(A102) Advancing Hearing Care in Primary Care: A Pilot Study in New Hampshire and Vermont

Introduction: Hearing loss is a significant public health issue, particularly in Vermont (VT) and New Hampshire (NH), where aging and rural populations face added healthcare barriers. This study explores the barriers to hearing healthcare and hearing loss in NH and VT primary care clinics.

Methods: A pilot study was conducted on adults attending primary care clinics from May to November 2024. Data included hearing thresholds, demographics, employment status, income, insurance coverage, healthcare barriers, and hearing disability (Hearing Handicap Inventory for the Elderly - HHIE-S). Participants were referred for audiologic evaluation if their HHIE-S score exceeded 10 or pure-tone average (PTA – 0.5, 1.0, 2.0, and 4.0 kHz) exceeded 30 dB HL. Logistic regression models were used to identify predictors of hearing loss and referral, with elastic net regression to address multicollinearity

Results: Among the 102 participants (mean age 53 years, SD 17), 81% lived in census-designated isolated areas, and 23% reported healthcare barriers. Logistic regression showed that increased age (β = 0.04, p=.008) and increased healthcare barriers (β=0.98, p=0.02) were associated with increased hearing care referrals by HHIE-S. Additionally, uninterrupted insurance coverage over the past year correlated with a lower PTA (β= -10.652, p=0.02). Elastic net analysis confirmed healthcare barriers as a significant predictor of referral based on HHIE-S scores.

Conclusions: This study highlighted that a substantial number of participants reside in remote areas with limited access to healthcare. In these regions, age and healthcare accessibility were found to significantly impact hearing care referrals and the prevalence of hearing disabilities. These findings underscore the need for targeted interventions in remote primary care clinics to enhance hearing care quality in resource-limited settings.