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Malmberg M, Hagberg J. Synchronous remote fine-tuning and follow-up within aural rehabilitation: a randomised controlled trial. Int J Audiol 2024; 63:458-466. [PMID: 36971711 DOI: 10.1080/14992027.2023.2188437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The objective of the study was to evaluate the effect of including synchronous remote fine-tuning and follow-up as a part of the aural rehabilitation process. DESIGN A randomised controlled trial (RCT). STUDY SAMPLE Experienced hearing aid users who were due for renewed aural rehabilitation were randomised to either an intervention group (n = 46) or a control group (n = 49). Both groups underwent all stages of the conventional renewed aural rehabilitation process within our clinics, but the intervention group was also offered remote follow-up visits, including an opportunity for synchronous remote fine-tuning of hearing aids. The Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the International Outcome Intervention for Hearing Aid Users (IOI-HA) were used as outcome measures. RESULTS Both groups improved in self-rated hearing difficulties and hearing aid benefits measured with HHIE/A and APHAB. No significant differences were found between the intervention and the control group. CONCLUSION Including synchronous remote follow-up and fine-tuning as a part of an aural rehabilitation process may effectively complement clinical visits. Additionally, the synchronous remote follow-up has the potential to further develop person-centred care by enabling hearing aid users to identify individual needs directly in an everyday environment.
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Affiliation(s)
- Milijana Malmberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennie Hagberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
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Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
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Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
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Kuang L, Hu H, Dai H, Ma H, Jia Y, Sheng Y. Interventions to improve social network in older people with sensory impairment: a systematic review. Aging Clin Exp Res 2024; 36:34. [PMID: 38345702 PMCID: PMC10861684 DOI: 10.1007/s40520-024-02695-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Sensory impairment significantly reduces speech discrimination and perception ability, presenting a challenge to effective communication. It can lead to social withdrawal and a reduced social network which can lead to cognitive impairment, seriously affecting the quality of life of older people. However, it is unclear which intervention components are effective to improving social network in older people with sensory impairment. OBJECTIVE The aim of this systematic review was to summarize interventions designed to improve social network in older people with sensory impairment. METHODS We searched seven databases from inception to December 1, 2023. Eligible studies included randomized clinical trials (RCT) and quasi-experimental studies of interventions for older people with sensory impairment aimed at improving social networks. Two reviewers searched databases, extracted data, and assessed the quality of the included studies independently. RESULTS Nine studies including five RCTs and four quasi-experimental studies were selected, enrolling 721 older people with sensory impairment. Methodological quality of the studies was modest. Eight studies demonstrated a positive impact of the interventions used in older people with sensory impairment. The detailed effective intervention components may include communication strategies, resources for older people and their significant others, exercise or tech-back of communication, sensory device fitting, and use and maintenance of sensory devices. CONCLUSION There are few interventions available for improving social network in older people with sensory impairment. Most interventions mainly focus on communication education and care, and sensory device fitting and education. To improve the social network in older people with sensory impairment, it is necessary to develop more effective, multidisciplinary collaborative effective interventions and conduct more high-quality original studies.
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Affiliation(s)
- Li Kuang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Hanyu Hu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Halina Dai
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Huiying Ma
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yuling Jia
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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Bennett RJ, Kelsall-Foreman I, Barr C, Campbell E, Coles T, Paton M, Vitkovic J. Barriers and facilitators to tele-audiology service delivery in Australia during the COVID-19 pandemic: perspectives of hearing healthcare clinicians. Int J Audiol 2023; 62:1145-1154. [PMID: 36194040 DOI: 10.1080/14992027.2022.2128446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the utilisation, safety, cost, and patient outcomes of delivering tele-audiology services during the COVID-19 pandemic. DESIGN A national cross-sectional self-report online survey asking participants to reflect on interactions with hearing services between April and October 2020. Data were analysed using descriptive statistics. The COM-B model of behaviour change guided survey creation and the presentation of a subset of the results. STUDY SAMPLE 249 Australia-based hearing healthcare clinicians (age range 23-74 years; 162 female). RESULTS Clinicians reported an increase in the use of tele-audiology services, with key drivers relating to keeping their patients safe and keeping businesses running. Clinicians generally viewed the provision of tele-audiology services as successful and resulting in improved patient outcomes. Overall, clinicians were highly motivated to provide tele-audiology services, and they expressed being confident in their knowledge and understanding of tele-audiology service delivery. Barriers to providing tele-audiology services included concerns about the reliability of the results obtained from remote assessments, as well as concerns around information security and privacy issues. CONCLUSIONS Clinicians' motivations to use tele-audiology services appeared to be driven by their desire to maintain COVID-safe practices during the pandemic and by the COVID-driven increase in availability of funding for tele-audiology services.
