Ear and hearing care programs for First Nations children: a scoping review
Kai Nash1, Rona Macniven2, Liesa Clague3
1The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia. kai.nash@mq.edu.au.
BMC Health Services Research
|April 19, 2023
Summary
Ear and hearing care programs for First Nations children are vital for early detection of otitis media. Many programs focus on detection and management, but require better evaluation and community involvement for long-term success.
Area of Science:
- Public Health
- Indigenous Health
- Audiology
Background:
- Ear and hearing care programs are crucial for the early detection and management of otitis media (middle ear disease).
- Otitis media and associated hearing loss disproportionately affect First Nations children, impacting speech, language, social, cognitive, educational, and life outcomes.
- This review examines ear and hearing care programs for First Nations children in high-income colonial-settler countries to understand strategies for reducing otitis media burden and improving equitable access to care.
Purpose of the Study:
- To chart the strategies employed by ear and hearing care programs for First Nations children.
- To map program focus across the care pathway: prevention, detection, diagnosis/management, and rehabilitation.
- To identify factors contributing to the longer-term sustainability and success of these programs.
Main Methods:
- A comprehensive database search was conducted in March 2021 across multiple academic databases (Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, Academic Search Premier).
- Included programs were developed or operational between January 2010 and March 2021.
- Search terms included 'First Nations children,' 'ear and hearing care,' and 'health programs, initiatives, campaigns, and services.'
Main Results:
- Twenty-seven articles described twenty-one distinct ear and hearing care programs.
- Program strategies focused on connecting patients to specialist services, enhancing cultural safety, and increasing access to care.
- Evaluation measures were predominantly limited to outputs or service-level outcomes, not patient-based outcomes. Funding and community involvement were identified as sustainability factors but were often limited.
Conclusions:
- Programs primarily target detection and diagnosis/management stages of the care pathway, with some limited strategic approaches.
- Many programs rely on potentially unsustainable funding sources and evaluate success based on outputs rather than patient outcomes.
- Future programs require integration into existing systems, policy alignment, and governance by First Nations communities for long-term sustainability and community-needs alignment.
