Prioritizing hearing: A qualitative analysis (Bellnier et al., 2025)
Purpose: Hearing loss is the third most prevalent chronic health condition among adults in the United States. Rural adults face disproportionately high rates of hearing loss and numerous systemic barriers to hearing health care (HHC). This study aims to explore experiences of hearing loss, identify factors that impact access, and assess the potential acceptability of a patient navigation program. Perspectives of patients experiencing hearing loss and rural health care providers are vital for designing an intervention that addresses barriers to HHC experienced in rural settings.
Method: As the first phase of a larger project guided by the PRECEDE-PROCEED planning model, a qualitative needs assessment was conducted using semistructured interviews with 21 adult primary care patients with hearing loss and 11 health care personnel from primary care clinics in rural Kentucky. Thematic analysis identified predisposing, enabling, and need factors perceived as influencing whether HHC is accessed by rural adults with hearing loss.
Results: Analyses revealed that patients accessing HHC was perceived to be affected by predisposing (concerns about noise exposure and attitudes about HHC), enabling (connection to HHC and resources, lack of local HHC services, communication challenges, transportation challenges, and cost of care), and need factors (experience with hearing loss). Participants agreed that a patient navigator (PN) could increase access to HHC by providing social support and by connecting patients to education and resources.
Conclusions: Results from this analysis will inform the development of a patient navigation intervention for HHC for rural adults. PNs will receive specialized training to help patients meet stated needs and overcome commonly reported barriers.
Supplemental Material S1. Consolidated Criteria for Reporting Qualitative Research (COREQ): 32-item checklist.
Bellnier, L., Mahairas, A., Oberman, M. K., Board, R., Pattabiraman, M., Heltsley, C., Ranseen, E., Shinn, J., & Bush, M. L. (2025). Prioritizing hearing: Patient and provider perspectives on rural hearing health care and patient navigation. Journal of Speech, Language, and Hearing Research, 68(4), 2127–2143. https://doi.org/10.1044/2025_JSLHR-24-00284
Funding
Research reported in this publication was supported by the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health (NIH) under Award R21DC019602. The project was also supported by the NIH National Center for Advancing Translational Sciences through Grant UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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