Hearing Health Care Delivery Research Articles

Adolescent-Centered mHealth Applications in a Collaborative Care Model: A Virtual Focus Group Study With Audiologists.

Technology-enabled care, including the use of mobile health (mHealth), is emerging as a viable hearing health care delivery method. While the integration of mHealth with adult populations currently supports a wide array of hearing services, a better understanding of the implementation across the lifespan is needed. Literature surrounding the unique population of adolescent hearing aid users is currently lacking. Research is needed to highlight factors important to the use and clinical integration of mHealth hearing aid applications (apps) with adolescents. This study explored two primary objectives: (a) audiologists' perceptions around the use of mHealth apps to enable collaborative, child-inclusive hearing aid personalization, and (b) person-centered ideation around potential app design components to benefit users aged 12 to 17 years. Twelve audiologists participated in virtual synchronous focus groups, across three group sessions using Cisco Webex. Sessions were recorded, transcribed, and analyzed using an inductive, codebook thematic analysis approach. Six main themes resulted from group discussion analyses: (a) client candidacy: characteristics impacting suitability for mHealth use; (b) clinical implementation: organizational, professional, or patient-level strategies for mHealth adoption; (c) collaboration: the use of two or more individuals working together; (d) empowerment: process of acquiring and using knowledge, skills, and strategies; (e) remote technology: technologies enabling remote hearing aid personalization; and (f) application functionality and design: features and characteristics important to an adolescent-focused app. Findings identified the potential for clinical integration of hearing aid apps with adolescents in a collaborative care model, including consideration of child-specific use patterns, outcomes, and key design and technology components to support real-world implementation and use. Results may guide development and tailoring efforts around existing and future hearing aid apps for use with adolescent populations.

Assessment of Consumer Attitudes Following Recent Changes in the US Hearing Health Care Market

The addition of over-the-counter hearing aid (HA) options has transformed the way individuals can access hearing health care (HHC). However, although critical to their adoption and use, consumer attitudes and opinions about direct-to-consumer (DTC) models of health care are often understudied. To assess how recent DTC market changes in HHC delivery may be associated with consumer choice and attitudes towards specific HHC models. A mixed-methods survey, distributed online between March 22 and 25, 2022, using Qualtrics Survey Panels. Participants were US residents older than 50 years with no previous hearing aid experience, enrolled using consecutive sampling. A minimum of 1000 completed responses was set; once the 70% threshold was met, any future respondent who identified as White would not be given the survey. Respondents were asked to report their level of comfort with using different variations of DTC-HHC and asked about their previous experience with other DTC health care models. Respondents then reported which model (in-person vs online) of HHC they would most likely pursue. Of 1377 respondents, 1037 were included in the survey study (mean [SD] age, 61.4 [7.84] years; 714 [69.0%] were female; 674 [65.0%] were White). Most respondents reported discomfort with pursuing hearing aids via DTC pathways, with 84% (874 of 1037) indicating they would pursue HHC via an in-person model. Individuals who were older (odds ratio [OR], 0.95; 95% CI, 0.92-0.98), reported an income greater than $150 000 (OR, 0.29; 95% CI, 0.08-0.91), and were not interested in HA (OR, 0.42; 95% CI, 0.23-0.79) were less likely to pursue HHC online. Those who had previous experience with DTC health care (OR, 1.97; 95% CI, 1.27-3.02), and did not have (OR, 2.61; 95% CI, 1.59-4.31) or were uncertain (OR, 2.05; 95% CI, 1.13-3.70) about their insurance coverage for HA were more likely to pursue HHC online. Current consumer attitudes and opinions found in this survey study suggest that DTC-HHC may not find immediate acceptance by most potential HA seekers in the US.

