| Individual (intrapersonal) |
Social isolation/withdrawal Emotional distress Denial of hearing loss Adaptation to improve hearing Challenges such as driving, talking on the phone Language barriers, cost, and distance from specialists affect access to care
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Culturally tailored audiologic rehabilitation intervention that focuses on strategies to improve communication for those with hearing loss regardless of access to hearing aids. Self-advocacy training to increase access to audiology services, self-efficacy, and social support for hearing loss.
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| Family/friends (Interpersonal) |
Conflict related to hearing loss Concern over changes in personality of person with hearing loss Motivation to seek help Proactive and reactive adaptation to hearing loss Gathering collective resources to seek care, address hearing loss
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Culturally tailored audiological rehabilitation intervention for communication partners who stress mutual responsibility for strategies to reduce conflict and improve communication-related quality of life. Develop support systems for family members.
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| Health-care provider(organization) |
Hearing screening not part of regular care. Challenges in patient–provider communication. Lack of provider expertise and equipment. Low interest and delays in referring patients for hearing tests when patient cannot afford out-of-pocket expense of intervention. Lack of awareness of hearing interventions and rehabilitation beyond hearing aids.
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Provide training to medical staff in communication strategies. Develop screening protocols for hearing loss. Provide amplification technology (pocket talkers) for medical visits. Increase FQHC capacity to conduct hearing tests and support self-management of hearing and communication health. Create continuity of care in hearing health care.
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| Community (Nogales) |
Acceptance of the problems of hearing loss as part of aging. Lack of hearing health resources. Lack of peer support for hearing loss and its management. Need for community-level information.
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Train FQHC CHWs to recognize hearing loss and include communication strategies into health promotion efforts. Advocate for the increased use of assistive listening devices in community settings. Implement a community campaign about solutions to living with hearing loss. Develop a used hearing aid bank to increase hearing aids and recruit audiologists/dispensers to provide fitting services.
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| Policy |
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