title: Identifying a context-effective school hearing screening test: An emic/etic framework.
abstract: OBJECTIVE
  To identify a context-effective hearing screening test for primary schools in the Western Cape, South Africa using an emic-etic framework for test selection.
  
  
  METHODS
  A sequential mixed methods design was used to: (1) Identify test properties needed to successfully screen hearing in primary school children in the Western Cape, (2) select the hearing screening test most likely to succeed in this context, and (3) assess the use of the test in context.
  
  
  METHODS
  Three nurses, two nursing assistants, two paediatric audiologists, and 100 grade-one children participated.
  
  
  RESULTS
  Distortion product otoacoustic emissions (DPOAEs) were identified as the test most likely to succeed as a hearing screening test in primary school children in the Western Cape. While school nurses were able to successfully apply OAE testing in this context, its sensitivity to hearing loss in these children was 57.14%.
  
  
  CONCLUSIONS
  The sensitivity would need to be improved before OAE testing could be used as a context-effective screening test for primary school children in the Western Cape. The study demonstrated the value of collaborative program planning using an emic-etic framework to ensure that screening tests are contextually appropriate.
authors.affiliation: * Department of Health and Rehabilitation Sciences, Division of Communication Sciences and Disorders, University of Cape Town , South Africa.
authors.forename: Tracey-Lee
authors.initials: TL
authors.lastname: Cloete
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Wilson
authors.forename: Lucretia
authors.initials: L
authors.lastname: Petersen
authors.forename: Harsha
authors.initials: H
authors.lastname: Kathard
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D002648:Child; D005260:Female; D017144:Focus Groups; D034381:Hearing Loss / Q000175:diagnosis*; D006320:Hearing Tests / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D015588:Observer Variation; D036301:Qualitative Research; D012572:School Health Services; D012680:Sensitivity and Specificity; D013019:South Africa
keywords: School hearing screening; context-effective; contextual relevance; emic/etic framework; otoacoustic emissions