Many rural and under-resourced areas lack audiology services exacerbating hearing health care disparities. Inthe United States hearing loss impacts an estimated 50 million individuals aged 65 years and older. Access tohearing aid rehabilitation can improve health outcomes yet an uneven geographic distribution of audiologistsacross the U.S. results in communities that lack services. In teleaudiology an audiologist delivers care to apatient from a remote workplace via videoconferencing technology minimizing the barrier of geography.Evidence has demonstrated the clinical equivalence of teleaudiology to face-to-face procedures including inthe area of hearing aid fitting and verification. However additional barriers to accessibility affecting disparitypopulations including socioeconomic and cultural differences are known to contribute to poor health serviceutilization. In teleaudiology a facilitator is located at the patient site to assist with hands-on tasks under thesupervision of the remote audiologist. Community Health Workers may be a feasible patient-site support forteleaudiology due to their established role in health promotion for disparity populations. For decadesCommunity Health Workers have supported a number of disease-specific (e.g. Diabetes) and general healthareas by providing community-receptive health education patient advocacy and integrating with patient-careteams. Given their established history of addressing disparities in a vast range of other health areasCommunity Health Workers have been identified for their emergent role in reducing disparities in access tohearing health care (Marrone et al. 2017; Marrone Ingram et al. 2016). The proposed research builds on theSponsors ongoing research with an established Community Health Worker program serving Hispanic/Latinoolder adults with hearing loss. The proposed study aims to test the feasibility of an innovative approach inwhich Community Health Workers serve as the patient-site support for teleaudiology. The hypothesis is thatproviding evidence-based audiology services delivered via teleaudiology with patient-site support fromCommunity Health Workers will lead to improved access to care and therefore improved hearing healthoutcomes. In this project remote hearing aid fittings will be delivered by an audiologist with patient-site supportfrom a Community Health Worker for a cohort of older adults (>65 years) from a rural area that has beenidentified as under-resourced for hearing health care. Hearing aid benefit will be measured quantitatively viastandardized patient-reported outcome measures and qualitatively via focus groups. We expect hearing aidbenefit to be improved at 3 months in an immediate intervention group relative to a waitlist comparison groupand for outcomes to be maintained at 6 months. The proposed research and training plans are supported by amultidisciplinary team of researchers with a longstanding history of collaboration across audiology publichealth telemedicine and community health. The overall goal aligns with the NIDCD research priority togenerate evidence for high-quality accessible hearing health care in under-resourced areas.!