{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:17:13Z","timestamp":1783696633184,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["PPO 19\u2010397"],"award-info":[{"award-number":["PPO 19\u2010397"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Age\u2010related hearing loss is common and a particularly prevalent disability among Veterans. In response, comprehensive hearing services are available within the Veterans Affairs (VA) integrated healthcare system. Severe hearing loss may pose distinct communication challenges inadequately addressed by hearing aids, but data suggest severe hearing loss is often not treated differently. We sought to identify barriers and facilitators to evidence\u2010based and individualized management of severe hearing loss from the perspectives of VA clinicians and Veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used purposeful sampling to conduct remote semi\u2010structured video interviews with 33 current VA clinicians encompassing multiple disciplines and 39 Veterans with severe hearing loss over approximately an 18\u2009month period (May 2022 to December 2023). We analyzed qualitative data using content thematic analysis. Coding categories were summarized within each participant; then across all participants to yield clinician\u2010specific and Veteran themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the sample of 33 VA clinicians (20 audiologists, 9 otolaryngologists and 4 primary care clinicians), the overarching theme of qualitative data is that hearing loss is undertreated in the Veteran population. Across clinician groups, the qualitative data revealed multi\u2010level factors (system\u2010, clinician\u2010, and patient\u2010level) that influence the delivery of hearing care and management for Veterans with severe hearing loss. Interviews revealed that efficient access and collaborative care facilitate evidence\u2010based practice. Among Veterans, inadequately managed hearing loss impacts quality of life; lack of knowledge and misconceptions about hearing care options and system\u2010level barriers influence Veterans' perceptions of their hearing care and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although hearing care is available to Veterans, multi\u2010level factors influence the delivery of hearing care and management for Veterans with severe hearing loss. Greater attention both in primary and specialty care is needed to ensure tailored treatments are available to Veterans with severe hearing loss across the integrated VA health care system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70353","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T02:01:01Z","timestamp":1771639261000},"page":"1089-1098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Veteran and Provider Perspectives on Rehabilitation for Severe Hearing Loss"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9136-6483","authenticated-orcid":false,"given":"David R.","family":"Friedmann","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery NYU Grossman School of Medicine  New York New York USA"},{"name":"Veterans Affairs New York Harbor Healthcare System  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Winchester","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Bender","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery NYU Grossman School of Medicine  New York New York USA"},{"name":"Veterans Affairs New York Harbor Healthcare System  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julienne","family":"Ching","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery NYU Grossman School of Medicine  New York New York USA"},{"name":"Veterans Affairs New York Harbor Healthcare System  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Veterans Affairs New York Harbor Healthcare System  New York New York USA"},{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frankie","family":"Hamilton","sequence":"additional","affiliation":[{"name":"NYU Rory Meyers College of Nursing  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-4306","authenticated-orcid":false,"given":"Joshua","family":"Chodosh","sequence":"additional","affiliation":[{"name":"Veterans Affairs New York Harbor Healthcare System  New York New York USA"},{"name":"Department of Medicine, Division of Geriatric Medicine and Palliative Care NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Vaughan","family":"Dickson","sequence":"additional","affiliation":[{"name":"University of Connecticut Elisabeth DeLuca School of Nursing  Storrs Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.506"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED\u2010D\u201014\u201000100"},{"issue":"28","key":"e_1_2_10_4_1","first-page":"955","article-title":"Severe Hearing Impairment Among Military Veterans \u2013 United States, 2010","volume":"60","author":"Centers for Disease C, Prevention","year":"2011","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420130084028"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14308"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.2504.593"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15833"},{"key":"e_1_2_10_9_1","unstructured":"\u201cHistorical VA Hearing Aids Procurement Distribution Summaries 2023 \u201d accessed June 1 2024."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000946"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211070993"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/23312165241273393"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.750"},{"key":"e_1_2_10_14_1","first-page":"492","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell J. 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V.Dickson andJ.Chodosh \u201cManagement of Veterans with Severe Hearing Loss: Challenges and Opportunities \u201d (forthcoming)."},{"key":"e_1_2_10_21_1","unstructured":"VHA and DoD Prosthetic Clinical Management Program \u201cCliical Practice Recommendations for Prescription of Cochlear Implants \u201d Updated 2022."},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.19088"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)01406\u2010X"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000762"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101739369"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1044\/2022_AJA\u201022\u201000007"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001873"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.06.010"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.1918"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70353","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:22:23Z","timestamp":1776226943000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/jgs.70353"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70353","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"assertion":[{"value":"2025-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}