Supporting hearing health in vulnerable populations through community care workers using mHealth technologies

Abstract

Objective: Access to hearing care is challenging in low- and middle-income countries, where the burden of hearing loss is greatest. This study investigated a community-based hearing screening programme using smartphone testing by community care workers (CCWs) in vulnerable populations infected or affected by HIV. Experiences of CCWs were also surveyed.

Design: The study comprised two phases. Phase one employed a cross-sectional research design to describe the community-based programme. Phase two was a survey design to describe CCW’s knowledge and experiences.

Study Sample: Fifteen trained CCWs administered hearing screenings on 511 participants during home-based visits using a validated smartphone application (hearScreen™) during phase one. Diagnostic follow-up assessments included evaluation using the smartphone test (hearTest™), otoscopy and tympanometry. Phase two surveyed the 15 CCW screening experiences.

Results: Referral rates for adults and children were 5.0% and 4.2%, respectively. 75.0% of referred participants returned for follow-up diagnostic assessments, 33.3% were diagnosed with hearing loss and referred for further intervention. All 15 CCWs agreed that communities needed hearing services and only 6.6% did not want to continue providing hearing screening.

Conclusion: Trained CCWs can decentralise hearing services to vulnerable communities using smartphone screening incorporating automated testing and measures of quality control.

Keywords:

• mHealth
• community based
• HIV and AIDS
• smartphone
• tele-assisted
• vulnerable

Acknowledgements

The authors would like to acknowledge and thank Future Families NPO and affiliates for their assistance and contribution toward the researc h, as well as all participants involved with this study. The authors would also like to acknowledge and thank the United States Agency for International Development (USAID), the Resilient Africa Network (RAN) and University of Pretoria Southern Africa Resilience Innovation Lab (SA RILab) for their generous support and contribution towards funding the research. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the supporting organisations.

Disclosure statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The hearScreen™ and hearTest™ application is intellectual property owned, patented, and trademarked by the University of Pretoria. The product is being developed and commercialised by the hearX group (www.hearxgroup.com). The third author’s relationship with the hearX Group includes equity and consulting. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The financial assistance of the United States Agency for International Development (USAID), the ResilientAfrica Network (RAN) and University of Pretoria Southern Africa Resilience Innovation Lab (SA RILab). The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the supporting organisations.