Abstract
Purpose An alarming two thirds of adults aged 50 years or over with hearing impairment who could benefit from hearing aids do not own any, leaving these adults with no support to self-manage their hearing problems. In the HEAR-aware project, it is hypothesized that self-management can be facilitated via a smartphone app if its educational content is tailored to a person's dynamic stage of readiness to take action on their hearing (stage of change) and to a person's dynamic acoustical situations (as measured via a wearable microphone) and associated challenges (as captured via ecological momentary assessment). As such, the HEAR-aware app would be an ecological momentary intervention. This research note describes the rationale and theoretical underpinnings of the app, as well as the rationale for planning a series of studies to develop and evaluate it. Study Designs After a preparatory phase, Study 1 includes qualitative group interviews to assess user needs. Next, a creative session will be held, in which all stakeholders involved will work toward a specified version of the app. Subsequently, prototypes of the app will be developed and pilot-tested (Pilot Studies 2A and 2B). Users' usage and ratings (usability and quality indicators) of the app's elements will be examined and processed in the app. Lastly, the effectiveness of the app's final version will be examined in a randomized controlled trial (Study 3). Discussion The project's merits and challenges will be discussed.
Highlights
O n average, adults have waited 7–10 years before seeking professional help for their hearing loss and are in their early to mid-seventies when they do so (Davis, 1995; Davis et al, 2007)
Examples of such Self-management support programs (SMSPs) in audiology are C2Hear (Ferguson et al, 2016); HearSupport (Meijerink et al, 2017); the home education program (Kramer et al, 2005); and the online rehabilitative intervention by Thorén et al (2014), in which elements of the Active Communication Education program (Hickson et al, 2007, 2019) were used. Use of these programs showed a positive impact on psychosocial well-being (Hickson et al, 2007; Thorén et al, 2014), awareness of hearing difficulties, identification of solutions to these difficulties (Hickson et al, 2019), activity limitations and participation restrictions (Hickson et al, 2007), Hearing aid (HA) handling skills and HA use (Ferguson et al, 2016; Meijerink et al, 2019), knowledge of hearing loss and HAs (Ferguson et al, 2016), and quality of life (Kramer et al, 2005). These results suggest that there is potential for e-health SMSPs in audiology
Rationale for Tailoring to Readiness to Take Action (SoCs) It is widely recognized that the development of interventions should be underpinned by appropriate theory (Craig et al, 2008), and this is advocated in audiology (e.g., Coulson et al, 2016)
Summary
O n average, adults have waited 7–10 years before seeking professional help for their hearing loss and are in their early to mid-seventies when they do so (Davis, 1995; Davis et al, 2007). HAs have shown to reduce hearing disability and improve health outcomes such as health-related quality of life, loneliness, social participation, and cognitive health (Barker et al, 2016; Chisolm et al, 2007). A large proportion of this group does not or not yet wish to take on HAs, independent of eligibility for insurance coverage. Key reasons for this are low reported activity limitations and participation restrictions (partly stemming from low awareness of hearing problems), strong stigma perceptions (attached to hearing loss, HAs, and ageism), poor social support, limited expected or experienced hearing improvement, and wearing discomfort (Meyer et al, 2014; Pronk et al, 2017)
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