scholarly journals Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study (Preprint)

2019 ◽  
Author(s):  
Husmita Ratanjee-Vanmali ◽  
De Wet Swanepoel ◽  
Ariane Laplante-Lévesque
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Patient Satisfaction ◽  
Process Evaluation ◽  
Screening Test ◽  
Instant Messaging ◽  
Hearing Screening ◽  
Web Based ◽  
Face To Face ◽  
Hearing Health

BACKGROUND Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. OBJECTIVE This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. METHODS A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic’s Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. RESULTS Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (<i>P</i>=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. CONCLUSIONS This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

scholarly journals Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study

10.2196/15875 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e15875 ◽  
Author(s):  
Husmita Ratanjee-Vanmali ◽  
De Wet Swanepoel ◽  
Ariane Laplante-Lévesque
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Patient Satisfaction ◽  
Process Evaluation ◽  
Screening Test ◽  
Instant Messaging ◽  
Hearing Screening ◽  
Web Based ◽  
Face To Face ◽  
Hearing Health

Background Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. Objective This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. Methods A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic’s Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. Results Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. Conclusions This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

scholarly journals Digital Proficiency Is Not a Significant Barrier for Taking Up Hearing Services With a Hybrid Online and Face-to-Face Model

2020 ◽  
Vol 29 (4) ◽  
pp. 785-808
Author(s):  
Husmita Ratanjee-Vanmali ◽  
De Wet Swanepoel ◽  
Ariane Laplante-Lévesque
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Mobile Device ◽  
Hearing Aids ◽  
Screening Test ◽  
Target Location ◽  
Care Model ◽  
Face To Face ◽  
Computer Proficiency ◽  
Hearing Health

Purpose The aim of this study was to determine the effect of self-perceived digital proficiency on the uptake of hearing services through a hybrid online and face-to-face hearing health care model. Method Adults were recruited via online methods to complete an online hearing screening test within the greater Durban area in South Africa. On submission of contact details after failing the screening, contact was made via telephone to assess readiness for further hearing care. If motivated and willing to continue, a face-to-face appointment for diagnostic hearing testing was confirmed, at which time an e-mail with an online mobile device and computer proficiency survey was sent. Hearing services were offered using combined online and face-to-face methods. Results Within 2 years (June 2017 to June 2019), 1,259 people from the target location submitted their details for the clinic audiologist to contact, of whom 931 participants (73.95%) failed the screening test. Of these participants, 5.69% (53/931, 57.41% men) attended a face-to-face diagnostic hearing evaluation. Mobile device and computer proficiency scores were not a predictor of acquiring hearing services. Age was the only significant predictor ( p = .018) for those continuing with hearing care. Patients who continued with hearing care by acquiring hearing aids and support services were older ( M = 73.63 years, SD = 11.62) and on average aware of their hearing loss for a longer time ( M = 14.71 years, SD = 15.77), as compared to those who discontinued hearing health care who were younger ( M = 59.21 years, SD = 14.42) and on average aware of their hearing loss for a shorter time ( M = 6.37 years, SD = 9.26). Conclusions Digital proficiency is not a predictor for acquiring hearing services through a hybrid online and face-to-face hearing care model. Hybrid services could allow professionals to assist patients in a combination of face-to-face and online services tailored to meet individual needs, including convenience and personalized care.

scholarly journals Feasibility, Acceptability, and Impact of a Web-Based Structured Education Program for Type 2 Diabetes: Real-World Study

JMIR Diabetes ◽  
10.2196/15744 ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. e15744 ◽  
Author(s):  
Shoba Poduval ◽  
Louise Marston ◽  
Fiona Hamilton ◽  
Fiona Stevenson ◽  
Elizabeth Murray
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Education Program ◽  
Self Efficacy ◽  
Completion Rates ◽  
Web Based ◽  
Structured Education ◽  
Face To Face ◽  
The United Kingdom

Background Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake. Objective The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress. Methods HDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program. Results It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education. Conclusions The study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.

scholarly journals Concurrent genetic and standard screening test for hearing reduction

