Carlson Kathleen F, Sell Sara, Vachhani Jay, Folmer Robert L, Saunders Gabrielle, Feeney M Patrick
National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR.
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
J Am Acad Audiol. 2019 Apr;30(4):250-263. doi: 10.3766/jaaa.15087. Epub 2018 Sep 24.
Although hearing loss is a common health issue, hearing healthcare (HHC) is poorly accessed. Screening to identify hearing loss is an important part of HHC access, specifically for those who screen positive for hearing loss and would benefit from seeing a HHC provider. New technologies can be automated to provide information and recommendations that are tailored to the needs of individual users, potentially enhancing rates of HHC access after positive screens. A greater understanding of the facilitators of postscreening HHC access that could be leveraged in such systems is needed.
The purpose of this project was to identify facilitators of postscreening HHC access that can be used in automated screening systems.
This qualitative study used focus groups (FGs) to understand perceived barriers, perceived benefits, and potential cues to action, as informed by the Health Belief Model, for accessing HHC after use of automated hearing screening systems.
Fifty individuals participated in one of seven FGs. FGs were conducted separately with three types of stakeholders: four FGs included adults who reported some degree of perceived hearing loss and had recently completed a hearing screening; two FGs included adults who had recently sought HHC for the first time because of hearing loss; and one FG involved significant others/family members of individuals with hearing loss.
FGs were 60-90 minutes in length and were led by a trained facilitator following a discussion guide. A research audiologist was present at each FG and served as a notetaker. FGs were recorded and transcribed by research team members, and transcripts were then coded in an iterative process by multiple team members. Qualitative content analysis was used to reduce data and to identify salient themes and subthemes, following an inductive approach. We focused on identifying themes that were related to facilitators of HHC access after positive screens for hearing loss and, separately, potential enhancements to automated hearing screening systems that would leverage these facilitators to improve HHC access.
We identified five key themes related to HHC access after a positive screen for hearing loss, along with ideas for enhancing automated hearing screening systems based on these themes. The themes included knowledge, trust, access, quality of life, and interpersonal influence.
The results of our work help inform the development of innovative hearing screening systems that can be automated to leverage individual facilitators of HHC access.
尽管听力损失是一个常见的健康问题，但听力保健服务（HHC）的可及性较差。听力损失筛查是听力保健服务可及性的重要组成部分，对于那些听力损失筛查呈阳性且能从看听力保健服务提供者中受益的人来说尤其如此。新技术可以自动化，以提供针对个体用户需求的信息和建议，这可能会提高筛查呈阳性后的听力保健服务可及率。因此，需要更深入了解在这类系统中可以利用的筛查后听力保健服务可及性的促进因素。
本项目的目的是确定可用于自动化筛查系统的筛查后听力保健服务可及性的促进因素。
这项定性研究采用焦点小组（FGs）来了解使用自动听力筛查系统后获得听力保健服务的感知障碍、感知益处和潜在行动线索，这些线索由健康信念模型提供信息。
50个人参加了7个焦点小组中的一个。焦点小组分别与三种类型的利益相关者进行：四个焦点小组包括报告有一定程度听力损失且最近完成听力筛查的成年人；两个焦点小组包括因听力损失最近首次寻求听力保健服务的成年人；一个焦点小组包括听力损失患者的重要他人/家庭成员。
焦点小组时长60 - 90分钟，由一名经过培训的主持人按照讨论指南主持。每个焦点小组都有一名研究听力学家在场并担任记录员。焦点小组由研究团队成员进行录音和转录，然后由多名团队成员以迭代的方式对转录本进行编码。采用定性内容分析方法，以归纳法减少数据并确定突出的主题和子主题。我们专注于确定与听力损失阳性筛查后听力保健服务可及性促进因素相关的主题，以及分别基于这些促进因素对自动听力筛查系统的潜在改进，以提高听力保健服务的可及性。
我们确定了与听力损失阳性筛查后听力保健服务可及性相关的五个关键主题，以及基于这些主题改进自动听力筛查系统的想法。这些主题包括知识、信任、可及性、生活质量和人际影响。
我们的工作结果有助于为创新听力筛查系统的开发提供信息，这些系统可以自动化，以利用听力保健服务可及性的个体促进因素。
