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Hearing for Learning Initiative - a Health Facilitator Model for Otitis Media

Not Applicable
Completed
Conditions
Otitis Media
Conductive Hearing Loss
Interventions
Behavioral: facilitator
Registration Number
NCT03916029
Lead Sponsor
Menzies School of Health Research
Brief Summary

The Hearing for Learning Initiative is a stepped-wedge cluster randomised controlled trial. The HfLI will implement and rigorously evaluate an innovative community-based service-enhancement model of ear and hearing health, in partnership with participating communities and health and education services.

This initiative will address the following research question: In urban, rural and remote Aboriginal communities in the Northern Territory, does employment, training and integration of local Ear and Hearing Clinical and Education Support Officers into health and education services (the Hearing for Learning initiative), compared to current practice, increase the proportion of children who receive an ear assessment, reduce the prevalence of ear and hearing problems and improve education outcomes of Aboriginal and Torres Strait Islander children, during a four year trial period?

Detailed Description

Background: Australian Indigenous children achieve lower scores in school readiness and education outcomes than their non-Indigenous peers. Chronic otitis media and hearing loss during early childhood are associated with lower scores for these outcomes. Local problem: Failure to meet child health program schedules and evidence based practice in ear and hearing health is linked to high turnover of the health workforce, inadequate clinical skills and poor knowledge of ear and hearing health needs of children.

This Hearing for Learning Initiative aims to improve health care and education services.

Interventions: The intervention involves training and employing non-professional community members to facilitate busy primary health care services to deliver evidence-based ear and hearing health assessments in children 0 to 16 years of age, and to facilitate the teaching and home learning of hearing impaired children (the intervention).

Trial design: A stepped-wedge community (n=18) cluster-randomised trial will compare the proportion of children receiving an ear assessment (primary outcomes) in the HfLI (intervention) periods with no HfLI (control) periods. Participating communities will be randomly assigned in 6-monthly steps to shift from control to intervention on pre-specified start dates.

Outcomes: the primary outcome is the change in the proportion of Aboriginal and Torres Strait Islander children who receive an ear assessment, between intervention and control periods.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria

Aboriginal or Torres Strait Islander, resident in participating community (cluster)

Exclusion Criteria

none

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Facilitatorfacilitator120 hours training for local community members delivered on-country face-to-face during 6 4-day weeks and over a 3-6 month period. Certificate II modules in Aboriginal Primary Health Care, ear and hearing health skills development (otoscopy, tympanometry, and hearScreen) and employment as Ear Health Facilitators to the end of the trial.
Primary Outcome Measures
NameTimeMethod
Ear assessment6-monthly

Proportion of children who have had a documented ear assessment

Secondary Outcome Measures
NameTimeMethod
Prevalence of otitis media6-monthly

Proportion of children with any otitis media

Appropriate management plan6-monthly

Proportion of management plans that are appropriate

Management plan6-monthly

Proportion of otitis media cases with a management plan

Follow-up6-monthly

Proportion of cases with follow-up within 10 days

Trial Locations

Locations (20)

Ampilatwatja

🇦🇺

Ampilatwatja, Northern Territory, Australia

Palumpa Community Health Centre

🇦🇺

Palumpa, Northern Territory, Australia

Darwin

🇦🇺

Darwin, Northern Territory, Australia

Kalkarindji Primary Health Centre

🇦🇺

Kalkarindji, Northern Territory, Australia

Nauiyu

🇦🇺

Nauiyu, Northern Territory, Australia

Ali Curung

🇦🇺

Ali Curung, Northern Territory, Australia

Galiwin'ku

🇦🇺

Galiwin'ku, Northern Territory, Australia

Gunbalanya

🇦🇺

Gunbalanya, Northern Territory, Australia

Wurli Wurlinjang Health Service

🇦🇺

Katherine, Northern Territory, Australia

Lajamanu Primary Health Centre

🇦🇺

Lajamanu, Northern Territory, Australia

Mala'la Health Service

🇦🇺

Maningrida, Northern Territory, Australia

Milikapiti Community Health Centre

🇦🇺

Milikapiti, Northern Territory, Australia

Milingimbi Health Clinic

🇦🇺

Milingimbi, Northern Territory, Australia

Minjilang Community Health Centre

🇦🇺

Minjilang, Northern Territory, Australia

Pirlangimpi Health Clinic

🇦🇺

Pirlangimpi, Northern Territory, Australia

Ti Tree Community Health Centre

🇦🇺

Ti Tree, Northern Territory, Australia

Warruwi Community Health Centre

🇦🇺

Warruwi, Northern Territory, Australia

Wadeye Community Health Centre

🇦🇺

Wadeye, Northern Territory, Australia

Julanimawu (Nguiu) Community Health centre

🇦🇺

Wurrumiyanga, Northern Territory, Australia

Yirrkala Clinic

🇦🇺

Yirrkala, Northern Territory, Australia

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