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Affiliation(s)
- Rebecca J Bennett
- Brain and Hearing, University of Western Australia, Crawley, Western Australia, Australia
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, Western Australia, Australia
| | - India Kelsall-Foreman
- Brain and Hearing, University of Western Australia, Crawley, Western Australia, Australia
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, Western Australia, Australia
| | - Caitlin Barr
- Soundfair Australia Ltd, Melbourne, Victoria, Australia
| | | | - Tony Coles
- Audiology Australia, Cremorne, Victoria, Australia
| | - Mark Paton
- Australian College of Audiology (ACAud), Spring Hill, Queensland, Australia
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Frisby C, Eikelboom RH, Mahomed-Asmail F, Kuper H, Moore DR, de Kock T, Manchaiah V, Swanepoel DW. Mobile Health Hearing Aid Acclimatization and Support Program in Low-Income Communities: Feasibility Study. JMIR Form Res 2023; 7:e46043. [PMID: 37610802 PMCID: PMC10483300 DOI: 10.2196/46043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use. This study developed an mHealth acclimatization and support program for first-time hearing aid users and subsequently implemented and pilot-tested the feasibility of the program. The program was facilitated by community health workers (CHWs) in low-income communities in South Africa. OBJECTIVE This study aimed to evaluate the feasibility of an mHealth acclimatization and support program supported by CHWs in low-income communities. METHODS An application-based acclimatization and support was adapted and translated for use in low- and middle-income countries. This program was delivered in the form of 20 different voice notes accompanied by graphical illustrations via WhatsApp or 20 different SMS text messages. The program was provided to first-time hearing aid users immediately after a community-based hearing aid fitting in March 2021 in 2 low-income communities in the Western Cape, South Africa. The 20 messages were sent over a period of 45 days. Participants were contacted telephonically on days 8, 20, and 43 of the program and via open-ended paper-based questionnaires translated to isiXhosa 45 days and 6 months after the program started to obtain information on their experiences, perceptions, and accessibility of the program. Their responses were analyzed using inductive thematic analysis. RESULTS A total of 19 participants fitted with hearing aids received the mHealth acclimatization and support program. Most participants (15/19, 79%) received the program via WhatsApp, with 21% (4/19) of them receiving it via SMS text message. Participants described the program as helpful, supportive, informative, sufficient, and clear at both follow-ups. A total of 14 participants reported that they were still using their hearing aids at the 6-month follow-up. Three participants indicated that not all their questions about hearing aids were answered, and 5 others had minor hearing aid issues. This included feedback (n=1), battery performance (n=1), physical fit (n=2), and issues with hearing aid accessories (n=1). However, CHWs successfully addressed all these issues. There were no notable differences in responses between the participants who received the program via WhatsApp compared with those who received it through SMS text message. Most participants receiving WhatsApp messages reported that the voice notes were easier to understand, but the graphical illustrations supplemented the voice notes well. CONCLUSIONS An mHealth acclimatization and support program is feasible and potentially assists hearing aid acclimatization and use for first-time users in low-income communities. Scalable mHealth support options can facilitate increased access and improve outcomes of hearing care.
