Addressing disparities in accessing hearing health care in a U.S. Mexico Border community

Hearing loss has a major impact on the quality of life among older adults.  In population-based studies, 90-96% of Mexican-American adults with hearing loss do not have access to hearing healthcare. To begin to reduce this health disparity, we used a community-based participatory research approach to investigate unmet needs of families affected by hearing loss in a rural, predominately Mexican-American community on the U.S.-Mexico border.  We utilized the community health worker (CHW) model as a means to address cultural aspects that might impact access to hearing health care. CHWs are individuals from the community who serve as intermediaries between health professionals and patients.  Our academic-community partnership includes a rural federally-qualified health center serving low socio-economic status Mexican American adults. Partners engaged in a theory-based needs assessment of hearing loss among elder adults with hearing loss using the social-ecological and health belief models among the population in Nogales, Arizona. CHWs facilitated 20 interviews with elder adults with hearing loss and three focus groups with family members. The research team conducted interviews with medical providers and other clinic staff. The resulting multicomponent intervention, Oyendo Bien, aims to reduce disparities in access to hearing healthcare and improve outcomes identified as important to families experiencing hearing loss. The use of CBPR methods provided a way to identify barriers and facilitators in access to care and raise the profile of hearing loss as an important health issue in the community.