# Extending Capacity for Affordable, Accessible Hearing Care through Peer Mentorship

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2022 · $245,625

## Abstract

PROJECT SUMMARY
Access to hearing care is unequal with large disparities among older adults. Despite evidence that supports
community health worker (CHW) care models as an approach to health disparities, community-delivered
hearing care models are only beginning. Among existing efforts, only the HEARS (Hearing Health Equity
through Accessible Research & Solutions) intervention is specifically designed for older adults and includes the
provision of over-the-counter (OTC) hearing technology in a community setting through a theory-driven
approach. The HEARS intervention was designed and tested with NIDCD support from 2015 to 2020
(R22/R33DC015062) to address common barriers to hearing care experienced by older adults, particularly
racial/ethnic minority and low-income older adults. Preliminary data from the randomized controlled trial
demonstrate the efficacy of HEARS as a first-in-kind intervention delivered entirely in the community by older
adult peer mentors using OTC hearing technology with outcomes on par to hearing aids fit by audiologists.
With increasing availability of OTC devices and a growing demand for new care models, the HEARS
intervention is poised to be brought to scale. To move HEARS into practice, we propose partnering with local
Area Agencies on Aging (AAAs), a national network of public and private non-profit agencies who provide
services to older adults aging in place. This proposal will complete the HEARS intervention package and test
the delivery of the HEARS intervention entirely within a community setting by community-based audiologists
working with older adult peer mentors in AAAs, positioning the HEARS program for broader implementation
through AAAs. The proposal has the following aims: R21 Aim 1 To develop the train-the-trainer curriculum and
manuals for audiologist supervisors that reflect the needs of audiologists and ensure the safety, efficacy, and
fidelity of a peer mentor-delivered intervention as guided by the Scientific and Community Advisory Boards.
R33 Aim 1 To recruit and train an audiologist-peer mentor care team of 2 audiologists and 9 peer mentors (3
per site) through partner AAAs (n=3) to assess the trainer curriculum. R33 Aim 2 To conduct a community-
based pragmatic trial of delivering the HEARS intervention through 3 AAAs throughout Maryland via a within-
subject 3-month intervention trial (n=100 per AAA site). R33 Aim 3 To develop an implementation strategy for
the HEARS intervention as delivered through AAAs via a mixed methods approach based on the barriers and
enablers encountered in the pragmatic trial. This proposal brings together a multidisciplinary team of
investigators in a highly collaborative effort spanning academia, government, and non-profit organizations. This
proposal will rigorously extend evidence for a community-delivered hearing care that leverages OTC devices
and CHW-partnered care and will directly inform the implementation and scaleup of the HEARS intervention.

## Key facts

- **NIH application ID:** 10418058
- **Project number:** 1R21DC020149-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CARRIE L NIEMAN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $245,625
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10418058

## Citation

> US National Institutes of Health, RePORTER application 10418058, Extending Capacity for Affordable, Accessible Hearing Care through Peer Mentorship (1R21DC020149-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10418058. Licensed CC0.

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