Community-Informed Adaptation of a School-Based Hearing Health Intervention: Formative Evaluation for an...

Area of Science:

• Public Health
• Health Services Research
• Telemedicine

Background:

• School hearing screening is crucial for early detection of hearing loss.
• Telemedicine offers a promising solution for follow-up care in underserved areas.
• The Specialty Telemedicine Access for Referrals (STAR) model aims to improve access to hearing healthcare for students.

Purpose of the Study:

• To identify factors for adapting the design, implementation, evaluation, and scalability of the STAR model.
• To codesign the intervention, implementation, and evaluation through community feedback.
• To prepare for a hybrid type 1 effectiveness-implementation trial in rural Alaska.

Main Methods:

• A formative evaluation was conducted using virtual semi-structured interviews with stakeholders.
• Snowball sampling recruited participants with experience in school hearing screening or ear/hearing healthcare.
• Rapid analysis methodology and coding using the Consolidated Framework for Implementation Research (CFIR) domains were employed.

Main Results:

• 23 interviews yielded 19 CFIR constructs across four domains (innovation, individuals, inner setting, outer setting).
• 43 actionable items were identified for adapting the STAR model, training, implementation, and evaluation.
• Specific adaptations included revising parent forms, updating training materials, and refining communication protocols.

Conclusions:

• Community-informed formative evaluation facilitated the adaptation of the STAR model for an effectiveness-implementation trial.
• The evaluation identified necessary changes for expanding the model's reach and scalability.
• Formative evaluations and rapid qualitative analysis are valuable for codesigning evidence-based hearing health interventions.