Hearing Screening in Older Adults in Primary Care Clinics: How the Effects of Setting and Provider Encouragement Differ by Patient Sex and Race.

Abstract

Few studies have examined how patient sex or race influence hearing healthcare, which was our study purpose. We performed a secondary analysis using data from a pragmatic clinical trial that examined the effect of provider encouragement (yes/no) or setting (at-home/clinic) for older adults to follow through with routine hearing screening in primary care and the hearing healthcare pathway. Three protocols were compared: at-home screening without provider encouragement, at-home screening with provider encouragement, and in-clinic screening with provider encouragement. Poisson regression (n = 627) showed few differences by patient sex but showed that Black patients in the at-home protocols were less likely to schedule or complete a formal diagnostic evaluation after a failed screening compared with Black patients in the clinic setting and White patients in all groups. Black patients, regardless of provider encouragement, were less likely to schedule or complete a diagnostic evaluation compared with White patients. Results suggest that in-clinic screenings may increase the use of hearing healthcare for Black patients.