title: Screening, Education, and Rehabilitation Services for Hearing Loss Provided to Clients with Low Vision: Measured and Perceived Value Among Participants of the Vision-Hearing Project.
abstract: Combined vision and hearing impairment, termed dual sensory impairment (DSI), is associated with poorer health outcomes compared with a single sensory loss alone. Separate systems of care exist for visual and hearing impairment which potentially limit the effectiveness of managing DSI. To address this, a Hearing Screening Education Model (HSEM) was offered to older adults attending a low-vision clinic in Australia within this pilot study. The present study aimed to evaluate the benefits of seeking help on hearing handicap, self-perceived health, and use of community services among those identified with unmet hearing needs after participation in the HSEM.
  
  
  
  Of 210 older adults (>55 years of age) who completed the HSEM and were referred for follow-up, 169 returned for a follow-up interview at least 12 months later. Of these, 68 (40.2%) sought help, and the majority were seen by a hearing healthcare provider (89.7%). Changes in hearing handicap, quality of life, and reliance on community services between the baseline and 12-month follow-up were compared between those who sought help and those who did not. In addition, the perceived value of the HSEM was assessed.
  
  
  
  Results showed that there was no significant difference in hearing handicap between those who sought help (mean change -1.02 SD = 7.97, p = 0.3) and those who did not (mean change 0.94 SD = 7.68, p = 0.3), p = 0.18. The mental component of the SF-36 worsened significantly between baseline and follow-up measures across the whole group (mean change -2.49 SD = 9.98, p = 0.002). This was largely driven by those not seeking help, rather than those seeking help, but was not significantly different between the two groups. Those who sought help showed a significant reduction in the use of community services compared with those who did not. Further, all participants positively viewed the HSEM's underlying principle of greater integration between vision and hearing services.
  
  
  
  These findings suggest a need to further develop and evaluate integrated models of healthcare for older adults with DSI. It also highlights the importance of using broader measures of benefit, other than use of hearing aids to evaluate outcomes of hearing healthcare programs.
authors.affiliation: 1Australian Hearing Hub, Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia; 2Menzies Centre for Health Policy, 3Work Integrated Learning, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia; 4Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, New South Wales, Australia; and 5Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: McMahon
authors.forename: Julie
authors.initials: J
authors.lastname: Schneider
authors.forename: Moira
authors.initials: M
authors.lastname: Dunsmore
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.forename: Annette
authors.initials: A
authors.lastname: Kifley
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Jie-Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Leeder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D034381:Hearing Loss / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation; D006320:Hearing Tests; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration*; D010865:Pilot Projects; D011788:Quality of Life; D015354:Vision, Low / Q000150:complications*