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Journal article
A community-based service enhancement model of training and employing Ear Health Facilitators to address the crisis in ear and hearing health of Aboriginal children in the Northern Territory, the Hearing for Learning Initiative (the HfLI): study protocol for a stepped-wedge cluster randomised trial
Trials, Vol.22(1), pp.1-19
2021
PMID: 34134736
Abstract
Background
Almost all Aboriginal children in remote communities have persistent bilateral otitis media affecting hearing and learning throughout early childhood and school years, with consequences for social and educational outcomes, and later employment opportunities. Current primary health care and specialist services do not have the resources to meet the complex needs of these children.
Method/design
This stepped-wedge cluster randomised trial will allocate 18 communities to one of five 6-monthly intervention start dates. Stratification will be by region and population size. The intervention (Hearing for Learning Initiative, HfLI) consists of six 20-h weeks of training (delivered over 3 months) that includes Certificate II in Aboriginal Primary Health Care (3 modules) and competencies in ear and hearing data collection (otoscopy, tympanometry and hearScreen), plus 3 weeks of assisted integration into the health service, then part-time employment as Ear Health Facilitators to the end of the trial. Unblinding will occur 6 months prior to each allocated start date, to allow Community Reference Groups to be involved in co-design of the HfLI implementation in their community. Relevant health service data will be extracted 6-monthly from all 18 communities. The primary outcome is the difference in proportion of children (0 to 16 years of age) who have at least one ear assessment (diagnosis) documented in their medical record within each 6-month period, compared to control periods (no HfLI). Secondary outcomes include data on sustainability, adherence to evidence-based clinical guidelines for otitis media, including follow-up and specialist referrals, and school attendance. Structured interviews with staff working in health and education services, Ear Health Trainees, Ear Health Facilitators and families will assess process outcomes and the HfLI broader impact.
Discussion
The impact of training and employment of Ear Health Facilitators on service enhancement will inform the health, education and employment sectors about effectiveness of skills and job creation that empowers community members to contribute to addressing issues of local importance, in this instance ear and hearing health of children.
Trial registration
ClinicalTrials.gov NCT03916029. Registered on 16 April 2019.
Details
- Title
- A community-based service enhancement model of training and employing Ear Health Facilitators to address the crisis in ear and hearing health of Aboriginal children in the Northern Territory, the Hearing for Learning Initiative (the HfLI): study protocol for a stepped-wedge cluster randomised trial
- Authors
- Kelvin Kong - John Hunter Children's HospitalAlan Cass - Charles Darwin UniversityAmanda Jane Leach (Corresponding Author) - Menzies School of Health ResearchPeter S Morris - Charles Darwin UniversityAmy Kimber - Charles Darwin UniversityJiunn-Yih Su - Charles Darwin UniversityVictor Oguoma - Charles Darwin University
- Publication details
- Trials, Vol.22(1), pp.1-19
- Publisher
- BioMed Central Ltd.
- Date published
- 2021
- DOI
- 10.1186/s13063-021-05215-7
- ISSN
- 1745-6215
- PMID
- 34134736
- Copyright note
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Data Availability
- Menzies is the trial data custodian, managed by the Senior Data Manager. The HfLI Statistician, Data Manager and Analyst, Program Manager and trial investigators will have access to the final trial data set. Funding partners will not have access to data.
- Grant note
- The Hearing for Learning Initiative is funded by the Australian Commonwealth Government, Northern Territory Government and The Balnaves Foundation.
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991121852602621
- Output Type
- Journal article
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