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Affiliation(s)
- Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
- Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH, United States
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | | | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between the University of Colorado and the University of Pretoria, Aurora, CO, United States
- Ear Science Institute Australia, Subiaco, Australia
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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Manchaiah V, Swanepoel DW, Sharma A. Prioritizing research on over-the-counter (OTC) hearing aids for age-related hearing loss. FRONTIERS IN AGING 2023; 4:1105879. [PMID: 37033402 PMCID: PMC10078955 DOI: 10.3389/fragi.2023.1105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
Hearing aids are the most commonly used treatment for people with age-related hearing loss, however, hearing aid uptake is low, primarily due to high cost of the device, stigma, and a lack of perceived need. To address accessibility and affordability issues, the U.S. Food and Drug Administration created a new over-the-counter (OTC) hearing aid category. Various types of hearing devices are available for both individuals with hearing loss and for those with normal hearing, as hearing enhancement devices. Hearing aids (i.e., prescription hearing aids, self-fitting OTC hearing aids, and pre-set OTC hearing aids) are regulated by the FDA. The purpose of this article is to (a) provide a summary of existing research on direct-to-consumer (DTC) hearing devices such as Personal Sound Amplification Products (PSAPs) that informs OTC service delivery models; (b) provide an update on existing and ongoing randomized controlled trials on currently marketed OTC hearing aids; and (c) highlight the need for immediate research on OTC hearing aids and service delivery models to inform policy and clinical care. It remains to be seen what effect OTC hearing aids have on improving the uptake of hearing aids by individuals with mild-to-moderate hearing loss. However, there is scant research on all aspects of OTC hearing aids that are currently on the market. We conclude that high quality independent research must be prioritized to supplement evidence provided by the OTC hearing aid manufacturers for regulatory approval purposes.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Virtual Hearing Lab, Collaborative Initiative Between The University of Colorado and The University of Pretoria, Aurora, CO, United States
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - De Wet Swanepoel
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- Virtual Hearing Lab, Collaborative Initiative Between The University of Colorado and The University of Pretoria, Aurora, CO, United States
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Perth, WA, Australia
| | - Anu Sharma
- Brain and Behavior Laboratory, Department of Speech Language and Hearing Sciences, Institute of Cognitive Science, Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
- *Correspondence: Anu Sharma,
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Humes LE. U.S. Population Data on Self-Reported Trouble Hearing and Hearing-Aid Use in Adults: National Health Interview Survey, 2007-2018. Trends Hear 2023; 27:23312165231160967. [PMID: 36947453 PMCID: PMC10083510 DOI: 10.1177/23312165231160967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
The National Health Interview Survey (NHIS) data on self-reported trouble hearing and the use of hearing aids were examined for the 12 recent surveys from 2007 to 2018 for adults from 18 to 85+ years of age. The aggregate dataset for all years included data from 357,714 adult respondents. Sample size for annual data ranged from 22,058 (2008) to 36,798 (2014). The prevalence of self-reported trouble hearing and hearing aid use, both current use and ever-using hearing aids, are reported for males and females for each age decade. Measures of unmet hearing healthcare (HHC) need were derived from estimates of the prevalence of hearing aid use among those with self-reported trouble hearing. Logistic-regression analyses identified variables affecting the odds of having self-reported trouble hearing, of using or rejecting hearing aids, and of having unmet HHC needs. The results largely corroborate and extend the findings of recent analyses of data from the National Health and Nutrition Examination Survey (NHANES) for a similar period (2011-2020). Overall, for males, 18.5% (95% CI [18.2%-18.8%]) had self-reported trouble hearing and 76.6% [76.0%-77.2%] of these individuals had never used hearing aids and, for females 13.1% [12.9%-13.4%] had trouble hearing and 79.5% [78.9%-80.1%] of these individuals had never used hearing aids. Unmet HHC needs are highly prevalent in the United States and have been so for many years.
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Affiliation(s)
- Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
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Galvin KL, Timmer BHB, Tomlin D, Cleaver Z. Designing a Hearing Health Care Smartphone App With Ecological Momentary Assessment: A Qualitative Study of Audiologists' Perspectives. Am J Audiol 2022; 31:1247-1259. [DOI: 10.1044/2022_aja-22-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of this study was to explore the perspectives of audiologists to provide input into development of a smartphone application (app) to document the real-life listening difficulties and the listening environment of hearing aid candidates and users.
Method:
Two focus groups were conducted. Facilitators utilized a topic guide to generate participants' input and perspectives. The focus groups were audio-recorded and transcribed verbatim. The transcripts were then qualitatively analyzed using content analysis.
