Advancing Hearing Care Equity: Outcomes From a Community-Based Hearing Aid Assistance Program for Underserved Adults

Access to hearing services is often limited by health care disparities and financial constraints. This retrospective longitudinal study examined hearing aid uptake and outcomes among low-income adults enrolled in the Dalhousie Hearing Aid Assistance Program-Community Services, a provincially funded initiative in Nova Scotia, Canada, designed to broaden access to hearing health care.

Demographic, audiologic, and self-reported hearing aid data were extracted from the digital patient management system. The study included 179 participants, with a mean age of 59.30 years.

Most participants (89.0%) received bilateral amplification. Average hearing thresholds indicated bilateral hearing loss in the moderate range. Tinnitus was reported by 47.5% of participants (18.40% persistent, 29.10% intermittent), most commonly affecting both ears (68.45%). Participants demonstrated strong hearing aid uptake, with an average daily use of 9.20 hr. Significant improvements were observed, including reductions in Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) total and subscale scores (p < .001) at both 3-month and 12-month follow-ups relative to postfitting baseline, as well as substantial gains on the annual Client-Oriented Scale of Improvement (COSI) outcomes (> 80%), with a large correlation between Degree of Change and Final Ability outcomes (r = .716, p < .001). Hierarchical linear regression analysis indicated that average hearing loss (p < .003) and gender (p < .048) were significant predictors of HHIE-S scores.

The findings demonstrate significant improvements in perceived hearing handicap and functional outcomes and highlight the value of accessible, community-based hearing aid services in reducing barriers to care and promoting hearing care equity.