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BackgroundAdults living with hearing loss have highly variable knowledge of hearing aids, resulting in suboptimal use or nonuse. This issue can be addressed by the provision of high-quality educational resources. ObjectiveThis study aims to assess the everyday experiences of first-time hearing aid users when using a newly developed, theoretically informed cocreated mobile health (mHealth) educational intervention called m2Hear. This intervention aims to deliver greater opportunities for individualization and interactivity compared with our previously developed multimedia intervention, C2Hear. MethodsA total of 16 first-time hearing aid users trialed m2Hear for a period of 10-weeks in their everyday lives, after which individual semistructured interviews were completed. The data were analyzed using an established deductive thematic analysis procedure underpinned by the Capability, Opportunity, Motivation-Behavior model. The model stipulates that to engage in a target behavior, an individual must have physical and psychological capability, physical and social opportunity, and automatic and reflective motivation. ResultsCapability—m2Hear was viewed as a concise and comprehensive resource, suitable for a range of digital literacy skills. It was stated that m2Hear could be conveniently reused to provide useful reminders that facilitate knowledge of hearing aids and communication. Opportunity—m2Hear was simple and straightforward to use, enabling greater individualization and independence. The availability of m2Hear via mobile technologies also improved accessibility. Motivation—m2Hear provided greater support and reassurance, improving confidence and empowering users to self-manage their hearing loss. ConclusionsOverall, this qualitative study suggests that m2Hear supports first-time hearing aid users to successfully self-manage their hearing loss postfitting. Furthermore, this study demonstrates the utility of employing a combined theoretical and ecologically valid approach in the development of mHealth educational resources to meet the individual self-management needs of adults living with hearing loss. Trial RegistrationClinicalTrials.gov NCT03136718; https://clinicaltrials.gov/ct2/show/NCT03136718

BackgroundThe use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. ObjectiveTo explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. MethodsPostal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the “PC confidence index.” The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). ResultsThe postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P

Introduction: Untreated hearing loss is reported to negatively impact on an individual's quality of life, affecting their psychological and physical health and placing them at greater risk of developing dementia. Despite this, hearing loss management is often delayed by up to a decade. This is likely due to difficulties in navigating the hearing care pathway, and the absence of a central, unbiased reference point for consumer-friendly hearing health information and resources. We intend to co-design an online support service for adults with hearing loss with the following aims: 1) to understand unmet needs and consumer barriers to accessing hearing health information, 2) to identify solutions to these unmet needs that can be developed into prototype ideas, 3) to incrementally build on iterations of a prototype until a usable online support service is developed and ready for real-life testing with end-users, and 4) to test and evaluate the usability, accessibility, and effectiveness of the prototype from the consumer's perspective, so that the prototype can be refined into the final product. Methods and analysis: This will be a mixed method study. Consumers will be involved in all stages of the design of the project following the Hasso Plattner model of design thinking. The qualitative component will involve sprints and semi-structured interviews to access the consumer perspective and understand unmet needs and challenges regarding the access of online hearing health information. For the quantitative component, an online survey will be administered prior to prototype testing as part of the remote usability study to collect self-efficacy and eHealth literacy outcome measures via validated questionnaires. Data collection will also be performed post-prototype testing for evaluation purposes. Finally, heuristic evaluation of the prototype will be conducted by an eLearning expert to help refine the prototype into the final product. [ABSTRACT FROM AUTHOR]

Purpose: Unaddressed hearing loss can adversely affect employment and day-to-day work-life. Efficient and effective audiology support can help optimise hearing in the workplace. This study explores the audiological rehabilitation experiences of workers with hearing loss (WHL). Materials and methods: Twenty-four WHL with experience of a wide range of audiology services across the UK participated in semi-structured interviews. Interviews were analysed using inductive thematic analysis. Results: Three main themes were generated: Theme 1: mixed experiences with audiology services (subdivided into two subthemes and four sub-subthemes). Theme 2: audiology role in work support (subdivided into three subthemes). Theme 3: "I think support could be improved if..." (subdivided into two subthemes). Conclusion: The audiological rehabilitation for working-age adults with hearing loss needs improvements to deliver sufficient support and quality care. Some of the barriers to having better-functioning hearing healthcare require fundamental standards in healthcare quality, such as access to services, staff (including audiologists) deaf awareness, information and technology support, and personalised care that considers work-life needs. Further research is required to evaluate the feasibility and cost-effectiveness of improvements, such as support that extends beyond hearing aid care, whether from audiology or non-audiology services. IMPLICATION FOR REHABILITATION: Workers with hearing loss need audiologists' support to address their work life needs beyond hearing-aids care. Improving audiologists' competencies, audiology departments' efficiency and developing relevant resources may promote better healthcare for workers with hearing loss. Audiologists, employers, workers, and the healthcare system need to collaborate in developing person-centred solutions to sufficiently assist workers with hearing loss. [ABSTRACT FROM AUTHOR]