Study Sample:
The study samples were 10 audiologists (seven females) with 2- to 10-plus years of hearing aid fitting experience.
Results:
Three main categories were identified: (a) The mobile device app could provide meaningful information to help audiologists to counsel their clients, (b) the app could give clients an insight into their hearing difficulties, and (c) the app could help clients to self-manage their hearing condition.
Conclusion:
These findings suggest that audiologists may better understand their clients' real-life listening difficulties through the use of a mobile device app; however, further research is required to harness the benefits of such an app.
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Affiliation(s)
- Karyn L. Galvin
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Barbra H. B. Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Sonova AG, Stäfa, Switzerland
| | - Dani Tomlin
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Zuzana Cleaver
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
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Abstract
PURPOSE Implementation science aims to facilitate the use of evidence-based programs, practices, and policies in routine care settings. In audiology, as in other health disciplines, there is a persistent research-to-practice gap. Improving the adoption, reach, implementation, and sustainment of effective interventions in audiology would increase their public health impact, ensuring that all individuals needing hearing health care services could benefit from innovations and evidence-based best practices. This tutorial provides an introductory overview of implementation science relevant to the field of audiology, including Internet-based practices and interventions. METHOD Major concepts and themes of implementation science are presented, including implementation outcomes, implementation science frameworks, implementation strategies, current topics in implementation science, and study design considerations. Recent publications in audiology are highlighted to illustrate implementation science concepts and themes. The relevance of each topic to the use of evidence-based programs, practices, and policies in audiology is highlighted with reference to recent research in the field. CONCLUSIONS Challenges in the widespread delivery of evidence-based audiological practices and interventions limit their public health impact. The application of implementation science principles and methods in audiology research, as demonstrated in other areas of health research, can increase our focus on ensuring that effective practices are widely available, accessible, equitable, and sustainable to improve the lives of those who need them.
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Affiliation(s)
- Christina R. Studts
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora
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Is Teleaudiology Achieving Person-Centered Care: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127436. [PMID: 35742684 PMCID: PMC9224155 DOI: 10.3390/ijerph19127436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Digital health and person-centered care are unquestionably linked in today’s Australian healthcare landscape. Teleaudiology is the application of digital health in the field of audiology, and it has become a popular component of standard audiological care. Behavior modification is essential in audiology intervention. Guidance on achieving behavior change, which is dependent on digitally enabled intervention, is a valuable resource when used in tandem to achieve person-centered care. The aim of this review is to determine whether teleaudiology achieves person-centered care. A qualitative review was conducted, followed by mapping and analysis. Analysis identified evidence of teleaudiology use, and ascertained guiding principles are appropriate to behavior change dependent digital intervention supported or enabled person-centered care. In conclusion, teleaudiology will continue to be a promising technology for promoting relatedness, a positive user experience, confidence and capability, and appropriate levels of autonomy for the user to choose from among the person-centered care options available.
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Karah H, Karawani H. Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids. Front Psychol 2022; 13:832100. [PMID: 35664209 PMCID: PMC9158114 DOI: 10.3389/fpsyg.2022.832100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/26/2022] [Indexed: 12/30/2022] Open
Abstract
Older adults with age-related hearing loss often use hearing aids (HAs) to compensate. However, certain challenges in speech perception, especially in noise still exist, despite today's HA technology. The current study presents an evaluation of a home-based auditory exercises program that can be used during the adaptation process for HA use. The home-based program was developed at a time when telemedicine became prominent in part due to the COVID-19 pandemic. The study included 53 older adults with age-related symmetrical sensorineural hearing loss. They were divided into three groups depending on their experience using HAs. Group 1: Experienced users (participants who used bilateral HAs for at least 2 years). Group 2: New users (participants who were fitted with bilateral HAs for the first time). Group 3: Non-users. These three groups underwent auditory exercises for 3 weeks. The auditory tasks included auditory detection, auditory discrimination, and auditory identification, as well as comprehension with basic (syllables) and more complex (sentences) stimuli, presented in quiet and in noisy listening conditions. All participants completed self-assessment questionnaires before and after the auditory exercises program and underwent a cognitive test at the end. Self-assessed improvements in hearing ability were observed across the HA users groups, with significant changes described by new users. Overall, speech perception in noise was poorer than in quiet. Speech perception accuracy was poorer in the non-users group compared to the users in all tasks. In sessions where stimuli were presented in quiet, similar performance was observed among new and experienced uses. New users performed significantly better than non-users in all speech in noise tasks; however, compared to the experienced users, performance differences depended on task difficulty. The findings indicate that HA users, even new users, had better perceptual performance than their peers who did not receive hearing aids.
