Ear disease and hearing loss: a descriptive study of Aboriginal children living in metropolitan South Australia.

OBJECTIVE: This article aims to describe the rates of middle ear disease in Aboriginal children living in metropolitan Adelaide. METHODS: Data from the Under 8s Ear Health Program (population-based outreach screening) were analysed to identify rates of ear disease and the referral outcomes for children identified with ear conditions during screening. RESULTS: In total, 1598 children participated in at least one screening between May 2013 and May 2017. Males and females were equally represented; 73.2% had one or more abnormal findings on otoscopy at the first screening visit, 42% had abnormal tympanometry, and 20% registered a "fail" on otoacoustic emission testing. The referral pathway for children with abnormal findings included referrals to their GP, Audiology, and Ear Nose Throat (ENT) Departments. Also, 35% (562/1598) of the children screened required referral either to a GP or Audiology, and 28% of those referred (158/562) or 9.8% (158/1598) of the total number of children screened required further ENT management. CONCLUSIONS: High rates of ear disease and hearing problems in urban Aboriginal children were detected in this study. Existing social, environmental, and clinical interventions need to be evaluated. Closer monitoring including data linkage may assist to better understand the effectiveness, timeliness, and challenges of public health interventions and follow-up clinical services to a population-based screening program. IMPLICATIONS FOR PUBLIC HEALTH: Aboriginal-led population-based outreach programs such as the Under 8s Ear Health Program augmented by seamless integration with education, allied health and tertiary health services should be prioritised for expansion and continued funding.

The role of Indigenous Health Workers in ear health screening programs for Indigenous children: a scoping review.

OBJECTIVE: To identify and describe the involvement of Indigenous Health Workers within ear health screening programs for Indigenous Peoples in Australia, Canada, the US and New Zealand. METHODS: Peer-reviewed and grey literature sources were systematically searched to identify evidence. This scoping review was conducted in accordance with the scoping review extension of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. RESULTS: Forty pieces of evidence were included in this review. While almost all included studies identified the critical role of Indigenous Health Workers in ear and hearing health, Indigenous leadership and involvement in research projects and service delivery varied significantly and none of the included studies reported Indigenous health worker perspectives. Approximately half of the authorship teams had at least one Indigenous author. CONCLUSIONS: There is a clear need for Indigenous leadership in ear and hearing health research and programming. Specialist teams involved in health service delivery and research need to enable this transition by understanding and privileging Indigenous leadership and investing in appropriate training for non-Indigenous specialists providing care in Indigenous health contexts. IMPLICATIONS FOR PUBLIC HEALTH: These findings are discussed in terms of opportunities to improve Indigenous ear and hearing health research and programming.