Advancing Hearing Care Equity: Outcomes From a Community-Based Hearing Aid Assistance Program for Underserved Adults

Purpose: Access to hearing services is often limited by health care disparities and financial constraints. This retrospective longitudinal study examined hearing aid uptake and outcomes among low-income adults enrolled in the Dalhousie Hearing Aid Assistance Program–Community Services, a provincially funded initiative in Nova Scotia, Canada, designed to broaden access to hearing health care. Method: Demographic, audiologic, and self-reported hearing aid data were extracted from the digital patient management system. The study included 179 participants, with a mean age of 59.30 years. Results: Most participants (89.0%) received bilateral amplification. Average hearing thresholds indicated bilateral hearing loss in the moderate range. Tinnitus was reported by 47.5% of participants (18.40% persistent, 29.10% intermittent), most commonly affecting both ears (68.45%). Participants demonstrated strong hearing aid uptake, with an average daily use of 9.20 hr. Significant improvements were observed, including reductions in Hearing Handicap Inventory for the Elderly–Screening Version (HHIE-S) total and subscale scores ( p < .001) at both 3-month and 12-month follow-ups relative to postfitting baseline, as well as substantial gains on the annual Client-Oriented Scale of Improvement (COSI) outcomes (> 80%), with a large correlation between Degree of Change and Final Ability outcomes ( r = .716, p < .001). Hierarchical linear regression analysis indicated that average hearing loss ( p < .003) and gender ( p < .048) were significant predictors of HHIE-S scores. Conclusion: The findings demonstrate significant improvements in perceived hearing handicap and functional outcomes and highlight the value of accessible, community-based hearing aid services in reducing barriers to care and promoting hearing care equity.