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Affiliation(s)
| | - Hanin Karawani
- Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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13
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Maidment DW, Heffernan E, Ferguson MA. A randomised controlled clinical trial to assess the benefits of a telecare tool delivered prior to the initial hearing assessment. Int J Audiol 2022; 62:400-409. [PMID: 35436167 DOI: 10.1080/14992027.2022.2059713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the benefits of the Ida Institute's Why improve my hearing? Telecare Tool used before the initial hearing assessment appointment. DESIGN A prospective, single-blind randomised clinical trial with two arms: (i) Why improve my hearing? Telecare Tool intervention, and (ii) standard care control. STUDY SAMPLE Adults with hearing loss were recruited from two Audiology Services within the United Kingdom's publicly-funded National Health Service. Of 461 individuals assessed for eligibility, 57 were eligible to participate. RESULTS Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (primary outcome) scores did not differ between groups from baseline to post-assessment (Mean change [Δ]= -2.28; 95% confidence interval [CI]= -6.70, 2.15, p= .307) and 10-weeks follow-up (Mean Δ= -2.69; 95% CI= -9.52, 4.15, p = .434). However, Short Form Patient Activation Measure scores significantly improved in the intervention group compared to the control group from baseline to post-assessment (Mean Δ= -6.06, 95% CI= -11.31, -0.82, p = .024, ES= .61) and 10-weeks follow-up (Mean Δ= -9.87, 95% CI= -15.34, -4.40, p = .001, ES= -.97). CONCLUSIONS This study demonstrates that while a patient-centred telecare intervention completed before management decisions may not improve an individual's self-efficacy to manage their hearing loss, it can lead to improvements in readiness.
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Affiliation(s)
- D W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - E Heffernan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Ireland
| | - M A Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.,Ear Science Institute Australia, Perth, Australia
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McShea L, Ferguson M. "We forget about peoples' hearing loss": identifying key aspects of hearing aid and communication training in residential care homes. Int J Audiol 2022:1-8. [PMID: 35436162 DOI: 10.1080/14992027.2022.2056720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES 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. DESIGN 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. STUDY SAMPLE Fourteen support workers employed by Sense (charity for deafblind people) were trained to become "Hearing Champions" and cascaded their learning to 117 support colleagues. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Lynzee McShea
- Audiology Department, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Melanie Ferguson
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Ear Science Institute Australia, Perth, Australia.,Curtin enAble Institute, School of Allied Health, Curtin University, Perth, Australia
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15
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Malmberg M, Anióse K, Skans J, Öberg M. A randomised, controlled trial of clinically implementing online hearing support. Int J Audiol 2022; 62:472-480. [PMID: 35436174 DOI: 10.1080/14992027.2022.2059712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: The research-oriented objective of this study was to document the effectiveness of online support for hearing aid (HA) users compared with traditional support.Design: This study is a randomised controlled trial with parallel group design. The research-oriented objectives were evaluated using the Hearing Handicap Inventory for the Elderly (HHIE) and the Communication Strategies Scale (CSS) at baseline and immediately postintervention.Study sample: Selected clients at five different clinics were randomised to an intervention group (n = 78) that took part in online hearing support and a control group (n = 58) that received standard care.Results: The analyses (intention-to-treat) showed statistically significant improvements in the HHIE-total and Emotional subscale scores for the intervention group compared with the control group. The intervention group also showed significantly greater improvement in the CSS-total and Verbal and Nonverbal subscale scores. A subgroup analysis was performed including two groups: HA use <1 year and HA use >1 year. A statistically significant improvement was found for the HA users >1 year compared with HA use <1 year.Conclusions: It is effective to clinically include online hearing support for HA users when addressing self-perceived hearing difficulties and to sharpen communication strategy skills.
