Search

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]

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]

To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians' ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services. [ABSTRACT FROM AUTHOR]

To identify the approaches taken by audiologists to address their adult clients' psychosocial needs related to hearing loss. A participatory mixed methods design. Participants generated statements describing the ways in which the psychosocial needs of their adult clients with hearing loss are addressed, and then grouped the statements into themes. Data were obtained using face-to-face and online structured questions. Concept mapping techniques were used to identify key concepts and to map each of the concepts relative to each other. An international sample of 65 audiologists. Ninety-three statements were generated and grouped into seven conceptual clusters: Client Empowerment; Use of Strategies and Training to Personalise the Rehabilitation Program; Facilitating Peer and Other Professional Support; Providing Emotional Support; Improving Social Engagement with Technology; Including Communication Partners; and Promoting Client Responsibility. Audiologists employ a wide range of approaches in their attempt to address the psychosocial needs associated with hearing loss experienced by their adult clients. The approaches described were mostly informal and provided in a non-standardised way. The majority of approaches described were not evidence-based, despite the availability of several options that are evidence-based, thus highlighting the implementation gap between research and clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To validate a method using self-reported speech communication effort in noise to estimate occupational noise levels by comparing with measured noise levels. Design: A comparative observational study. Reported vocal effort to communicate with a person at a distance of 1.2m during workplace-related tasks was used to provide an estimate of noise levels in the workplace. These estimated noise levels were compared against noise level measurements obtained using personal noise dosimetry badges for corresponding tasks undertaken by participants. Study sample: Participants (n=168) aged 16-25 years were recruited from companies where workplace noise levels were at least 85 dB(A). Results: Estimated noise levels using speech communication ability were evenly distributed above and below the measured noise levels (n=134), indicating a lack of systematic bias in the method. For 91% of participants, estimates of noise levels using speech communication were within ±6 dB of the measured levels, whilst 56% were within ±3 dB. Conclusions: Report of speech communication effort required in noise by employees is an effective method of estimating noise levels within the workplace. This can be used for retrospective noise level assessment where there are no recorded noise level measurements, such as for retrospective research studies or in medicolegal work. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to provide an example of the Medical Research Council's guidelines for evaluating complex health care interventions in the context of smartphone-connected listening devices in adults with hearing loss. Method: Twenty existing hearing aid users trialed 1 of the following smartphone-connected listening devices: made-for-smartphone hearing aids, a personal sound amplification product, and a smartphone "hearing aid" application used with either wireless or wired earphones. Following 2 weeks of use in their everyday lives, participants completed self-report outcome measures. Results: Relative to conventional hearing aids, self-reported use, benefit, and satisfaction were higher, and residual disability was lower for made-for-smartphone hearing aids. The converse was found for the other smartphoneconnected listening devices trialed. Similarly, overall usability was judged to be "above average" for the madefor- smartphone hearing aids, but "below average" for the remaining devices. Conclusions: This developmental work, guided by the Medical Research Council's framework, lays the foundation for feasibility and pilot studies, leading to high-quality research assessing the effectiveness of smartphoneconnected listening devices. This future evidence is necessary to guide health care commissioners and policymakers when considering new service delivery models for adults living with hearing loss. [ABSTRACT FROM AUTHOR]

Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582 [ABSTRACT FROM AUTHOR]

Objective: To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. Design: RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. Study sample: An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Results: Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. Conclusions: This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess whether Internet competency predicted practical hearing aid knowledge and handling skills in first-time hearing aid users. Method: The design was a prospective, randomized controlled trial of a multimedia educational intervention consisting of interactive video tutorials (or reusable learning objects [RLOs]). RLOs were delivered through DVD for TV or PC, and online. Internet competency was measured at the hearing aid fitting appointment, whereas hearing aid knowledge and practical handling skills were assessed 6 weeks postfitting. Results: Internet competency predicted practical hearing aid knowledge and handling skills, controlling for age, hearing sensitivity, educational status, and gender for the group that received the RLOs. Internet competency was inversely related to the number of times the RLOs were watched. Conclusion: Associations between Internet competency and practical hearing aid knowledge, handling skills, and watching the RLOs fewer times may have arisen because of improved self-efficacy. Therefore, first-time hearing aid users who are more competent Internet users may be better equipped to apply newly learned information to effectively manage their hearing loss. [ABSTRACT FROM AUTHOR]

Objective: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework. [ABSTRACT FROM AUTHOR]

