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

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Borg, JohanLund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups (author)

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

Article/chapterEnglish2018

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2017-06-02
Informa UK Limited,2018

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LIBRIS-ID:oai:lup.lub.lu.se:9b88a7be-40fe-4d01-a8ea-8d9295db300d
https://lup.lub.lu.se/record/9b88a7be-40fe-4d01-a8ea-8d9295db300dURI
https://doi.org/10.1080/17483107.2017.1332110DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:du-30343URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:art swepub-publicationtype
Subject category:ref swepub-contenttype

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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.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
centre-based service
community-based service
developing countries
Hearing aids
outcomes
service delivery
Hearing aids

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Ekman, Björn OlofLund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups(Swepub:lu)nek-bek (author)
Östergren, Per OlofLund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups(Swepub:lu)smi-pos (author)
Socialmedicin och global hälsaForskargrupper vid Lunds universitet (creator_code:org_t)

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