Hearing Health Care Delivery Outside the Booth

Purpose The purpose of this review article is to discuss how boothless audiometry may help address changes in hearing health care services and provide progressive tools to expand beyond traditional audiology clinic visits. The primary drivers for these changes include the COVID-19 pandemic, our aging population, comorbid effects of unidentified hearing loss, and the critical need for effective communication between patients and providers. This review article highlights key features and technical specifications of boothless audiometry, provides an overview of Food and Drug Administration (FDA)–approved boothless audiometry products, and describes how to leverage these products to increase access to hearing health services across the continuum of health care. Method Boothless audiometry literature was reviewed using PubMed and audiometry technology websites. FDA-approved boothless audiometry products were reviewed, and audiological features were categorized. Civilian and Department of Defense subject matter experts were consulted. Conclusions Boothless audiometry technology introduces opportunities for early audiometric assessment outside of the audiology clinic, in settings where traditional testing has been less possible, or even impossible, such as military environments, clinic waiting areas, schools, and nursing homes. This technology allows health care providers to identify individuals with significant hearing loss early and seek comprehensive services to prevent and treat hearing loss. By expanding the current hearing health care delivery model via boothless audiometry technology, the following benefits may be achieved, which can result in better outcomes overall: increased access to care, early identification and treatment of hearing loss, and reduced impact from the comorbid effects of hearing impairment.

Pharmacist competencies for over-the-counter hearing aids: A Delphi study

BackgroundThe 2017 Food and Drug Administration Reauthorization Act established a new category of hearing aids to be available over the counter to increase accessibility and affordability of hearing aid devices. To prepare for increased consumer demand, pharmacists must be ready to meet the needs of the millions of adults eligible to seek over-the-counter hearing aids at the community pharmacy. To date, no organization has proposed competency statements to describe a pharmacist with the knowledge, skills, and abilities aligning with safe and effective use of over-the-counter hearing aids to be sold at community pharmacies. ObjectivesThe objective of this study was to establish competencies needed for pharmacists to safely and effectively assist patients seeking over-the-counter hearing aids at the community pharmacy. MethodsThe Delphi technique was selected to achieve group consensus for competency statements. The project began with a kickoff meeting in July 2019 and continued with a brainstorming round followed by 3 rounds of surveys ending in March 2020. Each survey presented competency statements for panelists to review, rate their agreement, and offer revisions. Statements that reached consensus to accept (≥80% agreement) were advanced to the final list. Statements that did not reach consensus were advanced to subsequent survey rounds. ResultsA total of 14 individuals representing pharmacy, audiology, hearing aid manufacturers, and persons with hearing loss participated. In total, 26 competency statements were accepted by consensus, 2 statements were rejected by consensus, and 11 statements did not reach consensus. All 26 accepted statements were mapped to the Pharmacists’ Patient Care Process before final approval by the stakeholder panel. ConclusionPharmacists will likely play new interprofessional roles in the delivery of hearing health care as over-the-counter hearing aids come to market. With professional competency statements, pharmacists will have a framework for the knowledge, skills, and abilities needed to safely assist patients seeking over-the-counter hearing aids at the community pharmacy.

MarkeTrak 10: History and Methodology.

MarkeTrak has been conducted on a regular schedule for over 30 years to take the pulse of the hearing health care market and of consumers with hearing loss. The current version, MarkeTrak 10 (MT10), builds on the successful completion of MarkeTrak 9, with the same two objectives: to estimate hearing difficulty, hearing aid usage, and adoption of hearing aids in the United States and to gain insights into the consumer's journey through the hearing health care delivery system. In addition, MarkeTrak 10 added additional questions regarding use and satisfaction with Personal Sound Amplification Products (PSAPs) by both owners and nonowners of hearing aids.

A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies.

Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones. A template analysis was applied to data. Results Five themes emerged from the interviews: (a) prerequisites to the successful implementation of user-driven and app-controlled technologies, (b) benefits and advantages of user-driven and app-controlled technologies, (c) barriers to the acceptance and use of user-driven and app-controlled technologies, (d) beliefs that age is a significant factor in how well people will adopt new technology, and (e) consequences that flow from the adoption of user-driven and app-controlled technologies. Specifically, suggested benefits of the technology included fostering empowerment and providing cheaper and more discrete options, while challenges included lack of technological self-efficacy among older adults. Training and support were emphasized as necessary for successful adaptation and were suggested to be a focus of audiologic services in the future. Conclusion User perceptions of user-driven and app-controlled hearing technologies challenge the audiologic profession to provide adequate support and training for use of the technology and manufacturers to make the technology more accessible to older people.

