Is centre-based provision of hearing aids better than community-based provision? A cluster-randomized trial among adolescents in Bangladesh
(2018) In Disability and Rehabilitation: Assistive Technology 13(6). p.497-503- Abstract
Purpose: In response to the need for hearing aids in low-income countries, an approach to provide hearing aids through trained community workers was developed. This study compares the effectiveness of the community-based approach with that of a centre-based approach. Methods: One hundred and forty adolescents (56% girls; 12–18 years; mean: 15 years) from eleven sub-districts participated in a cluster-randomized trial comparing a community-based service (n = 75) with a centre-based service (n = 65) in Bangladesh. The International Outcome Inventory for Hearing Aids (IOI-HA) was administered to the participants six weeks after fitting of a hearing aid, and its scores were analyzed by Mann–Whitney U-tests and an ordinal regression model.... (More)
Purpose: In response to the need for hearing aids in low-income countries, an approach to provide hearing aids through trained community workers was developed. This study compares the effectiveness of the community-based approach with that of a centre-based approach. Methods: One hundred and forty adolescents (56% girls; 12–18 years; mean: 15 years) from eleven sub-districts participated in a cluster-randomized trial comparing a community-based service (n = 75) with a centre-based service (n = 65) in Bangladesh. The International Outcome Inventory for Hearing Aids (IOI-HA) was administered to the participants six weeks after fitting of a hearing aid, and its scores were analyzed by Mann–Whitney U-tests and an ordinal regression model. Results: The community-based approach performed as well as the centre-based approach on five out of seven outcome measures. The latter approach performed statistically significantly better on Residual participation restrictions (p = .007) and Impact on others (p = .012), but the effect sizes were small. Controlling for sex, age, hearing loss, place of living and proxy responses did not change the results. Conclusions: The community-based approach is a viable and effective option for hearing aid delivery in low-resourced settings. The approach needs to be adapted to particular contexts, and possible down-sides may need to be counteracted by special interventions.Implications for RehabilitationHearing aid use can contribute to improved activity, participation and quality of life among adolescents in low-income countries.Community-based approaches to delivering hearing aids can be viable and effective options to centre-based services.
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- author
- Borg, Johan LU ; Ekman, Björn Olof LU and Östergren, Per Olof LU
- organization
- publishing date
- 2018-08-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- centre-based service, community-based service, developing countries, Hearing aids, outcomes, service delivery
- in
- Disability and Rehabilitation: Assistive Technology
- volume
- 13
- issue
- 6
- pages
- 497 - 503
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:85020162693
- pmid:28573939
- ISSN
- 1748-3107
- DOI
- 10.1080/17483107.2017.1332110
- language
- English
- LU publication?
- yes
- id
- 9b88a7be-40fe-4d01-a8ea-8d9295db300d
- date added to LUP
- 2017-07-07 09:03:35
- date last changed
- 2024-07-22 00:17:31
@article{9b88a7be-40fe-4d01-a8ea-8d9295db300d, abstract = {{<p>Purpose: In response to the need for hearing aids in low-income countries, an approach to provide hearing aids through trained community workers was developed. This study compares the effectiveness of the community-based approach with that of a centre-based approach. Methods: One hundred and forty adolescents (56% girls; 12–18 years; mean: 15 years) from eleven sub-districts participated in a cluster-randomized trial comparing a community-based service (n = 75) with a centre-based service (n = 65) in Bangladesh. The International Outcome Inventory for Hearing Aids (IOI-HA) was administered to the participants six weeks after fitting of a hearing aid, and its scores were analyzed by Mann–Whitney U-tests and an ordinal regression model. Results: The community-based approach performed as well as the centre-based approach on five out of seven outcome measures. The latter approach performed statistically significantly better on Residual participation restrictions (p = .007) and Impact on others (p = .012), but the effect sizes were small. Controlling for sex, age, hearing loss, place of living and proxy responses did not change the results. Conclusions: The community-based approach is a viable and effective option for hearing aid delivery in low-resourced settings. The approach needs to be adapted to particular contexts, and possible down-sides may need to be counteracted by special interventions.Implications for RehabilitationHearing aid use can contribute to improved activity, participation and quality of life among adolescents in low-income countries.Community-based approaches to delivering hearing aids can be viable and effective options to centre-based services.</p>}}, author = {{Borg, Johan and Ekman, Björn Olof and Östergren, Per Olof}}, issn = {{1748-3107}}, keywords = {{centre-based service; community-based service; developing countries; Hearing aids; outcomes; service delivery}}, language = {{eng}}, month = {{08}}, number = {{6}}, pages = {{497--503}}, publisher = {{Taylor & Francis}}, series = {{Disability and Rehabilitation: Assistive Technology}}, title = {{Is centre-based provision of hearing aids better than community-based provision? A cluster-randomized trial among adolescents in Bangladesh}}, url = {{http://dx.doi.org/10.1080/17483107.2017.1332110}}, doi = {{10.1080/17483107.2017.1332110}}, volume = {{13}}, year = {{2018}}, }