Factors that influence health service access in deaf and hard-of-hearing children: a narrative review

Abstract

Objectives

Early diagnosis and intervention of deaf and hard-of-hearing (DHH) children leads to improved language and psychosocial outcomes. However, many child, parent and provider related factors can influence access to early intervention services, including hearing devices. This narrative review aims to explore factors that influence health service access in DHH children.

Design

A systematic search was conducted to identify articles that explored factors that influenced health service access in DHH children in countries with Universal Newborn Hearing Screening, published between 2010 and 2022.

Study samples

Fifty-nine articles met the inclusion criteria for data extraction. This included 4 systematic reviews, 2 reviews, 39 quantitative and 5 mixed methods studies and 9 qualitative studies.

Results

The identified factors were grouped into the following themes: (a) demographic factors, (b) family related factors, (c) child related factors, (d) factors specific to hearing devices, (e) service delivery, f) telehealth and (g) COVID-19.

Conclusion

This review provided a comprehensive summary of multiple factors that affect access to health services in DHH children. Psychosocial support, consistent clinical advice, allocation of resources to rural communities and use of telehealth are possible ways to address barriers and improve health service access.

Keywords:

• Access
• deaf and hard of hearing
• children
• barriers
• facilitators
• demographics
• hearing devices
• tele-health

Author contributions

The search strategy for this review was developed with the assistance of Poh Chua, The Royal Children’s Hospital librarian. AZR performed the literature search under the supervision of VS. AZR wrote the first draft of the manuscript. Both authors are responsible for the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study does not have any funding supports. Research at the Murdoch Children’s Research Institute is supported by the Victorian Government’s Operational Infrastructure Support Program. The researchers were independent of the funders. VS was supported by Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship [1125687], a Melbourne Children’s Clinician Scientist Fellowship and a L’Oréal-UNESCO Australian & New Zealand For Women in Science Fellowship 2019.