Increasing access to hearing rehabilitation for older adults.

To provide an update on the recent research and policy developments affecting the current and future care of the 23 million older Americans with untreated hearing loss. Increasing evidence supports the association of age-related hearing loss with significant negative outcomes that affect the ability of older adults to age well. Despite an evolving understanding of the role hearing loss plays in the well being and vitality of older adults, the vast majority of older adults go untreated and hearing health care disparities exist. Recent work to understand the multitude of factors involved in hearing health care decisions, coupled with innovative approaches and technology to deliver hearing care, aim to provide more older adults with equal access to the tools needed to age well. Most importantly, significant national efforts and policy proposals substantiate these efforts and will be reviewed. Age-related hearing loss is a critical public health issue that affects almost all older adults. Through the application of novel approaches and perspectives, the delivery of hearing health care for older adults is evolving to provide more affordable and accessible care. Accompanying policy efforts provide the necessary support needed to increase access to care significantly.

Revising the Hearing Health Care Delivery System

Revising the Hearing Health Care Delivery System

Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care

The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems. Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting. Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting. Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients.

Spotlight on Special Interest Group 8, Public Health Issues Related to Hearing and Balance

You have accessThe ASHA LeaderSIG Spotlight1 Mar 2014Spotlight on Special Interest Group 8, Public Health Issues Related to Hearing and Balance Ingrid BloodPhD, CCC-A Ingrid Blood Google Scholar More articles by this author , PhD, CCC-A https://doi.org/10.1044/leader.SIGS.19032014.np SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In How many affiliates does Special Interest Group 8 have? As SIG 8 celebrates its fourth anniversary, the number of affiliates continues to grow. Approximately 150 ASHA members affiliate with SIG 8. Originally, SIG 8 focused on hearing conversation and occupational audiology. Newly restructured, SIG 8 expanded its scope of interests which, in turn, is attracting affiliates from multiple disciplines from a broad and global community. Why did you originally choose to affiliate with SIG 8? SIG membership provides a dynamic venue for networking. I consider our online community forum (http://community.asha.org/home) important for sharing ideas for research, teaching and clinical practice. (Keeping up with the latest in our field is important to me because I teach courses on audiology and hearing loss at Pennsylvania State University.) Perspectives on Public Health Issues Related to Hearing and Balance and the SIG 8 Community forum provide timely and practical resources for curriculum development. What is the most important issue surrounding SIG 8 right now? Preventing falls was our thematic focus for 2013. Recent issues of Perspectives and online discussions also focus on changes in hearing health care delivery, innovative hearing conservation programs and outreach initiatives, the influence of genetics on hearing loss, and dizziness. The latest conversations question whether hearing loss contributes to cognitive decline in an aging population … and the implications for audiologists. What upcoming events related to or sponsored by SIG 8 should everyone know about? SIG 8 will sponsor educational sessions in collaboration with other audiology SIGs during the 2014 ASHA Convention in Orlando, Fla. We are planning a short course and seminars on genetics and hearing loss, and on the connection between cognitive decline and hearing loss. Presenters will review recent research findings and lead discussions on the influences and implications of these discoveries for audiologists. Which of your recent Perspectives articles is a must-read for CSD professionals, and why? Falls are a substantial hazard to the health and independence of older adults in the United States. The following articles are related to falls prevention and/or dizziness: Fall Risk Assessment and Intervention, by Angela K. Smith and Amy Porter (November 2013, Vol.14, 4–10). Falls Among Older Adults: A Public Health Concern, by Jaynee Handelsman (December 2011, Vol.12, 13–18). Audiologists' Role in Assessing Risk of Falls, by Robin E. Criter, Jessie N. Patterson, and Julie A. Honaker (November 2013, Vol.14, 22–34). Interdisciplinary Approach to Dizziness: Roles of Audiology and Physical Therapy, by Faith W. Akin, Courtney D. Hall, and Kristal M. Riska (November 2013, Vol.14, 11–21). Innovative learning experiences help develop healthy hearing practices necessary for a lifetime. Related articles include: Noise and Public Health, by Ann Dix (December 2011, Vol.12, 19–23). Promoting Hearing Loss Prevention in Audiology Practice, by David C. Byrne, Christa L. Themann, Deanna K. Meinke, Thais C. Morata, & Mark R. Stephenson (December 2012, Vol.13, 3–19). For Those About to Rock, by Jennifer Tufts (December 2012, Vol.13, 29–35). Podcasts, Google, and YouTube—Oh My! An Innovative Online Course for University Students on Preventing Hearing Loss by Ingrid M. Blood and Gordon W. Blood (December 2011, Vol.12, 4–12). Author Notes Ingrid Blood, PhD, CCC-A, is professor of communication sciences and disorders at The Pennsylvania State University, University Park. She is coordinator of Special Interest Group 8, Public Health Issues Related to Hearing and Balance. ·[email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 19Issue 3March 2014 Get Permissions Add to your Mendeley library History Published in print: Mar 1, 2014 Metrics Current downloads: 102 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2014 American Speech-Language-Hearing AssociationLoading ...

