Effectiveness of an online continuing education course in infant hearing health for primary care professionals.

OBJECTIVE: To evaluate the effectiveness of an online continuing education course on infant hearing health for primary care professionals. DESIGN: A prospective longitudinal study with interrupted time series pre-test/post-test design. The effectiveness of the online course was assessed by comparing pre- vs. post-training performance and analysing responses to evaluations of the quality of the course. STUDY SAMPLE: The sample comprised individuals enrolled between September 2018 and August 2019 in a Ministry of Health course, "Actions in primary care for the early identification of hearing impairment" offered on the AVASUS platform. RESULTS: Of the 2908 individuals registered, 1842 (63.3%) completed the course. Their ages ranged from 18 to 77 years, and 67.4% of them were females. Students and doctors were overrepresented among the enrollees. All Brazilian states were included in the sample. Comparisons of pre- and post-training performances showed a significant improvement in knowledge, and 99.3% of the participants provided positive comments regarding the quality of the course. CONCLUSIONS: The course is an effective distance learning tool on infant hearing health for primary care professionals. The online course circumvents the limitations posed by geographical barriers and also facilitates decentralisation.

Analysis of a hearing loss identification and intervention program in the first years of life in primary care / Análise de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária

ABSTRACT Purpose: to analyze the implementation and effectiveness of a hearing loss identification and intervention program in the first years of life in primary care. Methods: an experimental study carried out in two Basic Health Units. Twenty-three Community Health Workers participated, trained through an online self-instructional course from the Ministry of Health. Subsequently, they followed the hearing and language of children from zero to two years old, referring them, if necessary, to audiological evaluation. For the analysis of pre and post online course knowledge, the Wilcoxon test was applied, and to compare the performance between the participants of the two Basic Health Units, the Mann Whitney test was used, adopting p<0.05. Additionally, the qualitative perception of participating community workers, the referrals, and the result of the audiological evaluation were analyzed. Results: the online course was effective in improving the knowledge of the participants. A total of 102 children were monitored, 15 of them were referred for evaluation. From these, four underwent hearing screening and 11 underwent a complete hearing assessment, a case of conductive hearing loss being identified. Conclusion: the implementation of a program for the identification and intervention of hearing loss, in the first years of life, in primary care, permeated by community health workers, is feasible.

RESUMO Objetivo: analisar a implantação e a eficácia de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária. Métodos: estudo experimental realizado em duas Unidades Básicas de Saúde. Participaram 23 agentes comunitários de saúde, capacitados por meio de um curso autoinstrucional online do Ministério da Saúde. Posteriormente, acompanharam a audição e a linguagem das crianças de zero a dois anos, encaminhando-as, se necessário, para avaliação audiológica. Para análise do conhecimento pré e pós curso online foi aplicado o teste de Wilcoxon e para comparação do desempenho entre os participantes das duas Unidades Básicas de Saúde empregou-se o teste de Mann Whitney, com adoção de p<0,05. Adicionalmente, avaliou-se a percepção qualitativa dos agentes comunitários participantes, os encaminhamentos realizados e o resultado da avaliação audiológica. Resultados: o curso online foi eficaz na melhoria do conhecimento dos participantes. Totalizaram-se 102 crianças acompanhadas, 15 delas encaminhadas para avaliação. Destas, quatro realizaram triagem auditiva e 11 realizaram a avaliação auditiva completa, sendo identificado um caso de perda auditiva condutiva. Conclusão: a implantação de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária, permeada por agentes comunitários de saúde, mostrou-se viável.

Wideband absorbance for the assessment of pressure equalizing tubes patency in children.

OBJECTIVES: To analyze the feasibility of using wideband absorbance to verify the patency of pressure equalizing tubes (PETs) in clinical practice and to present the response pattern of this measure for ears with patent PET. METHODS: This observational case-control type study evaluated 48 ears of 30 children with severe or profound hearing loss, aged 10-44 months, of both sexes. The subjects were subdivided into two groups: 24 ears with Sheppard type PET (experimental group - EG) and 24 ears with normal middle ear (control group - CG), paired with the EG, according to age, sex, and ear evaluated. To obtain the wideband absorbance, a Middle-Ear Power Analyzer, version 5.0 (Mimosa Acoustics), was used, and absorbance values for pure tone and chirp stimuli were analyzed. RESULTS: There was no influence of ear (right or left) on the measurements obtained. The EG showed higher absorbance values at low frequencies. Although the two stimuli made it possible to identify the difference in acoustic transfer function between the groups studied, compared to pure tone, the chirp stimulus allowed identification of differences in a higher number of frequencies. CONCLUSIONS: Ears with a patent PET present an acoustic transfer pattern that differs from that obtained for normal middle ears, with a higher absorbance at low frequencies. Both pure tone and chirp stimuli can be used to identify such differences, nevertheless, the use of chirp stimulus is recommended, since it allows differentiation over a wider frequency range.