Oberman Mary Katherine, Gebert Marissa Schuh, Henderson Olivia, Taylor Olivia, Bettger Janet Prvu, Lane Hannah, Schoenberg Nancy, Robler Samantha Kleindienst, Deshpande Shayu, Emmett Susan D, Bush Matthew
College of Medicine, University of Kentucky, Lexington, Kentucky, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA.
Ear Hear. 2025 Sep 8. doi: 10.1097/AUD.0000000000001737.
School-based hearing screening serves as a critical resource for children in rural areas to be screened and connected to hearing healthcare. Telemedicine interventions in schools have shown promise in connecting children to providers; however, there is limited research on systematic adaptation and deployment of telemedicine in rural schools. Obtaining community perspectives and preferences on school-based telemedicine hearing evaluation is essential to ensure such interventions are deployable in a rural context. Grounded in the ADAPT-ITT framework, this research focused on assessing community perspectives and preferences regarding school-based telemedicine hearing screening to inform adaptation of a school-based telemedicine intervention. This analysis represents the first step of the ADAPT-ITT framework (Assessment of community perspectives).
We completed 21 semi-structured interviews of 3 informant groups: parents of children in elementary school, school staff, and regional care providers from 14 rural Appalachian counties. We analyzed data from informant groups using qualitative methods across two a priori domains: (1) experience with childhood hearing loss, screening, and follow-up process, (2) components of childhood hearing screening (school-based screening, exchange of information with educators/parents/providers, integration of technology and telemedicine).
Important implications and opportunities drawn from these data include the need for an adapted hearing screening intervention that can integrate care coordination into the screening process, provide clear yet secure communication to parents, educational staff, and regional healthcare providers, and facilitate comprehensive and timely collection of screening data.
Rural school-based hearing screening programs face a pervasive lack of communication and coordination of care following screening. By gaining community perspectives on hearing screening, communication, and care coordination, this study presents a model for how to initiate intervention adaptation when it will be studied in another context.
基于学校的听力筛查是农村地区儿童接受筛查并获得听力保健服务的关键资源。学校的远程医疗干预在将儿童与医疗服务提供者联系起来方面已显示出前景；然而，关于在农村学校系统地调整和部署远程医疗的研究有限。了解社区对基于学校的远程医疗听力评估的看法和偏好对于确保此类干预措施在农村环境中可行至关重要。本研究以ADAPT-ITT框架为基础，重点评估社区对基于学校的远程医疗听力筛查的看法和偏好，以为基于学校的远程医疗干预的调整提供参考。该分析代表了ADAPT-ITT框架的第一步（社区观点评估）。
我们对三个信息提供者群体进行了21次半结构化访谈：小学儿童的家长、学校工作人员以及来自14个阿巴拉契亚农村县的地区医疗服务提供者。我们使用定性方法对信息提供者群体的数据进行了分析，涉及两个先验领域：（1）儿童听力损失、筛查及后续过程的经历，（2）儿童听力筛查的组成部分（基于学校的筛查、与教育工作者/家长/医疗服务提供者的信息交流、技术与远程医疗的整合）。
从这些数据中得出的重要启示和机会包括，需要一种经过调整适应的听力筛查干预措施，该措施能够将护理协调整合到筛查过程中，向家长、教育工作人员和地区医疗服务提供者提供清晰且安全的沟通，并促进全面及时地收集筛查数据。
农村基于学校的听力筛查项目在筛查后普遍缺乏沟通和护理协调。通过了解社区对听力筛查、沟通和护理协调的看法，本研究提出了一个在另一环境中进行研究时如何启动干预措施调整的模型。
