A Community-based Service Enhancement Model of Training and Employing Ear Health Facilitators to Address the Crisis in Ear and Hearing Health of Aboriginal Children in the Northern Territory, the Hearing for Learning Initiative (the HfLI): Study...

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2021 Jun 17

PMID 34134736

Citations 2

Authors

Kelvin Kong

Alan Cass

Amanda Jane Leach

Peter Stanley Morris

Amy Kimber

Jiunn-Yih Su

Victor Maduabuchi Oguoma

Affiliations

Soon will be listed here.

Abstract

Background: Almost all Aboriginal children in remote communities have persistent bilateral otitis media affecting hearing and learning throughout early childhood and school years, with consequences for social and educational outcomes, and later employment opportunities. Current primary health care and specialist services do not have the resources to meet the complex needs of these children.

Method/design: This stepped-wedge cluster randomised trial will allocate 18 communities to one of five 6-monthly intervention start dates. Stratification will be by region and population size. The intervention (Hearing for Learning Initiative, HfLI) consists of six 20-h weeks of training (delivered over 3 months) that includes Certificate II in Aboriginal Primary Health Care (3 modules) and competencies in ear and hearing data collection (otoscopy, tympanometry and hearScreen), plus 3 weeks of assisted integration into the health service, then part-time employment as Ear Health Facilitators to the end of the trial. Unblinding will occur 6 months prior to each allocated start date, to allow Community Reference Groups to be involved in co-design of the HfLI implementation in their community. Relevant health service data will be extracted 6-monthly from all 18 communities. The primary outcome is the difference in proportion of children (0 to 16 years of age) who have at least one ear assessment (diagnosis) documented in their medical record within each 6-month period, compared to control periods (no HfLI). Secondary outcomes include data on sustainability, adherence to evidence-based clinical guidelines for otitis media, including follow-up and specialist referrals, and school attendance. Structured interviews with staff working in health and education services, Ear Health Trainees, Ear Health Facilitators and families will assess process outcomes and the HfLI broader impact.

Discussion: The impact of training and employment of Ear Health Facilitators on service enhancement will inform the health, education and employment sectors about effectiveness of skills and job creation that empowers community members to contribute to addressing issues of local importance, in this instance ear and hearing health of children.

Trial Registration: ClinicalTrials.gov NCT03916029 . Registered on 16 April 2019.

Citing Articles

Hearing loss in Australian First Nations children at 6-monthly assessments from age 12 to 36 months: Secondary outcomes from randomised controlled trials of novel pneumococcal conjugate vaccine schedules.

Leach A, Wilson N, Arrowsmith B, Beissbarth J, Mulholland K, Santosham M PLoS Med. 2024; 21(6):e1004375.

PMID: 38829821 PMC: 11146696. DOI: 10.1371/journal.pmed.1004375.

An evaluation of the quality of ear health services for Aboriginal children living in remote Australia: a cascade of care analysis.

Su J, Leach A, Cass A, Morris P, Kong K BMC Health Serv Res. 2023; 23(1):1186.

PMID: 37907905 PMC: 10617165. DOI: 10.1186/s12913-023-10152-z.

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