Advanced

Is centre-based provision of hearing aids better than community-based provision? A cluster-randomized trial among adolescents in Bangladesh

Borg, Johan LU ; Ekman, Björn Olof LU and Östergren, Per Olof LU (2017) In Disability and Rehabilitation: Assistive Technology
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.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
centre-based service, community-based service, developing countries, Hearing aids, outcomes, service delivery
in
Disability and Rehabilitation: Assistive Technology
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85020162693
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
2017-07-08 03:00:01
@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},
  keyword      = {centre-based service,community-based service,developing countries,Hearing aids,outcomes,service delivery},
  language     = {eng},
  month        = {06},
  pages        = {7},
  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},
  year         = {2017},
}