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Affiliation(s)
- Milijana Malmberg
- Research and Development, Region Västra Götaland, Habilitation & Health, Göteborg, Sweden.,Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Katja Anióse
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Göteborg, Sweden
| | - Johanna Skans
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Göteborg, Sweden
| | - Marie Öberg
- Department of Otorhinolaryngology in Linköping, and Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Linköping, Sweden
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Young T, Pang J, Ferguson M. Hearing From You: Design Thinking in Audiological Research. Am J Audiol 2022; 31:1003-1012. [PMID: 35344385 DOI: 10.1044/2022_aja-21-00222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
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.
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Affiliation(s)
- Taegan Young
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Jermy Pang
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Melanie Ferguson
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- enAble Institute and School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Ear Science Institute Australia, Perth, Western Australia
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Heffernan E, Withanachchi CM, Ferguson MA. ‘The worse my hearing got, the less sociable I got’: a qualitative study of patient and professional views of the management of social isolation and hearing loss. Age Ageing 2022. [DOI: 10.1093/ageing/afac019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Social isolation is a major consequence of hearing loss. It includes an objective component (e.g. small social network) and a subjective component (e.g. loneliness).
Objective
To examine the perspectives of key stakeholders regarding (i) the relationship between hearing loss and social isolation and (ii) interventions to address hearing loss and social isolation.
Design
A phenomenological qualitative study.
Setting
A UK research centre with a role to engage patients and clinicians.
Participants
Hearing healthcare professionals (n = 7) and adults with hearing loss (n = 6) were recruited via maximum variation sampling.
Methods
Individual (n = 3) and group (n = 3) semi-structured interviews were conducted. Inductive thematic analysis was performed.
Results
Five themes were identified. Theme 1 (experience of isolation and hearing loss): hearing loss can cause people to feel disconnected at social events or to cease attending them. Theme 2 (complexity of isolation and hearing loss): the various causes of isolation (e.g. hearing loss, retirement, comorbidities) are difficult to disentangle. Theme 3 (downstream effects of isolation and hearing loss): hearing loss and/or isolation can lead to mental health problems, stigmatisation, fatigue and unemployment. Theme 4 (preferred components of an isolation intervention): an isolation intervention should be patient-led and patient-centred and take place in the community. Theme 5 (challenges to implementing an isolation intervention): barriers to implementing an isolation intervention include a lack of time, training and continuity.
Conclusion
This study demonstrated that social isolation arising from hearing loss is a substantial, complex problem and provided novel insights on implementing an intervention to address this issue.
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Affiliation(s)
- Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Ireland
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Christine M Withanachchi
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Melanie A Ferguson
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
- Curtin enAble Institute, School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Ear Science Institute Australia, Perth, Australia
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Frisby C, Eikelboom R, Mahomed-Asmail F, Kuper H, Swanepoel DW. MHealth Applications for Hearing Loss: A Scoping Review. Telemed J E Health 2021; 28:1090-1099. [DOI: 10.1089/tmj.2021.0460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Robert Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, Australia
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Martin-Payo R, Carrasco-Santos S, Cuesta M, Stoyan S, Gonzalez-Mendez X, Fernandez-Alvarez MDM. Spanish adaptation and validation of the User Version of the Mobile Application Rating Scale (uMARS). J Am Med Inform Assoc 2021; 28:2681-2686. [PMID: 34613400 PMCID: PMC8633643 DOI: 10.1093/jamia/ocab216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/16/2021] [Accepted: 09/30/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE While the professional version of the Mobile App Rating Scale (MARS) has already been translated, and validated into the Spanish language, its user-centered counterpart has not yet been adapted. Furthermore, no other similar tools exist in the Spanish language. The aim of this paper is to adapt and validate User Version of the MARS (uMARS) into the Spanish language. MATERIALS AND METHODS Cross-cultural adaptation, translation, and metric evaluation. The internal consistency and test-retest reliability of the Spanish version of the uMARS were evaluated using the RadarCovid app. Two hundred and sixteen participants rated the app using the translated scale. The app was then rated again 2 weeks later by 21 of these participants to measure test-retest reliability. RESULTS No major differences were observed between the uMARS original and the Spanish version. Discrimination indices (item-scale correlation) obtained appropriate results for both raters. The Spanish uMARS presented with excellent internal consistency, α = .89 and .67 for objective and subjective quality, respectively, and temporal stability (r > 0.82 for all items and subscales). DISCUSSION The Spanish uMARS is a useful tool for health professionals to recommend high-quality mobile apps to their patients based on the user's perspective and for researchers and app developers to use end-user feedback and evaluation, to help them identify highly appraised and valued components, as well as areas for further development, to continue ensuring the increasing quality and prominence of the area of mHealth. CONCLUSION uMARS Spanish version is an instrument with adequate metric properties to assess the quality of health apps from the user perspective.
