Disparities in hearing healthcare (HHC) persist between Hispanic/Latino adults and non-Hispanic/Latino Whites,
despite similar hearing loss prevalence rates. Limited English language proficiency (LEP) significantly and neg-
atively impacts general healthcare access and utilization, but interventions that take into account the preferred
language and culture of patients have been shown to reduce or eliminate disparities in many areas of healthcare.
Yet there is a fundamental gap in the current understanding as to whether addressing LEP will alleviate dispari-
ties in HHC for Hispanic/Latino older adults. As untreated hearing loss is associated with increased risks of costly
health outcomes, there is an urgent need to improve HHC service delivery, particularly to vulnerable populations
such as those with LEP. The applicant's long-term goal is to develop hearing loss interventions that address the
needs of vulnerable populations in the US. The overall objective of the current proposal, which is the next step
toward attainment of the applicant's long-term goal, is to develop and assess the benefits of printable, Spanish-
language hearing loss self-management patient education materials. The central hypothesis is that participants
will demonstrate better understanding of their hearing loss difficulties, and will be better able to identify options
for self-management following delivery of culturally and linguistically appropriate patient education materials. The
rationale for the proposed research is that findings will contribute to the development and testing of novel inter-
ventions aimed at increasing HHC access and utilization in vulnerable populations. Guided by preliminary data,
this hypothesis will be tested by pursuing two specific aims: 1) Using an iterative approach with members from
the target audience, develop a culturally and linguistically appropriate Spanish-language hearing loss self-man-
agement program that takes into account varying health literacy backgrounds; and 2) Assess the benefits for
Spanish-speaking adults with hearing loss, in terms of HHC knowledge and self-efficacy for managing hearing
loss, following delivery of a Spanish-language hearing loss self-management program. Aim #1 will be addressed
through utilizing focus groups consisting of representatives of the target audience to develop the education ma-
terials. Aim #2 will be addressed by comparing self-efficacy for managing hearing loss in a single-group, pre/post
design with 53 Hispanic/Latino adults with hearing loss who have LEP. These aims in line with advancing the
overall mission of the NIDCD to “help prevent, detect, diagnose, and treat disease and disability”, as well as
NIDCD's 2017-2022 Strategic Plan to address hearing health disparities. This contribution is expected to be
significant because it poses to reduce language barriers to HHC experienced by US adults from Hispanic/Latino
background with LEP. The proposed research is innovative because it represents a substantive departure from
the status quo by delivering a hearing loss intervention that addresses the intersection of LEP and health literacy.
It is expected that results will provide compelling data to include in a future R01 application aimed at reducing
structural and clinical barriers to HHC access and utilization for vulnerable populations in the US.
