Smartphone hearing screening in mHealth assisted community-based primary care

J Telemed Telecare. 2016 Oct;22(7):405-12. doi: 10.1177/1357633X15610721. Epub 2015 Oct 14.


Introduction: Access to ear and hearing health is a challenge in developing countries, where the burden of disabling hearing loss is greatest. This study investigated community-based identification of hearing loss using smartphone hearing screening (hearScreen™) operated by community health workers (CHWs) in terms of clinical efficacy and the reported experiences of CHWs.

Method: The study comprised two phases. During phase one, 24 CHWs performed community-based hearing screening as part of their regular home visits over 12 weeks in an underserved community, using automated test protocols employed by the hearScreen™ smartphone application, operating on low-cost smartphones with calibrated headphones. During phase two, CHWs completed a questionnaire regarding their perceptions and experiences of the community-based screening programme.

Results: Data analysis was conducted on the results of 108 children (2-15 years) and 598 adults (16-85 years). Referral rates for children and adults were 12% and 6.5% respectively. Noise exceeding permissible levels had a significant effect on screen results at 25 dB at 1 kHz (p<0.05). Age significantly affected adult referral rates (p < 0.05), demonstrating a lower rate (4.3%) in younger as opposed to older adults (13.2%). CHWs were positive regarding the hearScreen™ solution in terms of usability, need for services, value to community members and time efficiency.

Conclusion: Smartphone-based hearing screening allows CHWs to bring hearing health care to underserved communities at a primary care level. Active noise monitoring and data management features allow for quality control and remote monitoring for surveillance and follow-up.

Keywords: community-based; mHealth; primary care; smartphone; tele-assisted.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Community Health Services / methods
  • Community Health Workers
  • Female
  • Hearing Disorders / diagnosis
  • Hearing Tests / instrumentation
  • Hearing Tests / methods*
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Primary Health Care / methods*
  • Smartphone*
  • Telemedicine / instrumentation
  • Telemedicine / methods*
  • Young Adult