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Affiliation(s)
- Ruben Martin-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Sergio Carrasco-Santos
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain.,Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | | | - Stoyan Stoyan
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,Division of Advocacy and Research, Yourtown, Brisbane, Australia
| | - Xana Gonzalez-Mendez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain.,Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | - María Del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
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20
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Smartphone-Connected Hearing Aids Enable and Empower Self-Management of Hearing Loss: A Qualitative Interview Study Underpinned by the Behavior Change Wheel. Ear Hear 2021; 43:921-932. [PMID: 34653030 DOI: 10.1097/aud.0000000000001143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify patient-reported barriers and facilitators to using smartphone-connected hearing aids, using the Behavior Change Wheel (BCW) to understand experiences and how these can be addressed. DESIGN A single-center, prospective, observational study. Eight hearing aid users (new = 1, existing = 7; mean age = 71.75 years, SD = 5.23, range = 65 to 81 years) were identified through convenience sampling from 44 participants who took part in a 7-week evaluation of smartphone-connected hearing aids controlled by a prototype app. The app allowed users to manually control settings such as gain, noise reduction, and microphone directionality, preset, and customized programmes. Participants were assigned to one of two focus groups following trial of the app. RESULTS Focus group transcripts were thematically analyzed and underpinned by the COM-B (Capability, Opportunity, Motivation-Behavior) model and Theoretical Domains Framework to identify barriers and facilitators to using smartphone-connected hearing aids (the target behavior). Mapping of themes to the BCW allowed use of the Behavior Change Technique Taxonomy (version 1) to identify behavior change techniques that audiologists could implement in clinical practice to address the barriers and facilitators. Capability: The app increased participants' knowledge of hearing aid controls, encouraging use of the app for improved hearing loss self-management. However, barriers to using the app included perception of insufficient digital literacy skills for smartphone-connected hearing aid use and an increased cognitive load caused by decisions over which controls to use. Opportunity: Perceived smartphone norms (i.e., acceptable occasions to use smartphones) and differing listening contexts acted as both facilitators and barriers. Motivation: The ability to control hearing aid settings in any listening situation (e.g., to reduce noise) empowered users to successfully self-manage their hearing loss, leading to greater confidence and participation in everyday life. The app also reduced hearing aid-related and self-stigma, and the ability to self-adjust hearing aids benefitted both participants and communication partners. It was the adjustability and interaction afforded by the app that empowered users, rather than the hearing aid technology itself. Perceived beliefs and knowledge about digital literacy skills, and specifically abilities to use a smartphone, were perceived to be barriers in this typically older population, particularly when they compared themselves to younger generations. Using the Behavior Change Technique Taxonomy (version 1), behavior change techniques that could be used by audiologists to address these barriers included enablement, goal setting, reframing perceptions toward technology, and addressing patient educational needs. CONCLUSIONS Smartphone-connected hearing aids, when used in their everyday lives, were viewed positively by participants across a range of domains, empowering them and enabling hearing loss self-management. Audiologists should consider smartphone-connected hearing aid candidacy for all who have access to smartphones and are willing to use one. Use of the BCW has identified that modifiable barriers to using smartphone-connected hearing aids exist. Audiologists could use these evidence-based behavior change techniques to support patients in adopting and using these technologies to successfully self-manage hearing loss. Overall, by reframing smartphone technologies as a tool to remain connected with society, smartphone-connected hearing aids could shift the power of managing hearing loss from clinician to patient.