Purpose: An educational intervention to improve knowledge of hearing aids and communication in first-time hearing aid users was assessed. This intervention was based on the concept of reusable learning objects (RLOs). Method: A randomized controlled trial was conducted. One group received the educational intervention, and the other acted as a control group. RLOs were delivered online and through DVD for television and personal computer. Knowledge of both practical and psychosocial aspects of hearing aids and communication was assessed using a free-recall method 6 weeks postfitting. Results: Knowledge of both practical and psychosocial issues was significantly higher in the group that received the RLOs than in the control group. Moderate to large effect sizes indicated that these differences were clinically significant. Conclusion: An educational intervention that supplements clinical practice results in improved knowledge in first-time hearing aid users. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this research forum article was to examine accessibility, use, and adherence to computerized and online interventions for people with hearing loss. Method: Four intervention studies of people with hearing loss were examined: 2 auditory training studies, 1 working memory training study, and 1 study of multimedia educational support. Results: A small proportion (approximately 15%) of participants had never used a computer, which may be a barrier to the accessibility of computer and Internet-based interventions. Computer competence was not a factor in intervention use or adherence. Computer skills and Internet access influenced participant preference for the delivery method of the multimedia educational support program. Conclusions: It is important to be aware of current barriers to computer and Internet-delivered interventions for people with hearing loss. However, there is a clear need to develop and future-proof hearing-related applications for online delivery. [ABSTRACT FROM AUTHOR]

The nature of auditory processing deficits is at the heart of understanding auditory processing disorder (APD) in children. This article reviews evidence that confounding nonsensory factors, including maturation, processing efficiency, and cognition, influence auditory processing in children with APD or language learning impairment. Experimental evidence is presented to show that performance thresholds on nonspeech auditory processing (AP) tests, such as tone detection tasks in noise or in quiet, are poorer in children clinically diagnosed with APD or specific language impairment (SLI), compared to typically developing mainstream school (MS) children. However, with the exception of backward masking, these group differences disappeared for all AP tests after accounting for nonverbal IQ. Intrinsic attention, indexed by variability in AP test performance, was examined alongside AP threshold performance. Generally there was no difference in intrinsic attention across the three participant groups (MS, SLI, APD), but frequency discrimination (FD) was an exception. Thus, although reduced intrinsic attention has been shown to be a factor in the presenting symptoms of APD, including poor listening, speech intelligibility, and communication, there is, surprisingly, no robust evidence that intrinsic attention in children identified with APD or SLI is any poorer than that in typically developing children. [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. [ABSTRACT FROM AUTHOR]

Background: Unlike conventional hearing aids, smartphone-connected listening devices may require limited or no input from a trained audiologist in terms of device programming and adjustment. However, there is a lack of peer-reviewed evidence assessing the real-world perspectives of people living with hearing loss toward such technological innovations. Purpose: This study assessed the everyday experiences of adults living with hearing loss toward a range of smartphone-connected listening devices using the Capability, Opportunity, Motivation, Behaviour (COM-B) model as a theoretical framework. Research Design: A qualitative study where participants trialed one of the following smartphone-connected listening devices for two weeks in their everyday lives: made-for-smartphone hearing aid, personal sound amplification product, and smartphone ''hearing aid'' app with wired earphones or wireless hearable. Individual semistructured interviews were conducted. Study Sample: Twenty adults (13 male and 7 female; mean age 5 62.25 years, SD 5 11.59) with mild-to- moderate hearing loss (mean better ear pure-tone average 5 30.49 dB HL, SD 5 17.51) were recruited using a convenience sampling strategy. All participants owned conventional hearing aids. Data Analysis: The data were analyzed using an established deductive thematic analysis procedure within the context of the COM-B model. The model stipulates that for individuals to engage in a particular behavior (B), they must have sufficient capability (C), opportunity (O), and motivation (M). Results: Capability: One of the key advantages facilitating use and adherence of smartphone-connected listening devices was the ability for participants to make fine-tune adjustments in any listening situation. Opportunity: Participants commented that these devices could address issues surrounding stigma as smartphones are ubiquitous in everyday life. Motivation: Participants consistently reported that the ability to make adjustments via a smartphone provided them with a greater sense of autonomy and empowerment. As a result, they felt more in control of their hearing loss. Conclusions: This study lays the foundation for further high-quality research to explore whether smartphone-connected technologies have the potential to yield optimum benefits for people living with hearing loss. [ABSTRACT FROM AUTHOR]