Aim: Best-practice in audiological rehabilitation takes a holistic client- and family-centred approach and considers hearing care in the context of personal well-being. Hearing loss not only impairs the ability to hear, but can also compromise the ability to communicate, thus negatively impacting both social and emotional well-being. Hearing care professionals play a key role in fostering their client's well-being. This paper aims to provide evidence-based recommendations to ensure inclusion of social-emotional well-being in audiologic rehabilitation clinical practice. Methods: A review of current research and expert opinion. Results: This guide proposes a 5-step plan which includes: identifying the client's social-emotional well-being; including family members in audiological rehabilitation; incorporating social-emotional needs and goals in an individualized management plan; relating identified hearing needs and goals to rehabilitation recommendations; and using counselling skills and techniques to explore and monitor social-emotional well-being. Each component of the 5-step plan is discussed and clinical considerations are presented. Conclusion: These comprehensive recommendations provide guidance to hearing care professionals looking to ensure clients' social-emotional well-being are considered throughout the rehabilitation journey. [ABSTRACT FROM AUTHOR]

To conduct the first phases in the development of a self-report measure of empowerment on the hearing health journey, specifically, item generation and content evaluation of the initial pool of items generated. A content expert panel survey and cognitive interviews were conducted. Descriptive statistics were obtained for the quantitative data, and the cognitive interviews were analysed using thematic analysis. Eleven researchers and clinicians participated in the content expert surveys. Sixteen experienced hearing aid users participated in the cognitive interviews, recruited from the USA and Australia. The items underwent five iterations based on feedback from the survey and interview data. This resulted in a set of 33 quality-tested potential survey items that were rated highly for relevance (mean = 3.96), clarity (mean = 3.70) and fit to dimensions of empowerment (mean = 3.92) (scale 0-4, where 4 was the maximum rating). Involving stakeholders in item generation and content evaluation increased relevance, clarity, fit to dimension, comprehensiveness, and acceptability of the items. This preliminary version of the 33-item measure underwent further psychometric refinement (Rasch analysis and traditional classical test theory testing) to validate it for clinical and research use (reported separately). [ABSTRACT FROM AUTHOR]

The first objective was to assess the feasibility of training on hearing aids and communication strategies by support workers in residential care via a cascade training model using two different training packages. The second was to identify key elements of these packages to inform the design of a multimedia training package. Quantitative and qualitative methodologies were used. A pre-post feasibility design assessed the questionnaire data from residential care support workers to measure knowledge and confidence at three stages during the training. Semi-structured interviews explored the support workers' experiences and adherence to cascading the training packages. Fourteen support workers employed by Sense (charity for deafblind people) were trained to become "Hearing Champions" and cascaded their learning to 117 support colleagues. Hearing Champions gained knowledge, skills and confidence, which were subsequently enhanced by sharing their learning with others. Despite individual and organisational barriers, they reported examples of improved practice and feelings of empowerment. It is feasible to deliver training to support workers in residential homes using the face-to-face "Hearing Champions" and multimedia C2Hear training methods by cascading training to their colleagues. Support workers expressed a preference for training that is portable, adaptable and interactive. [ABSTRACT FROM AUTHOR]

