title: The Baltimore HEARS Pilot Study: An Affordable, Accessible, Community-Delivered Hearing Care Intervention.
abstract: Age-related hearing loss negatively affects health outcomes, yet disparities in hearing care, such as hearing aid use, exist based on race/ethnicity and socioeconomic position. Recent national efforts highlight reduction of hearing care disparities as a public health imperative. This study a) describes a community engagement approach to addressing disparities, b) reports preliminary outcomes of a novel intervention, and c) discusses implementation processes and potential for wide-scale testing and use.
  
  
  
  This was a prospective, randomized control pilot, with a 3-month delayed treatment group as a waitlist control, that assessed feasibility, acceptability, and preliminary efficacy of a community-delivered, affordable, and accessible intervention for older adults with hearing loss. Outcomes were assessed at 3 months, comparing immediate and delayed groups, and pooled to compare the cohort's pre- and 3-month post-intervention results.
  
  
  
  All participants completed the study (n = 15). The program was highly acceptable: 93% benefited, 100% would recommend the program, and 67% wanted to serve as future program trainers. At 3 months, the treated group (n = 8) experienced fewer social and emotional effects of hearing loss and fewer depressive symptoms as compared to the delayed treatment group (n = 7). Pooling 3-month post-intervention scores (n = 15), participants reported fewer negative hearing-related effects (effect size = -0.96) and reduced depressive symptoms (effect size = -0.43).
  
  
  
  The HEARS (Hearing Equality through Accessible Research & Solutions) intervention is feasible, acceptable, low risk, and demonstrates preliminary efficacy. HEARS offers a novel, low-cost, and readily scalable solution to reduce hearing care disparities and highlights how a community-engaged approach to intervention development can address disparities.
authors.affiliation: Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.|The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Nieman
authors.affiliation: Department of Speech, Language, & Hearing Sciences, University of Arizona, Tucson.
authors.forename: Nicole
authors.initials: N
authors.lastname: Marrone
authors.affiliation: Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.|The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Mamo
authors.affiliation: The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.|Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Joshua
authors.initials: J
authors.lastname: Betz
authors.affiliation: Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.|The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Janet S
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.|The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Contrera
authors.affiliation: The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Roland J
authors.initials: RJ
authors.lastname: Thorpe
authors.affiliation: Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland.|Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.affiliation: The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.|Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Tanner
authors.affiliation: Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland.
authors.forename: Hae-Ra
authors.initials: HR
authors.lastname: Han
authors.affiliation: The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.|Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland.|Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Szanton
authors.affiliation: Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.|The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Lin
mesh_terms: D000368:Aged; D015142:Baltimore; D003695:Delivery of Health Care / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D054625:Healthcare Disparities / Q000458:organization & administration; D006310:Hearing Aids / Q000600:supply & distribution*; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D054525:Minority Health / Q000706:statistics & numerical data; D010865:Pilot Projects; D011788:Quality of Life; D061665:Time-to-Treatment
keywords: Age-related hearing loss; Community engagement; Disparities; Hearing health care; Hearing loss; Implementation; Intervention development; Minority health