Prioritizing Hearing: Patient and Provider Perspectives on Rural Hearing Health Care and Patient Navigation

Purpose: Hearing loss is the third most prevalent chronic health condition among adults in the United States. Rural adults face disproportionately high rates of hearing loss and numerous systemic barriers to hearing health care (HHC). This study aims to explore experiences of hearing loss, identify factors that impact access, and assess the potential acceptability of a patient navigation program. Perspectives of patients experiencing hearing loss and rural health care providers are vital for designing an intervention that addresses barriers to HHC experienced in rural settings. Method: As the first phase of a larger project guided by the PRECEDEPROCEED planning model, a qualitative needs assessment was conducted using semistructured interviews with 21 adult primary care patients with hearing loss and 11 health care personnel from primary care clinics in rural Kentucky. Thematic analysis identified predisposing, enabling, and need factors perceived as influencing whether HHC is accessed by rural adults with hearing loss. Results: Analyses revealed that patients accessing HHC was perceived to be affected by predisposing (concerns about noise exposure and attitudes about HHC), enabling (connection to HHC and resources, lack of local HHC services, communication challenges, transportation challenges, and cost of care), and need factors (experience with hearing loss). Participants agreed that a patient navigator (PN) could increase access to HHC by providing social support and by connecting patients to education and resources. Conclusions: Results from this analysis will inform the development of a patient navigation intervention for HHC for rural adults. PNs will receive specialized training to help patients meet stated needs and overcome commonly reported barriers.