Ear and hearing care programs for First Nations children: A systematic scoping review
Bibliographic record
Abstract
Abstract Background Ear and hearing care programs are critical to early detection and management of otitis media which disproportionately impacts First Nations children, affecting speech and language development, social and cognitive development and, in turn, education and life outcomes. This review aimed to identify ear and hearing care programs to chart program approaches, sustainability, and areas focus across the care pathway. Method A systematic search was conducted using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Search terms included First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. Results Twenty-seven articles met the criteria to be included in the review and described total of twenty-one ear and hearing care programs. Programs focussed on connecting patients to specialist services, ensuring cultural safety of services, and increasing entry into ear and hearing care pathways. Conclusion The majority of programs focus on detection of otitis media and hearing loss, however gaps remain within and across the care pathway which continue to create system fragmentation. Cultural safety is often considered a priority, yet engagement in programs is primarily taking place at an operational level. Programs should ensure that cultural engagement takes place at all stages of program design, operation, and evaluation. The majority of studies (and programs) do not report outcome measures, but rather short-term outputs as indicators for program success limiting an understanding of their effectiveness at mitigating longer-term impacts of middle ear disease and hearing loss. Factors relating to program sustainability include government funding and Indigenous Health Worker or community involvement which is not always considered at a program design stage.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.052 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.013 | 0.015 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".