2020 ◽  
Vol 66 (2) ◽  
pp. 35-40
Author(s):  
Marina Davcheva Chakar ◽  
Gjorgji Bozhinovski ◽  
Emilija Shukarova Stefanovska ◽  
Dejan Trajkov
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Genetic Screening ◽  
Screening Test ◽  
Screening Program ◽  
Deaf Child ◽  
Hearing Screening ◽  
Pathogenic Variant ◽  
Gjb2 Gene ◽  
Brainstem Response

Reduction of hearing is the most common sensory impairment among newborns with an incidence of 1-3 per 1000 births. Introduction of an Auditory Newborn screening program allows early identification of hearing impairment. Mainly, congenital hearing loss in early childhood is a result of genetic changes. Due to high frequency of GJB2 pathogenic variants, its molecular characterization among sensorineural hearing reduction cases is already conducted as a routine analysis in many countries. The aim of this study is to show our initial results in the effort to determine whether genetic screening along with the standard hearing screening in newborns is justified. Otoacoustic emission (OAE) method was conducted in 223 newborns at risk of hearing impairment. Among them, 7 did not pass the test in both ears while 9 exhibited one-sided hearing loss. In all 7 children with indication of profound bilateral deafness, the diagnosis was confirmed using auditory brainstem response. Genetic screening of GJB2 gene was performed in 6 of them. Genetic analysis of GJB2 revealed homozygous state of the most common pathogenic variant 35delG in 3 (50%) of the analyzed infants. In the remaining 3 no pathogenic variant was determined. The results indicate that performing auditory OAE together with genetic screening is justified. In newborns who have not passed the hearing screening test and have profound hearing loss, without other syndrome traits, screening for mutations of GJB2 gene should be conducted. Genetic screening enables establishment of early definite diagnosis for deafness and helps in conducting adequate therapy providing timely rehabilitation and social inclusion of deaf child. Key words: hearing loss, genetic screening, auditory screening, GJB2 gene

scholarly journals Promoting healthy hearing over the lifespan

2021 ◽  
Author(s):  
James W. Hall III
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Test Battery ◽  
Patient Specific ◽  
Comorbid Conditions ◽  
Specific Test ◽  
Age Related ◽  
Central Auditory Function ◽  
Hearing Health ◽  
Age Related Hearing Loss

Background and Aim: Comorbid conditions and unhealthy lifestyles are risk factors for auditory dysfunction, including age-related hearing loss. With a focus on adults, this paper describes a new approach to hearing health care that aims to prevent or mitigate hearing loss and related disorders, like tinnitus. Accurate diagnosis and effective management of hearing loss is best achieved with a patient-specific test battery that includes sensitive measures of peripheral and central auditory function. Background and Aim: Comorbid conditions and unhealthy lifestyles are risk factors for auditory dysfunction, including age-related hearing loss. With a focus on adults, this paper describes a new approach to hearing health care that aims to prevent or mitigate hearing loss and related disorders, like tinnitus. Accurate diagnosis and effective management of hearing loss is best achieved with a patient-specific test battery that includes sensitive measures of peripheral and central auditory function. Conclusion: The traditional model for hearing health care service delivery relies on a rather outdated and simplistic protocol for evaluating and describing hearing loss, and a technologyfocused approach for management. This paper offers an evidence-based rationale for expanding the test battery for diagnosing hearing loss, and a multidisciplinary intervention approach.   Keywords: Comorbid conditions; smoking; diet; value-added tests

scholarly journals The development and process evaluation of the ACTION study: A person-centred communication intervention targeting nurse assistants in home care for older persons

2019 ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Health Care ◽  
Home Care ◽  
Process Evaluation ◽  
Educational Intervention ◽  
Older Persons ◽  
Complex Interventions ◽  
Implementation Process ◽  
Ageing Population ◽  
Web Based ◽  
The Web

