A systematic review of barriers and facilitators for ethnically diverse communities in accessing adult and paediatric hearing services

Objective
To conduct a systematic review of identified barriers and facilitators for ethnically diverse adults and children in accessing hearing health services.
Design
Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, Pychinfo, LLBA, and Scopus. The Strengthening of Reporting of Observational Studies in Epidemiology and Standards for Reporting Qualitative Research were used to assess quality of articles. Barriers and facilitators for ethnically diverse adults and children to access hearing services were summarised descriptively using Levesque et al.’s conceptual framework of access to healthcare.
Study Sample
25 articles met the inclusion criteria.
Results
Barriers and facilitators were identified for every domain of Levesque’s framework for ethnically diverse adults, children, and their families. Personal barriers included health literacy, health beliefs, and stigma. Environmental barriers included language, limited cultural and interpreter training for clinicians, time constraints in appointments, direct and indirect costs. Facilitators included availability of translated and/or simplified information, cultural responsiveness training, outreach programs, and community health workers to engage with ethnically diverse communities.
Conclusion
With increasingly multicultural societies globally, there is an increased need to provide culturally responsive care and accessible hearing health services. Understanding current barriers and facilitators to accessibility would facilitate global sustainable development goals around reduced inequality, health, and wellbeing.