted efficacy. GMT was well-received, with participants reporting frequent use of the trained metacognitive strategies. Future studies will examine online GMT’s effectiveness in samples with documented executive impairment and with additional supports to promote engagement for this virtual program.

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Developing a temporal processing-based auditory training program for the senior users of hearing aids: a home PC-based program

Auditory and Vestibular Research ◽

10.18502/avr.v30i1.5310 ◽

2021 ◽

Author(s):

Karim Sattari ◽

Nariman Rahbar ◽

Mohsen Ahadi ◽

Hamid Haghani

Keyword(s):

Hearing Loss ◽

Training Program ◽

Hearing Aids ◽

Temporal Processing ◽

Content Validity ◽

Rehabilitation Program ◽

Auditory Training ◽

Speech Comprehension ◽

Speech Stimuli ◽

Age Related

Background and Aim: One of the consequences of aging is temporal processing impairment and reduced neural synchronization, which reduces speech comprehension in challenging situations such as noisy and reflective environments. This study aimed to develop a novel temporal processing-based auditory training program for the senior users of hearing aids. Methods: The program was designed based on different aspects of temporal processing and consists of multiple duty including: 1) detect the number of stimuli, 2) detect the pitch of the stimuli, 3) detect the duration pattern, 4) detect the number of nonsense speech stimuli in noise, and 5) detect the gap in noise. The program consists of 36 sessions (1800 exercises) and one or more features of temporal processing are challenged in all sections. Results: Content validity ratio, content validity index and impact score were used for validation. The results showed acceptable validity. Conclusion: Since training exercises can improve the physiological representation of sounds by changing hearing maps and temporal decoding, and these changes lead to improved perception, therefore, the auditory rehabilitation program for the seniors with emphasis on the temporal features of speech, was designed and developed. So it is hoped that with the implementation of the rehabilitation program in the seniors with hearing loss, the effects of age related hearing loss, including depression and social isolation, will be reduced to some extent. Keywords: Aging; presbycusis; temporal processing; auditory training; hearing loss

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