Abstract
Objectives: To evaluate the process of implementing a web-based support program (SUPR) for hearing aid users in the Dutch dispensing setting in order to allow interpretation of the randomized controlled trial's results (positive effects on hearing-aid related outcomes; no effects on psychosocial outcomes).Design: Measures: context of implementation, recruitment, SUPR's: reach, implementation fidelity, dose delivered, dose received, satisfaction, and benefit. Data collection: quantitative and qualitative.Study Sample: One hundred thirty-eight clients (mean age 68.1 years; 60% male) and 44 dispensers completed questionnaires. Five clients and 6 dispensers participated in interviews and focus groups.Results: Clients and dispensers were generally satisfied with SUPR's usefulness. SUPR-videos were watched by 7–37% of the clients. Around half of the dispensers encouraged clients to watch them or informed them about SUPR. Some clients found the SUPR-materials suboptimal, and changes in personnel and limited dispenser-training were barriers acting on a contextual level.Conclusions: This study identified several factors that contributed to the success of SUPR. Others factors, acting on various levels (e.g., intervention material, dispensers, and implementation context), were suboptimal and may explain the absent psychosocial effects. The identified factors are important to consider in further development of SUPR, and in other web-based support programs.
Highlights
Hearing aid (HA) fitting is a central component of aural rehabilitation (AR) [1]
We previously reported that adding SUPR to standard clinical HA dispensing care resulted in short-term and long-term improvements in HA outcomes [22]
Combined with reasonably high satisfaction and benefit ratings of intervention materials from both clients and dispensers that resulted from the current study, we argue that these results indicate that SUPR can be considered an effective and useful addition to current care provided in hearing aid dispensing (HAD) practices
Summary
Hearing aid (HA) fitting is a central component of aural rehabilitation (AR) [1]. HA use has been found to ameliorate the adverse psychological, social, and emotional effects of hearing loss, thereby improving health-related quality of life [2]. It has been suggested that AR should use a holistic rather than a biomedical (or impairment) approach This means that AR should include aspects that go beyond HA fitting, like support in the use of communication strategies, acceptance of hearing loss, and HA handling skills [3, 12]. These aspects have been incorporated into several group and individual educational programs developed for adults with hearing loss and are typically offered as an addition to HA fitting [1]. Delivery of communication programs via eHealth allows for services that can improve (cost-) effectiveness and access to hearing care [15], because they can be delivered at the intensity the patient prefers, in an automated fashion (with limited efforts for health care professionals), and with a wide reach [16]
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