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Gerontologist. 2017 Nov 10;57(6):1173-1186. doi: 10.1093/geront/gnw153.

The Baltimore HEARS Pilot Study: An Affordable, Accessible, Community-Delivered Hearing Care Intervention.

Author information

Department of Otolaryngology-HNS, Johns Hopkins School of Medicine, Baltimore, Maryland.
The Johns Hopkins Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Department of Speech, Language, & Hearing Sciences, University of Arizona, Tucson.
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland.
Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland.
Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.


Purpose of the Study:

Age-related hearing loss negatively affects health outcomes, yet disparities in hearing care, such as hearing aid use, exist based on race/ethnicity and socioeconomic position. Recent national efforts highlight reduction of hearing care disparities as a public health imperative. This study a) describes a community engagement approach to addressing disparities, b) reports preliminary outcomes of a novel intervention, and c) discusses implementation processes and potential for wide-scale testing and use.

Design and Methods:

This was a prospective, randomized control pilot, with a 3-month delayed treatment group as a waitlist control, that assessed feasibility, acceptability, and preliminary efficacy of a community-delivered, affordable, and accessible intervention for older adults with hearing loss. Outcomes were assessed at 3 months, comparing immediate and delayed groups, and pooled to compare the cohort's pre- and 3-month post-intervention results.


All participants completed the study (n = 15). The program was highly acceptable: 93% benefited, 100% would recommend the program, and 67% wanted to serve as future program trainers. At 3 months, the treated group (n = 8) experienced fewer social and emotional effects of hearing loss and fewer depressive symptoms as compared to the delayed treatment group (n = 7). Pooling 3-month post-intervention scores (n = 15), participants reported fewer negative hearing-related effects (effect size = -0.96) and reduced depressive symptoms (effect size = -0.43).


The HEARS (Hearing Equality through Accessible Research & Solutions) intervention is feasible, acceptable, low risk, and demonstrates preliminary efficacy. HEARS offers a novel, low-cost, and readily scalable solution to reduce hearing care disparities and highlights how a community-engaged approach to intervention development can address disparities.


Age-related hearing loss; Community engagement; Disparities; Hearing health care; Hearing loss; Implementation; Intervention development; Minority health

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