Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center, 622 West 168th Street - VC417, New York, NY, 10032, USA.
Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032, USA.
Disabil Health J. 2022 Jan;15(1):101181. doi: 10.1016/j.dhjo.2021.101181. Epub 2021 Aug 13.
Children with hearing loss (HL) require coordination of care to navigate medical and social services. Strong evidence supports the role of community health workers (CHWs) to identify and address social barriers.
The goal of this study was to evaluate the impact of integrating CHWs into the medical teams of children with HL and identify the social needs associated with their caregivers at a large urban hospital center.
A retrospective chart review was conducted for 30 children with HL whose caregivers enrolled in a CHW program between August 1, 2017 and December 31, 2019. Baseline demographic data were collected, including social circumstances such as food and housing insecurity, status of social security supplemental income (SSI), and need for referral to early intervention (EI) or preschool/school services. Caregivers were assessed for confidence in self-management; baseline distress level was measured via a distress thermometer.
Of the 30 charts reviewed, 93% demonstrated social needs including food insecurity (24%) and educational service needs (45%). Eighty-seven percent of caregivers reported a sense of control over the child's condition, yet 73% reported a stress level of four or greater on the distress thermometer scale. At 3 months follow-up, 70% of patients completed referrals; a significant number of patients had obtained hearing aids and cochlear implants compared to baseline (p = 0.017).
Caregivers of children with HL face multiple social obstacles, including difficulties connecting to educational and financial resources. CHWs are instrumental in identifying social needs and connecting caregivers to services.
患有听力损失（HL）的儿童需要协调医疗和社会服务。有强有力的证据支持社区卫生工作者（CHWs）的作用，以确定和解决社会障碍。
本研究的目的是评估将 CHWs 纳入 HL 儿童医疗团队的影响，并确定大型城市医院中心 HL 儿童照顾者相关的社会需求。
对 2017 年 8 月 1 日至 2019 年 12 月 31 日期间参加 CHW 计划的 30 名 HL 儿童的照顾者进行了回顾性图表审查。收集了基线人口统计学数据，包括食物和住房不安全、社会安全补充收入（SSI）状况以及需要转介早期干预（EI）或学前/学校服务等社会情况。评估了照顾者自我管理的信心；使用痛苦温度计测量基线痛苦水平。
在审查的 30 份图表中，93%的图表显示存在社会需求，包括食物不安全（24%）和教育服务需求（45%）。87%的照顾者表示对孩子的病情有控制感，但 73%的照顾者报告在痛苦温度计量表上的压力水平为四或更高。在 3 个月的随访中，70%的患者完成了转介；与基线相比，许多患者获得了助听器和人工耳蜗（p=0.017）。
HL 儿童的照顾者面临多种社会障碍，包括难以连接到教育和财政资源。CHWs 在确定社会需求和将照顾者与服务联系起来方面发挥了重要作用。