Purpose: Parental reports of communication, listening, and behavior in children receiving a clinical diagnosis of specific language impairment (SLI) or auditory processing disorder (APD) were compared with direct tests of intelligence, memory, language, phonology, literacy, and speech intelligibility. The primary aim was to identify whether there were differences between these characteristics in children with SLI or APD. Method: Normally hearing children who were clinically diagnosed with SLI (n = 22) or APD (n = 19), and a quasirandom sample of mainstream school (MS) children (n = 47) aged 6-13 years, underwent tests of verbal and nonverbal IQ, digit span, nonsense word repetition, Spoonerisms, reading, grammar, and sentence and VCV nonword intelligibility. Parents completed questionnaires on the children's communication, listening, and behavior. Results: There was generally no difference between the performance of the children with SLI and the children with APD on the questionnaire and test measures, and both groups consistently and significantly underperformed compared with the children in the MS group. Speech intelligibility in both noise and quiet was unimpaired in the SLI and APD groups. Conclusion: Despite clinical diagnoses of SLI or APD, the 2 groups of children had very similar behavioral and parental report profiles, suggesting that the children were differentially diagnosed based on their referral route rather than on actual differences.

To examine patient and audiologist experiences and perspectives of using a patient-centred telecare tool, the Ida Institute's Why Improve My Hearing? (WIMH) Tool, before and during the initial hearing assessment appointment. A qualitative study comprising individual semi-structured interviews using a maximum variation sampling strategy. The data were analysed using an established thematic analysis technique. Fifteen participants, including ten patients (i.e. adults with hearing loss) and five audiologists, were recruited from Adult Audiology Services within the United Kingdom's publicly-funded National Health Service (NHS). Three themes described the impact of using the WIMH Tool. Theme 1 (i.e. enhanced preparation before the appointment): the Tool helps patients to better understand and accept their hearing difficulties in advance of their first appointment. Theme 2 (i.e. enriched discussion during the appointment): the tool can enhance patient-centred communication, as well as the efficiency of the appointment. Theme 3 (i.e. varied impact on outcomes following the appointment): the Tool can improve patient motivation, readiness, and involvement in decision-making, though it may have limited impact on additional outcomes, such as adherence. The WIMH Tool can be successfully implemented in audiological practice, resulting in benefits before and during the initial hearing assessment appointment. [ABSTRACT FROM AUTHOR]

To examine the benefits of home-delivered auditory training for adult hearing aid users using live-voice conversations in the presence of a single-talker distractor (experimental group) or in quiet (active-control group). Randomised controlled trial. The experimental group held conversations with their nominated communication partner in the presence of a single-talker distractor set to a challenging level, 30 min/day, 5 days/week over 4 weeks. The active-control group held comparable conversations in quiet. Behavioural outcome measures of speech-in-noise perception, cognition and self-reported hearing difficulties were assessed pre- and post-training. Participant feedback was obtained. Thirty-nine hearing aid users (32 males, 7 females, mean age = 73.02 years, SD = 4.71 years) and their communication partners. The experimental group significantly improved and outperformed the active-control group for words-in-noise perception. Both groups achieved improvements in self-reported hearing difficulty while only the experimental group improved on dual-task. Subjectively, both groups found live-voice conversations beneficial and reported increased concentration and listening skills. Home-delivered live-voice auditory training with communication partners shows potential to improve outcomes for adult hearing aid users, regardless of the presence or absence of a competing speech distractor. Further research is required to assess mechanisms of benefit and distractor effects within carefully controlled experiments. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to describe the emerging use of design thinking methodologies in hearing health care research using a participatory action approach with a consumer and community involvement panel, audiologists, and adults with hearing loss. Method: Two connected hearing health care projects that adopted design thinking principles are presented here as case studies. Case 1 investigated the applicability and acceptability of smart voice assistant technology as post--hearing aid fitting support. Case 2 investigated the feasibility of providing support for new adult patients with hearing loss before they attend their hearing assessment appointment. Discussion: The design thinking process provided a flexible structure in which researchers were able to empathize with stakeholders, define their unmet needs, and ideate potential connected hearing health care solutions to develop and evaluate prototypes in clinical and home settings. Conclusion: Utilizing a needs-based, collaborative design thinking approach to conduct development in hearing health care research is a viable and novel option to produce innovative, relevant, and translational hearing health solutions that address stakeholder needs. [ABSTRACT FROM AUTHOR]