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10/27/2018  |   10:30 AM - 11:30 AM   |  Kramer Lecture Theater 2

Adapting a Community Health Worker Model for Accessible and Affordable Care to Address Age-Related Hearing Loss

Recent national reports in the U.S.A. from the National Academies of Sciences, Engineering, and Medicine (NASEM 2016) and the President’s Council of Advisors on Science and Technology (PCAST 2015) have called for the development of novel approaches for addressing hearing loss among older adults as a public health imperative. The Baltimore Hearing Equality through Accessible Research and Solutions (HEARS) intervention is a theory-driven and community-based response. The program incorporates education and counseling for age-related hearing loss, including communication strategies, and training in the utilization of low-cost, over-the-counter amplification devices. We adapted a community health worker (CHW) model to cultivate an interventionist workforce for delivering HEARS to vulnerable older adults residing in subsidized senior housing. CHW models have a long history of implementation within lower resourced communities globally to address various health domains. Multiple prospective studies and reviews have reported on the efficacy and effectiveness of community-based delivery models with consistent recognition of CHWs as valuable members for increasing the accessibility and affordability of healthcare utilization. CHWs traditionally work as paraprofessionals under clinician supervision. As a community-based aural rehabilitation program, hearing healthcare professionals support HEARS CHWs in hosting didactic training modules, continuing education, and collaborations for troubleshooting issues encountered in the field. Our exploratory pilot studies identified important areas for clinician supervision and developed the community-based infrastructure for a CHW-delivered aural rehabilitation program. Findings demonstrated the acceptability and preliminary efficacy of the HEARS intervention in reducing self-reported hearing handicap among the target demographic. Community-based delivery models employing a team approach with CHWs and supervising hearing healthcare professionals offer a novel framework for increasing the accessibility and affordability of hearing healthcare in a rapidly aging world.

  • Attendees will be able to describe the role of the clinician in the HEARS community health worker paraprofessional model.
  • Attendees will be able to describe the necessary components of a community health worker training program for preparing and supporting community-based interventions.
  • Attendees will be able to identify elements of the HEARS community health worker model that supports increased accessibility of services.

Presentation:
18607_9863CarrieNieman.pdf

Handouts:
No handouts have been uploaded.

Carrie Nieman (POC,Co-Presenter,Author,Co-Author), Johns Hopkins University School of Medicine Dept. Otolaryngology-HNS, cnieman1@jhmi.edu;
Carrie Nieman MD, MPH is an Assistant Professor in the Johns Hopkins University School of Medicine and a core faculty member in the Cochlear Center for Hearing and Public Health at the Johns Hopkins University Bloomberg School of Public Health. Dr. Nieman is also the co-founder of Access HEARS, a social enterprise committed to affordable, accessible hearing care. As a clinician, researcher, and social entrepreneur, her commitment to social justice is inseparable from her drive to provide innovative solutions to address disparities in the nascent field of community-delivered hearing care and develop a sustainable model to provide accessible and affordable hearing care. Her work translates research in gerontology, social design, intervention development, community-based participatory research, and a human factors approach to design to advance research in hearing care disparities and bring innovation to underserved communities.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - Has a Personal relationship for Board membership.   Has a Personal relationship for Board membership.  


      AAA DISCLOSURE:

Financial - Receives support from NIH NIDCD R21/R33, NIH NIA K23, Access HEARS.  