Abstract Background A rapidly ageing population challenges the health care system in general and home care services in particular. Communication is a cornerstone of person-centred care. However, little research has been conducted on how to improve communication between health care professionals and older persons in home care contexts, despite research showing the importance of such interactions. The increasing demands on how to best and efficiently improve competence in health professionals is the reason why the ACTION intervention was conducted. This paper aims to describe the development and process evaluation of an educational intervention for nurse assistants (NAs) in home care and highlights the potential of self-directed web-based learning as well as the pitfalls of conducting complex interventions in home care. Methods A web-based educational intervention focusing on person-centred communication was developed that targeted NAs in home care for older persons. Twenty-seven NAs from two units in Sweden were recruited, and 23 NAs were offered the educational intervention. Data were collected from multiple sources before, during and after the intervention and were analysed using quantitative and qualitative methods. Data were extracted from the web platform and analysed to determine the NAs´ engagement in the intervention. Additionally, interviews, evaluation forms and field notes were used to evaluate the feasibility of the intervention. Results The main findings suggest that web-based education seems to be an appropriate strategy in the home care context. The majority of the NAs (91%) participated in full or in part in the intervention. During the implementation process, some adaptions were required to fit the local circumstances regarding technical support, scheduling, and the design of the lectures. The NAs perceived the format to be easy to use and flexible and appreciated the stepwise modules. The content was perceived as valuable. Conclusions Our findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.

Hearing Screening of High-Risk Newborns with Brainstem Auditory Evoked Potentials: A Follow-up Study

PEDIATRICS ◽  
1984 ◽  
Vol 73 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Dorothy A. Shannon ◽  
Jacob K. Felix ◽  
Allan Krumholz ◽  
Phillip J. Goldstein ◽  
Kenneth C. Harris
Keyword(s):  
Hearing Loss ◽  
High Risk ◽  
Predictive Value ◽  
Screening Test ◽  
Normal Hearing ◽  
Hearing Screening ◽  
Auditory Evoked Potential ◽  
Hearing Level ◽  
Lost To Follow Up

Numerous techniques have been used in attempts to find a reliable and efficient screening method for determining auditory function in the newborn. The brainstem auditory evoked potential (BAEP) is the latest method advocated for that purpose. The BAEP was evaluated as a hearing screening test in 168 high-risk newborns between 35 and 45 weeks of conceptual age. Follow-up data were obtained after 1 year (mean 17.3 months) on 134 of the infants (80%). Normal hearing was defined as a reproducible response in both ears to a 25 dB normal hearing level (nHL) click stimulus; 21 infants (12.5%) failed the initial screening test. Follow-up on 19/21 infants revealed 18 infants with normal hearing and one infant with an 80 dB nHL bilateral hearing loss substantiated. One infant with an abnormal screening test died before retesting, and the other infant was lost to follow-up but had only a unilaterally abnormal BAEP. None of the infants with a normal BAEP screening study had evidence of hearing loss on retesting. Sensitivity of the BAEP was 100%, specificity was 86%, predictive value of a positive test was 5.26%, and the predictive value of a negative test was 100%. The incidence of significant hearing loss in our population was between 0.75% (1/134 infants) confirmed, and 2.24% (3/134 infants) including infants who failed screening but were lost to follow-up. The BAEP is a sensitive procedure for the early identification of hearing-impaired newborns. However, the yield of significant hearing abnormalities was less than predicted in other studies using BAEP for newborn hearing screening.

Auditory Risk to Unprotected Bystanders Exposed to Firearm Noise

2011 ◽  
Vol 22 (02) ◽  
pp. 093-103 ◽  
Author(s):  
Gregory A. Flamme ◽  
Michael Stewart ◽  
Deanna Meinke ◽  
James Lankford ◽  
Per Rasmussen
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Data Collection ◽  
Descriptive Study ◽  
Poor Agreement ◽  
Acoustic Characteristics ◽  
Sound Levels ◽  
Data Collection And Analysis ◽  
Hearing Health ◽  
Damage Risk

