HEARS - Hearing Health Equity through Accessible Research and Solutions
The HEARS program, which trains community health workers to deliver hearing care, shows success among low-income older adults, has the potential to close gaps in hearing care access for older adults
Results of randomized clinical trial published in the Journal of the American Medical Association.
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All older adults deserve access to the tools they need for healthy aging. But there are gaps in who gets hearing care. Less than 20% of adults with hearing loss use a hearing aid and that rate is even lower among low-income adults. Racial and ethnic health inequities also contribute to low levels of hearing aid use among older African Americans with hearing loss.
To bridge this gap in access to hearing care, Johns Hopkins Medicine researchers developed HEARS - Hearing health Equity through Accessible Research and Solutions.
HEARS trained community health workers to connect older adults in their community with low-cost hearing technology. Researchers then measured whether those older adults saw benefit in their hearing and communication. Learn more about how the HEARS study was designed.
The HEARS program works: the team found that participants’ hearing and communication improved significantly – all with a 2-hour program delivered entirely by community health workers using over-the-counter, low-cost hearing technology. Results of the randomized clinical trial were published in the Journal of American Medical Association.
“They came to us and received help from us because we are just like them — we are seniors,” said Renee Hicks, a CHW who provided hearing devices and education to her peers. “They would learn from us because we were living in the same community. It helped health-wise, too; people were coming out of their apartments and participating in activities.”
Core faculty Carrie Nieman, MD, MPH , first author of the clinical trial and co-creator of the HEARS model, said the program is not intended to replace audiologists and otolaryngologists who have specialized training in hearing loss.
The goal instead, she said, is to “recruit and train community health workers who share some of the same lived experiences as those who go without hearing care, which represents the vast majority of older adults with hearing loss. From this position, CHWs can gain trust and connect with their clients in ways that hearing care professionals, like myself, often cannot.”
This trial validates a model of hearing care that empowers community health workers to reach older adults with untreated hearing loss. Further trials of the HEARS program are planned at three sites across Maryland, and Nieman is seeking collaborators and funding to grow the program globally.
The research team is cross-disciplinary, and includes Frank Lin, Joshua Betz, Emmanuel Garcia Morales, Jonathan Suen, Jami Trumbo, Nicole Marrone, Hae-Ra Han and Sarah Szanton.
Funding for this study was supported by the National Institute on Deafness and Other Communication Disorders.
HEARS BY THE NUMBERS
- The HEARS program tested a way to bridge the gap in who gets access to hearing care.
- HEARS is the largest trial of low-income older adults with hearing loss and the largest study of African American older adults with hearing loss.
- HEARS trained community health workers to connect older adults in their community with low-cost hearing technology.
- The study included 151 participants from 13 community sites in Baltimore, Maryland, which included affordable independent housing complexes and senior centers.
- 78 people were randomized to receive a CHW-led hearing care intervention; a waitlist control group of 73 people did not.
- The average age of participants was 76.7 years old.
- 101 participants were women and 65 identified as African American.
- Two-thirds of participants were in the low-income bracket, and nearly half did not have or use a smartphone.
- Communication function was assessed using the Hearing Handicap Inventory. Scoring on the measure ranges from zero to 40, with higher scores indicating more communication difficulty.
- Those who received help from a CHW had a baseline median score of 21.7 and a median score of 7.9 at a three-month follow-up visit with the CHW. By contrast, the waitlist control group saw little to no change, with a baseline median score of 20.1 and a median score of 21 at the three-month follow-up.
- This trial validates a model of hearing care that empowers community health workers to reach older adults with untreated hearing loss.