Jonathan Suen (POC,Primary Presenter,Author), Cochlear Center for Hearing & Public Health (Johns Hopkins University), suen@jhmi.edu;
Jonathan Suen, AuD, is an audiologist, research fellow in Dr. Frank Lin’s lab at the Cochlear Center for Hearing and Public Health (Johns Hopkins University Bloomberg School of Public Health), and a PhD student in the Johns Hopkins University School of Nursing. He was previously an instructor for Gallaudet University’s Peer Mentor Program, a training program for individuals with hearing loss to serve as peer educators and liaisons between the public and aural rehabilitation professionals. Drawing upon experiences in community engagements for public health initiatives and clinical care, he is interested in studying innovative approaches for increasing the accessibility of hearing healthcare utilization by older adults.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nicole Marrone (Co-Author), University of Arizona Department of Speech, Language, and Hearing Sciences, nmarrone@email.arizona.edu;
Nicole Marrone, PhD, CCC-A holds the James S. and Dyan Pignatelli/Unisource Clinical Chair in Audiologic Rehabilitation for Adults at the University of Arizona and is an Assistant Professor of Speech, Language, and Hearing Sciences. Her research investigates hearing loss and rehabilitation in adults. Her specialty is how interventions, including hearing aids and group audiologic rehabilitation, can improve people’s quality of life and communication in everyday environments. Part of Dr. Marrone’s research focuses on increasing access to hearing healthcare in rural communities. This interdisciplinary work is in collaboration with faculty in the Mel and Enid Zuckerman College of Public Health and the Department of Spanish and Portuguese, as well as with community health providers at the Mariposa Community Health Center in Nogales, Arizona. Dr. Marrone and her collaborators were recently awarded a phased innovation grant (R21/R33) from NIH/NIDCD for this work: “Reducing Disparities in Access to Hearing Healthcare on the U.S.-Mexico Border”.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Sarah Szanton (Author,Co-Author), Johns Hopkins University School of Nursing, Sszanto1@ jhu.edu;
A number of years ago, while making house calls as a nurse practitioner to homebound, low-income elderly patients in West Baltimore, Dr. Sarah Szanton noticed that their environmental challenges were often as pressing as their health challenges. Since then she has developed a program of research at the Johns Hopkins University School of Nursing on the role of the environment and stressors in health disparities in older adults, particularly those trying to “age in place” or stay out of a nursing home. Through a Robert Wood Johnson funded grant, a National Institutes of Health grant and a cooperative agreement from the Innovations office at the Center on Medicaid and Medicare Services, she is examining whether a program which combines handyman services with nursing and occupational therapy can improve mobility, reduce stress hormones, and decrease health care costs.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Hae-Ra Han (Co-Author), Johns Hopkins University School of Nursing, hhan3@jhu.edu;
Hae-Ra Han’s multidisciplinary team research is focused on innovative intervention and methodological approaches to improve care and outcomes for traditionally underserved ethnic minority populations by improving health literacy. Her program of research has advanced thinking from the traditional paradigm of knowledge transfer from provider to patients to developing skills of patients to traverse the landscape of health screening and patient self-care to reduce health disparities. In particular, Dr. Han has developed and tested health literacy interventions delivered by trained community health workers that have contributed to reducing health disparities in chronic care. In recognition of her work, Dr. Han has received numerous awards from organizations that include the Southern Nursing Research Society, the National Coalition of Ethnic Minority Nurse Associations, the American Public Health Association, the Asian American and Pacific Islander Caucus for Public Health, the League of Korean Americans, and Certificate of Congressional Recognition from U.S. Senator Barbara Mikulski.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Frank Lin (Author,Co-Author), Johns Hopkins University, flin1@jhmi.edu;
Frank Lin, MD, PhD, is an Associate Professor of Otolaryngology and Epidemiology at the Johns Hopkins University School of Medicine and the Bloomberg School of Public Health. He is the Director of the Cochlear Center for Hearing and Public Health. Dr. Lin's clinical practice is dedicated to otology and the medical and surgical management of hearing loss. His research is primarily focused on studying the interface between hearing loss and aging. In particular, Dr. Lin has established multiple collaborations with gerontologists, cognitive scientists, epidemiologists, and auditory scientists that form the basis for his current research program studying the impact of hearing loss on the cognitive and physical functioning of older adults and the potential role of aural rehabilitative strategies in mitigating these effects.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.