Hearing for Learning Initiative – a Health Facilitator Model for Otitis Media

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Brief Title

Hearing for Learning Initiative - a Health Facilitator Model for Otitis Media

Official Title

The Hearing for Learning Initiative - a Service-enhancement Model of Ear Health Facilitators to Address the Crisis in Ear and Hearing Health of Aboriginal Children in the Northern Territory: a Stepped-wedge Cluster Randomised Trial

Brief Summary

      The Hearing for Learning Initiative is a stepped-wedge cluster randomised controlled trial.
      The HfLI will implement and rigorously evaluate an innovative community-based
      service-enhancement model of ear and hearing health, in partnership with participating
      communities and health and education services.

      This initiative will address the following research question: In urban, rural and remote
      Aboriginal communities in the Northern Territory, does employment, training and integration
      of local Ear and Hearing Clinical and Education Support Officers into health and education
      services (the Hearing for Learning initiative), compared to current practice, increase the
      proportion of children who receive an ear assessment, reduce the prevalence of ear and
      hearing problems and improve education outcomes of Aboriginal and Torres Strait Islander
      children, during a four year trial period?

Detailed Description

      Background: Australian Indigenous children achieve lower scores in school readiness and
      education outcomes than their non-Indigenous peers. Chronic otitis media and hearing loss
      during early childhood are associated with lower scores for these outcomes. Local problem:
      Failure to meet child health program schedules and evidence based practice in ear and hearing
      health is linked to high turnover of the health workforce, inadequate clinical skills and
      poor knowledge of ear and hearing health needs of children.

      This Hearing for Learning Initiative aims to improve health care and education services.

      Interventions: The intervention involves training and employing non-professional community
      members to facilitate busy primary health care services to deliver evidence-based ear and
      hearing health assessments in children 0 to 16 years of age, and to facilitate the teaching
      and home learning of hearing impaired children (the intervention).

      Trial design: A stepped-wedge community (n=18) cluster-randomised trial will compare the
      proportion of children receiving an ear assessment (primary outcomes) in the HfLI
      (intervention) periods with no HfLI (control) periods. Participating communities will be
      randomly assigned in 6-monthly steps to shift from control to intervention on pre-specified
      start dates.

      Outcomes: the primary outcome is the change in the proportion of Aboriginal and Torres Strait
      Islander children who receive an ear assessment, between intervention and control periods.

Study Type


Primary Outcome

Ear assessment

Secondary Outcome

 Prevalence of otitis media


Otitis Media



Study Arms / Comparison Groups

Description:  120 hours training for local community members delivered on-country face-to-face during 6 4-day weeks and over a 3-6 month period. Certificate II modules in Aboriginal Primary Health Care, ear and hearing health skills development (otoscopy, tympanometry, and hearScreen) and employment as Ear Health Facilitators to the end of the trial.


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status


Estimated Enrollment


Start Date

February 3, 2019

Completion Date

June 30, 2024

Primary Completion Date

December 31, 2023

Eligibility Criteria

        Inclusion Criteria: Aboriginal or Torres Strait Islander, resident in participating
        community (cluster)

        Exclusion Criteria: none




N/A - 16 Years

Accepts Healthy Volunteers

Accepts Healthy Volunteers


Amanda Leach, PhD, +61889468560, [email protected]

Location Countries


Location Countries


Administrative Informations



Organization ID


Secondary IDs

TEHREC -18-3264

Responsible Party


Study Sponsor

Menzies School of Health Research


 Australian Government Department of Health and Ageing

Study Sponsor

Amanda Leach, PhD, Principal Investigator, Menzies School of Health Research

Verification Date

December 2020