Mamo to Examine Communication Challenges and Barriers to Hearing Care for Older Bilingual Latinx Adults
Only 15-30% of adults with hearing loss use hearing aids, and the number drops to only 5% of Latinx older adults.
Assistant Professor of Communication Disorders Sara Mamo recently received a three-year, $584,000 grant from the NIH’s National Institute on Deafness and Other Communication Disorders to examine communication challenges and barriers to hearing care faced by older, bilingual Latinx adults. The study will focus on speech understanding in noisy backgrounds and investigate the impacts of age, hearing, cognitive processing, and bilingual language history on speech-in-noise performance for this critically underserved population of older bilingual adults.
“Improving access to hearing health care for older adults is a public health priority,” notes Mamo. “And in order to better serve the growing population of older bilingual Latinx adults, we need to know what communication challenges and barriers to hearing care access they face in the community.”
Only 15-30% of adults with hearing loss use hearing aids, and large survey studies suggest that number drops to only 5% of Latinx older adults with hearing loss. In addition to this population reporting less hearing aid use than the general population, they may face increased communication challenges as they navigate multiple languages in their day-to-day life. The more effort required to communicate in noisy environments, the less likely the person is to continue to engage in social communication opportunities. “Simply put, treatment of hearing loss results in improved speech understanding and improved quality of life,” says Mamo. “
In clinical audiology, it is important to measure individuals’ speech understanding abilities, but multilingual individuals are rarely tested in languages other than English. A better understanding of communication abilities in the multiple languages the individual encounters day-to-day may result in better (and more targeted) management of the person’s hearing loss.
“For example, maybe an older adult with mild hearing loss does okay in their more dominant language, but struggles when they have to use their non-dominant language,” explains Mamo. “I think of an older Latinx adult who speaks Spanish with their family and at their church, but has a medical provider who speaks English with an unfamiliar accent. That individual might be motivated to address their hearing loss in that difficult scenario creating an easier path for introducing amplification for that person’s hearing loss.”
Mamo will use both lab-based and remote test protocols to measure speech understanding, nonspeech auditory processing, and nonverbal cognitive (i.e., executive function) processing skills. For example, participants will listen to sentences in the presence of background talkers over headphones using iPad-based protocols that allow the participant to report what was heard via the iPad interface. Researchers will also drop-off the iPad with participants and provide instructions via Facetime, a protocol that will allow for easier access to research participation for a population of adults who are underrepresented in research.
In the second part of her investigation, Mamo will assess the challenges associated with age, hearing loss, and bilingualism in every day communication. She’ll undertake a mixed methods approach that combines the use of surveys, interviews, and focus group sessions. An ecological momentary assessment (EMA)—brief surveys sent via mobile device periodically throughout the day—will be used to quantify the demand for use of both languages in a Latinx community of older adults within the broader context of a majority English-speaking environment. In addition, interviews with the EMA participants will add context to the survey questions related to communication and effort experienced in daily encounters. Finally, focus groups will explore issues related to aging and hearing loss, and their impact on social engagement for older bilingual Latinx adults.
These approaches will allow the researchers to identify specific communication challenges and priorities in a specific community of older adults. “My ultimate goal is to determine what the hearing and communication priorities are for this growing and underserved population of older adults,” says Mamo, “and then use this knowledge to develop community-integrated service models that will better serve them.”