Integrating community health workers into a community hearing health collaborative to understand the social determinants of health in children with hearing loss |
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| Institution: | 1. Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center, 622 West 168th Street – VC417, New York, NY, 10032, USA;2. Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032, USA;3. Ambulatory Care Network, Division of Community and Population Health, NewYork Presbyterian, 601 West 168th Street, New York, NY, 10032, USA;4. Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, 180 Fort Washington Avenue, New York, NY, 10032, USA;1. VA Puget Sound Health Care System, Seattle, WA, USA;2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA;3. Department of Psychiatry and Behavioural Sciences, University of Washington, Seattle, WA, USA;1. Centre for Research Excellence – Disability and Health, Faculty of Health Sciences, University of Sydney, Australia;2. Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, UK;3. College of Nursing and Health Sciences, Flinders University, Australia;4. Centre for Research Excellence – Disability and Health, Melbourne School of Population and Global Health, University of Melbourne, Australia;1. Research and Training Center on Disability in Rural Communities, University of Montana, USA;2. Research and Training Center on Independent Living, The University of Kansas, USA;1. Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Office of Medical Student Research, Tulsa, OK, USA;2. Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA;3. Department of Surgery, Oklahoma State Medical Center, Tulsa, OK, USA;4. Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA;5. Department of Family Medicine, Alliance Health, Durant, OK, USA;1. School of Medical Sciences, University of Campinas, Campinas, SP, 13083-887, Brazil;2. Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI, 54702, USA;3. Department of Physical Therapy, College of Health Professions, Wichita State University, Wichita, KS, 67260-0043, USA;4. Department of Kinesiology, Mississippi State University, Starkville, MS, 39762, USA;1. School of Health Technology and Management, Stony Brook University, Stony Brook, United States;2. College of Arts and Sciences, Whitworth University, United States;3. Renaissance School of Medicine, Stony Brook University, Stony Brook, United States |
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| Abstract: | BackgroundChildren with hearing loss (HL) require coordination of care to navigate medical and social services. Strong evidence supports the role of community health workers (CHWs) to identify and address social barriers.ObjectiveThe goal of this study was to evaluate the impact of integrating CHWs into the medical teams of children with HL and identify the social needs associated with their caregivers at a large urban hospital center.MethodsA retrospective chart review was conducted for 30 children with HL whose caregivers enrolled in a CHW program between August 1, 2017 and December 31, 2019. Baseline demographic data were collected, including social circumstances such as food and housing insecurity, status of social security supplemental income (SSI), and need for referral to early intervention (EI) or preschool/school services. Caregivers were assessed for confidence in self-management; baseline distress level was measured via a distress thermometer.ResultsOf the 30 charts reviewed, 93% demonstrated social needs including food insecurity (24%) and educational service needs (45%). Eighty-seven percent of caregivers reported a sense of control over the child's condition, yet 73% reported a stress level of four or greater on the distress thermometer scale. At 3 months follow-up, 70% of patients completed referrals; a significant number of patients had obtained hearing aids and cochlear implants compared to baseline (p = 0.017).ConclusionsCaregivers of children with HL face multiple social obstacles, including difficulties connecting to educational and financial resources. CHWs are instrumental in identifying social needs and connecting caregivers to services. |
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| Keywords: | Community health workers Children with hearing loss CSHCN Social determinants of health |
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