Background: What is the risk of hearing loss for someone standing next to a shooter? Friends, spouses, children, and other shooters are often present during hunting and recreational shooting activities, and these bystanders seem likely to underestimate the hazard posed by noise from someone else's firearm. Hunters use hearing protection inconsistently, and there is little reason to expect higher use rates among bystanders. Acoustic characteristics and estimates of auditory risk from gunfire noise next to the shooter were assessed in this study. Research Design: This was a descriptive study of auditory risk at the position of a bystander near a recreational firearm shooter. Data Collection and Analysis: Recordings of impulses from 15 recreational firearms were obtained 1 m to the left of the shooter outdoors away from reflective surfaces. Recordings were made using a pressure-calibrated 1/4 inch measurement microphone and digitally sampled at 195 kHz (24 bit depth). The acoustic characteristics of these impulses were examined, and auditory risk estimates were obtained using three contemporary damage-risk criteria (DRCs) for unprotected listeners. Results: Instantaneous peak levels at the bystander location ranged between 149 and 167 dB SPL, and 8 hr equivalent continuous levels (LeqA8) ranged between 64 and 83 dB SPL. Poor agreement was obtained across the three DRCs, and the DRC that was most conservative varied with the firearm. The most conservative DRC for each firearm permitted no unprotected exposures to most rifle impulses and fewer than 10 exposures to impulses from most shotguns and the single handgun included in this study. More unprotected exposures were permitted for the guns with smaller cartridges and longer barrel length. Conclusions: None of the recreational firearms included in this study produced sound levels that would be considered safe for all unprotected listeners. The DRCs revealed that only a few of the small-caliber rifles and the smaller-gauge shotguns permitted more than a few shots for the average unprotected listener. This finding is important for professionals involved in hearing health care and the shooting sports because laypersons are likely to consider the bystander location to be inherently less risky because it is farther from the gun than the shooter.

Understanding Hearing Loss and Barriers to Hearing Health Care Among Korean American Older Adults: A Focus Group Study

2016 ◽  
Vol 37 (11) ◽  
pp. 1344-1367 ◽  
Author(s):  
Janet S. Choi ◽  
Kyoo S. Shim ◽  
Kunhwa Kim ◽  
Carrie L. Nieman ◽  
Sara K. Mamo ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Social Cognitive ◽  
Qualitative Content Analysis ◽  
Korean American ◽  
Focus Group Study ◽  
Hearing Health ◽  
Older Korean Americans

Hearing loss is associated with an accelerated decline in social, cognitive, and physical functioning among older adults. However, little is known about its impact and barriers to hearing health care in any ethnic minorities. The aim of this study was to explore experiences related to hearing loss and barriers to hearing health care among older Korean Americans (KAs). We conducted four focus groups with 19 older KAs with hearing loss and four communication partners. Qualitative content analysis revealed four themes: (a) impact of hearing loss, (b) self-perception of hearing loss, (c) coping strategies for hearing loss, and (d) barriers to hearing health care (price, language, lack of collaborative communications, perceptions about hearing aids, and lack of knowledge). Older KAs were significantly impacted by hearing loss but tended not to seek care due to multiple factors. Culturally tailored hearing interventions are urgently needed to promote hearing health in the KA community.

scholarly journals Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures: a focus group analysis

2020 ◽  
Author(s):  
Eric Danjel Tutuhatunewa ◽  
Martin Stevens ◽  
Olivier C. Dams ◽  
Jeffrey van Son ◽  
Rebecca D. Louhanepessy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Focus Group ◽  
Focus Groups ◽  
Treatment Options ◽  
Clavicle Fracture ◽  
Group Analysis ◽  
Nonoperative Treatment ◽  
Web Based ◽  
Face To Face ◽  
Clavicle Fractures

Abstract BackgroundThere is no consensus on the optimal treatment for displaced midshaft clavicle fractures. Several studies indicate superior patient satisfaction in favour of operative reconstruction. It is unknown what drives superior satisfaction in this treatment group. The aim of this study was to explore patient satisfaction and identify contributors to patient satisfaction after operative and nonoperative treatment for displaced midshaft clavicle fractures in adults using a focus group approach.MethodsFour face-to-face and two web-based focus groups were hosted. A total of 24 participants who were treated nonoperatively (n = 14) or operatively (n = 10) agreed to participate. Participants were selected using purposive sampling, ensuring variation in gender, age, treatment complications and outcomes. A question script was developed to systematically explore patient expectations, attitudes and satisfaction with different dimensions of care. All focus groups were voice-recorded and transcribed at verbatim. Thematic analysis was conducted on all face-to-face and web-based transcripts. ResultsThe main emerging themes across treatment groups were; need for more information, functional recovery, speed of recovery and patient-doctor interaction. There was no difference in themes observed between operative and nonoperative focus groups. The lack of information was the most important complaint in dissatisfied patients. Conclusion Our study shows that informing patients about their injury, treatment options and expectations for recovery is paramount for overall patient satisfaction after treatment for a displaced midshaft clavicle fracture.

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