Training of Community Health Agents in health hearing children: current perspectives

Castro, Taís Teixeira de Oliveira; Zucki, Fernanda

doi:10.1590/2317-1782/20152014223

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Sumário

Systematic Reviews • CoDAS 27 (6) • Dec 2015 • https://doi.org/10.1590/2317-1782/20152014223 copy

Training of Community Health Agents in health hearing children: current perspectives

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To characterize the training of Community Health Workers in the field of child hearing health.

Research strategy

A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed.

Selection criteria

The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese.

Data analysis

: A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review.

Results

The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified.

Conclusion

Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

Keywords:
Community Health Workers; Training; Hearing; Hearing loss; Deafness; Family Health Strategy

Study/authors	Study description	Study conclusion
Araújo ES. Ensino a distância na capacitação de agentes comunitários de saúde na área de saúde auditiva infantil: análise da eficácia do CD-ROM [Distant teaching in CHW training in children's hearing health area: analysis of CD-ROM effectiveness]99. Araújo ES. Ensino a distância na capacitação de agentes comunitários de saúde na área de saúde auditiva infantil: análise da eficácia do CD-ROM [dissertação]. Bauru: Faculdade de Odontologia da Universidade de São Paulo; 2012.	The objective of the study was to assess CD-ROM efficacy as an interactive tele-education tool to train CHW in children's hearing health area. There were 43 CHW from Bauru, São Paulo (G1) that received a previous course in hearing health and 47 CHW from Itajaí, Santa Catarina (G2), with no previous formation. The "Saúde Auditiva Infantil" CD-ROM was developed in a project and comprised five modules that included topics from prevention to hearing rehabilitation. Work stages: first - training in basic computing; second - CHW training; third - preparation of a simulator of daily situations; fourth - CD-ROM validation as an interactive tele-education tool: use and learning of content were assessed through comparison of the performance in the questionnaire before and after immediate training, of performance in a daily situation simulator and through a qualitative questionnaire regarding the used interactive tele-education tool; fifth - data analysis. Comparison of performance before and after immediate training showed differences for both groups in total scores and in different domains evaluated in the questionnaire. With regard to CHW performance in the daily situation simulator, there was a difference among the groups, with better performance of the G1. No significant correlation was seen between immediate posttraining performance and evaluation through the simulator. The qualitative analysis of CHW opinion about the CD-ROM showed great acceptability of this interactive tele-education tool.	The author concluded that the"Saúde Auditiva Infantil" CD-ROM is an efficient interactive tele-education tool to train CHW in children's hearing health area. It represents a resource that may help CHW to provide complete care with quality to the population all over the country.
Alvarenga KF, et al. Prosposta para capacitação de agentes comunitários de saúde em saúde auditiva [Proposal for CHW training in hearing health]1313. Alvarenga KF, Bevilacqua MC, Martinez ANS, Melo TM, Blasca WQ, Taga MFL. Proposta para capacitação de agentes comunitários de saúde em saúde auditiva. Pro Fono. 2008;20(3):171-6.	The objective of the study was to verify the efficacy of a training program for Community Health Workers (CHW) from the Programa de Saúde da Famíliain the field of child hearing health. Two groups were created: A, 31 CHWs in the city of Bauru, São Paulo; and B, 75 CHWs in Sorocaba, São Paulo. Training was performed through live classes for both groups; however, group A used a handout adapted from the WHO (2006) so that the CHW could follow their activities interactively. Training approached the themes: hearing and hearing impairment (HI), types, prevention and causes of HI, HI identification and diagnostic techniques, and HI general aspects. For validation, a questionnaire was applied before and after training with questions about the subjects that were discussed throughout the course to analyze content assimilation. The training was effective, with an increase in the total score achieved in the questionnaires before and after training.	Authors believed that the results proved the efficacy of the training program with use of interactive material and approaches proposed for community health workers from Programas de Saúde da Família.
Alvarenga KF, et al. Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida. [Questionnaire for monitoring hearing and language development in the first year of life]1414. Alvarenga KF, Araújo ES, Melo TM, Martinez ANS, Bevilacqua MC. Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida. Codas. 2013;25(1):16-21.	The study aimed to validate a monitoring questionnaire regarding the development of hearing and oral functions, applied by CHW in the first year of life. Seventy-six CHW previously trained in children's hearing health applied the questionnaire to families of 304 children aged 0 to 1 year. It comprised questions regarding the development of hearing and oral functions. All age ranges have the question "Does your son hear well"? Its validation was verified through analysis of false-positive and false-negative rates of the investigated children. A double-blind study was carried out in which all children investigated in the questionnaire underwent audiological assessment performed by speech language pathologists. Four children (1.32%) were diagnosed with sensorineural hearing loss, where 2 were unilaterally, and 69 children (22.7%) had conductive hearing loss. The follow-up questionnaire showed a 96% specificity and 67% sensitivity with a 33% false-negative rate for not identifying unilateral hearing losses and 4% false-positive rate.	Using the proposed questionnaire was viable and pertinent to the actions developed by the CHW from the Family Health Strategy. It shows high specificity and moderate sensitivity. Use of a validated instrument should be considered as a complement to Neonatal Hearing Screening Programs to identify hearing alterations of acquired character or late beginning.
Melo TM, et al. Capacitação de agentes comunitários de saúde em saúde auditiva: efetividade da videoconferência [Training for community health workers in hearing health: videoconference effectiveness]1818. Melo TM, Alvarenga KF, Blasca WQ, Taga MFL. Capacitação de agentes comunitários de saúde em saúde auditiva: efetividade da videoconferência. Pro Fono. 2010;22(2):139-45.	The study assessed the effectiveness of training for Community Health Workers (CHW) through videoconference in the field of child hearing health. Fifty CHWs were randomly divided into two groups according to the teaching methodology: 31 participated in the live training and 19 had the videoconference. The activity took place during an 8-hour meeting with expositional classes about the taught content and use of an adapted material calledPrimary ear and hearing care training resource - basic, intermediate, and advanced levels, simultaneously for both groups. Training was organized and assessed based on the proposal of a previous study. Both groups presented differences regarding the performance presented before and after training, with a more expressive result in the group that took part in the live training, both in the analysis of the total score or when the themes were considered separately.	Authors concluded that the videoconference used as a teaching tool was effective for CHW training in the hearing health area, but it should be used as a complement of the live training.

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[1] Correspondence address: Taís Teixeira de Oliveira Castro Rua F, 27, Vila Serrana 1, Vitória da Conquista (BA), Brasil, CEP: 45078-244. E-mail:taifono@yahoo.com.br