PP105 - Outcomes of a Pilot Project to Support Hearing Health Equity in Arizona

More than 200,000 Arizonans with hearing loss lack access to hearing health care. Audiologists and speech-language pathologists at Arizona State University’s Speech and Hearing Clinic and specialists at Arizona Commission for the Deaf and the Hard of Hearing partnered to form the Hearing Healthcare Assistance Project to support hearing health equity. This project provides free hearing testing, hearing aid fitting, and aural rehabilitation to adult Arizonans who meet a two-step qualification process, based on financial and audiological criteria. In this poster, we will present a description of this vulnerable population and outcomes of our hearing health care services.  

Summary:

Rationale: We use a framework proposed by Kilbourne et al., (2006) to define the vulnerable population, document outcomes of one model of hearing health care delivery and outline factors contributing to those outcomes.

Method: Potential project participants were identified through community outreach efforts.  Applicants completed a two-step qualification process. The first step was based on income (< 133% FPL), residency status, and lack of coverage for hearing aids through other third-party payers. The second step was based on degree of hearing loss and speech perception scores. Individuals who met both sets of criteria were provided with free hearing aids and follow-up appointments focusing on aural rehabilitation (expectations counseling, communication strategies and self-advocacy training). 

Retrospective chart review was used to collate demographic and hearing health information about participants. This information was extracted from electronic medical records in the ASU Speech and Hearing Clinic. The Client Oriented Scale of Improvement (COSI) was used to determine listening needs, formulate aural rehabilitation activities and document outcomes. We are in the process of compiling those results and conducting semi-structured follow-up interviews with participants. The interview questions are designed to collect information about satisfaction with hearing aids in everyday life, quality of life before and after receiving hearing health care services, barriers and facilitators to accessing hearing health care.  

Results: In the first year of the project (July 1, 2021- June 30, 2022), 46 adults with hearing loss applied to the program. Of these, 32 met the first round of criteria. Case history information revealed the following coexisting conditions that could impact audiological care: 1) tinnitus (40%), 2) dizziness/ vertigo (30%) and 3) significant visual problems (20%). Twenty two individuals met the second round of criteria, and received hearing aids. All but one of the hearing aid fittings were bilateral. Most hearing aid recipients were women in the 66-85 years age range, and most had mild to severe or moderate to severe hearing loss.  Over 70% of the hearing aid recipients did not complete the follow-up schedule after fitting, which consisted of a minimum of two appointments. Transportation was reported to be a problem for a majority. Results from follow-up interviews will be reported. 

Conclusions: Most individuals who participated in this project were women with clinically significant hearing loss and at least one coexisting condition. Most did not follow through with aural rehabilitation beyond hearing aid fitting. Transportation to access hearing health care was a major barrier mentioned during appointments. 

Reference:

Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ. Advancing health disparities research within the health care system: a conceptual framework. Am J Public Health. 2006 Dec;96(12):2113-21.