Rafinejad-Farahani, Bahar

English

Scholarship@Western

Global Impact of Social Determinants onAccess to Childhood Hearing Healthcare: A Scoping ReviewChildhood hearing loss is a major healthchallenge that can severely impact anindividual across their lifespan if leftuntreated. Implementation and accessto early hearing detection andintervention (EHDI) programs differglobally and depend on personal andsocial determinants (WHO, 2021). In working with families of children whoare deaf or hard of hearing, it is criticalto better understand the contexts inwhich hearing healthcare is beingaccessed and provided, and the benefitsof implementing contextually relevantsolutions. Children older than five years of ageaccessing EHDI programs participated.The study topic was outside of the fieldof family-centred EHDI programs.The study was not published in English.It was not published in a peer-reviewedjournal. To address this question, a scopingreview was conducted using theJoanna Briggs Institute (JBI) Methodsfor Scoping Reviews (Aromataris &Munn, 2017). Twenty-three original,peer-reviewed research articlespublished in English on familyparticipation in EHDI programs basedon financial status, education level,and/or culture were included in thisreview. A study was excluded if: Research QuestionGlobally, how do socialdeterminants of health,particularly financial status,education level, and culture,influence family participation inEDHI programs?ProblemMethods Bahar Rafinejad-Farahani and Dr. Sheila MoodieFaculty of Health Sciences, School of Communication Sciences & Disorders, Western University 1Highlights of thePRISMA-ScR FlowchartIdentificationScreeningEligibilityIncludedRecords identifiedthrough databasesearching(n = 131)Duplicatesremoved(n = 28)Records screened(n = 103)Records excluded(n = 47)Full-text articlesassessed foreligibility(n = 56)Full-text articlesexcluded(n = 40)Studies included (n = 16)Studies included infinal sample (n = 23) Additional recordsidentified throughreviewed references(n = 7)References:Aromataris, E., & Munn, Z. (Eds.). (2017). Joanna Briggs Institute reviewer’s manual. The Joanna Briggs Institute. https://reviewersmanual.joannabriggs.org/World Report on Hearing (2021). Accessed at https://www.who.int/publications/i/item/world-report-on-hearing. Global Impact of Social Determinants onAccess to Childhood Hearing Healthcare: A Scoping ReviewFinancial burdens were a significantbarrier to timely access to EHDIprograms and subsequent compliancefor low-income families across theglobeUrban and/or high-income regions didnot report financial status as acommon barrier to accessing EHDIprograms. Programs in these regionswere either government-funded orcovered through health insurance. A sufficient level of caregiver andfamilial education was generallyassociated with greater hearingscreening completion rates.In studies that did not report apositive association, increasing familyawareness of EHDI programs andtheir positive outcomes throughprovision of information throughhealthcare agencies aided in earlyaccess to EHDI programs, despite loweducational levels.Caregiver cultural beliefs andsuperstitions towards childhooddeafness were a prominentdisincentive for hearing screeningfollow-up compliance. Unfavourable attitudes of extendedfamilies towards hearing loss andstigmas associated with hearingdevices may negatively influencecompliance to hearing careinterventions.Financial StatusEducation LevelCulture Research ApplicationResultsBahar Rafinejad-Farahani and Dr. Sheila MoodieFaculty of Health Sciences, School of Communication Sciences & Disorders, Western University A deeper understanding of barriersis required to promote practicechange and aid EHDI providers andprograms in delivering contextuallyappropriate yet effective hearinghealthcare. On a broader scope, theimplementation of policies thataddress systemic inequities withrespect to hearing healthcare couldimprove access and participation inEHDI programs. The majority of the studies included inthis scoping review examined financialstatus, education level, and/or culturesimultaneously, identifying associationsbetween these factors and access tohearing interventions. Together, these studies highlight theinterconnectedness of various socialdeterminants on hearing healthcareand the vast diversity in how familiesaccess hearing intervention programsglobally. To improve access to care on a globallevel:2Financial StatusCultureEducationalLevel

Global Impact of Social Determinants on Access to Childhood Hearing Healthcare: A Scoping Review

https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1185&context=usri

Global Impact of Social Determinants on Access to Childhood Hearing Healthcare: A Scoping Review

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