Community Perspectives on Hearing Loss in Rural Alaska

• Published in: Ear & Hearing
• Main Authors: Inglis-Jenson, Meade, Robler, Samantha Kleindienst, Gallo, Joseph J., Ivanoff, Paul, Ryan, Stephanie, Hofstetter, Philip, Emmett, Susan D.
• Format: Text
• Language: English
• Published: Lippincott Williams & Wilkins 2023
• Subjects: Inclusion; Diversity; Equity; Accessibility Article; Bering Strait; Alaska
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426783/; http://www.ncbi.nlm.nih.gov/pubmed/36939709; https://doi.org/10.1097/AUD.0000000000001348

OBJECTIVES: The aim of this study is to present an explanatory model of hearing loss in the Bering Strait region of Alaska in order to contextualize the results of a cluster randomized trial and propose implications for regional hearing-related health care. DESIGN: To promote ecological validity, or the generalizability of trial findings to real world experiences, qualitative methods (focus groups and interviews) were used within a mixed methods cluster randomized trial evaluating school hearing screening and follow-up processes in 15 communities in the Bering Strait region of Alaska. Focus groups were held between April and August 2017, and semistructured interviews were conducted between December 2018 and August 2019. Convenience sampling was used for six of the 11 focus groups to capture broad community feedback. Purposive sampling was used for the remaining five focus groups and for all interviews to capture a variety of experiences with hearing loss. Audio recordings of focus groups and interviews were transcribed, and both notes and transcripts were deidentified. All notes and transcripts were included in the analysis. The constant comparative method was used to develop a codebook by iteratively moving between transcripts and preliminary themes. Researchers then used this codebook to code data from all focus groups and interviews using qualitative analysis software (NVIVO 12, QSR International) and conducted thematic analyses to distill the findings presented in this article. RESULTS: Participants in focus groups (n = 116) and interviews (n = 101) shared perspectives in three domains: etiology, impact, and treatment of hearing loss. Regarding etiology, participants emphasized noise-induced hearing loss but also discussed infection-related hearing loss and various causes of ear infections. Participants described the impact of hearing loss on subsistence activities, while also detailing social, academic, and economic consequences. Participants described burdensome treatment pathways that are repetitive and ...