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Olson A, Maidment DW, Ferguson MA. Consensus on connected hearing health technologies and service delivery models in the UK: a Delphi review. Int J Audiol 2021; 61:344-351. [PMID: 34182863 DOI: 10.1080/14992027.2021.1936223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To develop a consensus among hearing healthcare professionals in the UK on connected hearing health technologies and service delivery models. DESIGN A three-round, electronic Delphi review was developed using a participatory-design approach. This included ten open-ended questions (round one) that informed 69 Likert-scaled statements (rounds two and three). STUDY SAMPLE An expert panel of 34 hearing health professionals representing all geographic regions of the UK from either the publicly funded National Health Service (n = 22) or independent sector (n = 12). RESULTS The majority of statements (61%) showed ≥80% consensus, highlighting that there was broad agreement amongst professionals on connected hearing health technologies. For example, there was consensus that adults who report communication difficulties and have no medical contraindications would be ideal candidates. Furthermore, it was unanimously agreed that connected technologies could result in delays in diagnosis of treatable medical conditions, as well as result in inadequate amplification. Overall, the expert panel concurred that connected technologies could serve as "gateway products" that lead to earlier hearing aid uptake. CONCLUSIONS This Delphi review identified overarching areas of agreement that may serve as a blueprint for future implementation of connected hearing health technologies through either conventional or new service delivery models in the UK.
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Affiliation(s)
- Anne Olson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Department of Communication Sciences and Disorders, College of Health Sciences, University of Kentucky, Lexington, KY, USA.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - David W Maidment
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Melanie A Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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22
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Bennett RJ, Eikelboom RH, Sucher CM, Ferguson M, Saunders GH. Barriers and facilitators to delivery of group audiological rehabilitation programs: a survey based on the COM-B model. Int J Audiol 2021; 61:130-139. [PMID: 34120559 DOI: 10.1080/14992027.2021.1928304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. DESIGN A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. STUDY SAMPLE Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. RESULTS 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. CONCLUSIONS These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services.
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Affiliation(s)
- Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M Sucher
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Melanie Ferguson
- National Acoustic Laboratories, Macquarie University, Sydney, Australia
| | - Gabrielle H Saunders
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
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Muñoz K, San Miguel GG, Barrett TS, Kasin C, Baughman K, Reynolds B, Ritter C, Larsen M, Whicker JJ, Twohig MP. eHealth parent education for hearing aid management: a pilot randomized controlled trial. Int J Audiol 2021; 60:S42-S48. [PMID: 33635156 DOI: 10.1080/14992027.2021.1886354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Parents frequently experience challenges implementing daily routines important for consistent hearing aid management. Education that supports parents in learning new information and gaining confidence is essential for intervention success. We conducted a pilot study to test an eHealth program to determine if we could implement the program with adherence and affect important behavioural outcomes compared to treatment as usual. DESIGN Randomised controlled trial. STUDY SAMPLE Parents of children birth to 42 months who use hearing aids. Eighty-two parents were randomly assigned to the intervention or treatment-as-usual group. Four parents assigned to the intervention group did not continue after baseline testing. RESULTS The intervention was delivered successfully with low drop out (10%), high session completion (97%), and high program adherence. The intervention conditions showed significantly greater gains over time for knowledge, confidence, perceptions, and monitoring related to hearing aid management. Significant differences between groups were not observed for hearing aid use time. CONCLUSION We found that we could successfully implement this eHealth program and that it benefitted the participants in terms of knowledge and confidence with skills important for hearing aid management. Future research is needed to determine how to roll programs like this out on a larger scale.
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Affiliation(s)
- Karen Muñoz
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | | | - Tyson S Barrett
- Office of Research Services, Utah State University, Logan, UT, USA
| | - Courtney Kasin
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | - Kelsey Baughman
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | - Bailey Reynolds
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | - Caitlyn Ritter
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | - Makynzie Larsen
- Communication Disorders & Deaf Education, Utah State University, Logan, UT, USA
| | - John J Whicker
- Rehabilitation, Primary Children's Hospital, Salt Lake City, UT, USA
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