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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, Johan (author)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups
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- Ekman, Björn Olof (author)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups
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- Östergren, Per Olof (author)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups
- (creator_code:org_t)
- 2017-06-02
- 2018
- English.
- In: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 13:6, s. 497-503
- Journal article (peer-reviewed)
Abstract
Subject headings
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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
- 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)
Keyword
- centre-based service
- community-based service
- developing countries
- Hearing aids
- outcomes
- service delivery
- Hearing aids
Publication and Content Type
- art (subject category)
- ref (subject category)
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