Hazard

Adult hearing loss is the third most common chronic health condition in the United States, with adults in rural areas facing higher risks and more difficulties in receiving hearing tests and treatment compared to those in urban settings. This research aims to develop and pilot test a community-based hearing healthcare patient navigation program in rural Kentucky to see if it can increase the number of rural adults receiving diagnostic hearing tests. The study focuses on adults experiencing adult-onset or age-related hearing loss. The study involves 500 patients from 10 rural clinics who will be invited to participate during routine office visits. After informed consent and baseline assessment, participants who screen positive for hearing loss will be contacted by a Patient Navigator every two weeks. The navigator will support patients with education, screening, diagnosis, and treatment related to hearing health care. Participants will be assisted in obtaining a formal diagnostic audiogram within 12 months of enrollment. Each navigation session is expected to last between 10 and 30 minutes. Participants will be monitored from enrollment through 12 months, with data collected after the diagnostic audiogram or at 12 months if no audiogram is done. The main outcome measured is the number of participants who receive a diagnostic audiogram during this period. The study includes assessments conducted by trained interviewers and aims to improve hearing healthcare access for rural adults. Total participation spans a full year from enrollment to study completion.

Researchers are evaluating the effectiveness of peer coaching models to help older adults with unmanaged Type 2 Diabetes Mellitus (T2DM) improve their self-care. The study focuses on adults aged 55 and older living in rural Kentucky, aiming to understand which aspects of peer support best promote T2DM management. This approach uses the social connections within Appalachian communities to support behavior change and diabetes control. The intervention involves two main groups: peer coaches who have successfully managed their T2DM (with HbA1c below 7.5%) and peer participants who have unmanaged T2DM (with HbA1c above 7.5%). Peer coaches receive training before starting, then reach out to their participants either weekly or every two weeks. Participants are either allowed to choose their coach themselves or are matched with one. Researchers compare these four groups to explore how contact frequency and coach matching affect self-care outcomes. Stakeholders are engaged before, during, and after the study to provide feedback and help improve the program. Participants will be monitored at the start, 3 months, and 6 months to track changes in their HbA1c levels, an important diabetes control measure. Peer coaches keep records of contact frequency, discussion topics, and notes on interactions. A small group of participants and coaches will join interviews to share their experiences. The study includes cognitive assessments and collects data on self-management behaviors, aiming to understand how peer support can best help older adults manage their diabetes over time.

Researchers are studying older adults with unmanaged Type 2 Diabetes Mellitus in rural Kentucky to compare the effects of different peer coaching models on diabetes self-management. The study aims to find out if peer coaching helps improve self-care and which aspects of peer coaching are most effective. Peer coaches are trained individuals who have successfully managed their own diabetes, and they will support peer participants through regular interactions. The intervention divides participants into four groups based on how they are paired with a peer coach and how often they communicate: either self-selected or matched with a coach, with contact either once a week or every two weeks. Peer coaches receive training before the study begins to develop their coaching skills. Researchers will track the frequency and nature of contacts between coaches and participants and compare the impact of different coaching approaches. Stakeholder feedback will be gathered at three points during the study to help understand what influences successful self-care and how to best implement the program. Participants will be assessed at baseline, 3 months, and 6 months with a focus on changes in their HbA1c levels, a key marker of diabetes control. The study will also monitor interactions between coaches and participants, record topics discussed, and collect feedback from a small group at the end. Overall participation involves regular contact with coaches and periodic evaluations over six months to measure the effectiveness and feasibility of this peer support model for managing Type 2 Diabetes.