Audiology Groups Alert Members to Service Delivery Changes

You have accessThe ASHA LeaderASHA News1 Oct 2012Audiology Groups Alert Members to Service Delivery Changes Ingrida Lusis Ingrida Lusis Google Scholar More articles by this author https://doi.org/10.1044/leader.AN2.17122012.7 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Audiologists need to prepare for changes in audiology service delivery models that may affect the way they operate their practices, according to the three national organizations representing audiologists. That’s the message conveyed in an August letter [PDF]—signed by the leaders of ASHA, the American Academy of Audiology, and the Academy of Doctors of Audiology—sent to audiology members of all three organizations. The letter urges audiologists to review their current delivery systems as consumer-driven health care takes center stage in recent federal health care reform efforts. The organizations developed the joint letter in response to the growing number of consumers who purchase hearing aids online or from their health insurance companies. The letter provides a list of questions audiologists can use to assess their current practice models: What role does the sale of hearing aids play in your practice model? Do you have options in place to accommodate consumers who arrive at your practice with a hearing aid purchased elsewhere? Are the costs associated with the care you provide transparent to the patient? If appropriate, do you itemize the cost of your services? When discussing amplification and other treatment, do you offer patients options? Do you engage family and others to support the patient with hearing loss? Do you charge your patients appropriately for the products and services that you provide? Are you familiar with policies of competitive entities in your immediate locale? Are your services clearly defined and valued in your contracts with payer groups? Do you provide treatment for hearing loss that reflects the full scope of practice for audiology? Do you provide information on hearing assistive technology, listening training, and counseling—all of which could expand and enhance the service delivery model for your patients? How do you plan to engage consumers to facilitate and enhance access to your services? Do you use or have you considered employing audiology assistants to provide appropriate care under your supervision, thereby enabling you to expand professional services for your patients? Are you aware of your professional code of ethics, state licensure rules, and legal and regulatory guidelines that affect your specific practice setting (e.g., anti-trust policy, coding and billing practices)? Do you employ established best practices (verification, counseling, etc.) to ensure and improve patient outcomes? Do you measure patient satisfaction? The letter also provides a list of resources to help clinicians navigate changes. The Hearing Loss Association of America (HLAA), the nation’s leading organization representing people with hearing loss, issued a press release praising the three organizations for supporting consumer needs and setting a path for audiologists to evaluate how their practices will respond to and operate in a new hearing health care delivery system. Brenda Battat, HLAA executive director, called the letter a “watershed event for consumers” that validates HLAA’s advocacy for accessible and affordable hearing health care. For more information about changes in hearing health care service delivery, contact Pam Mason, MEd, CCC-A, director of audiology professional practices, at [email protected]. Author Notes Ingrida Lusis, director of federal and political advocacy, can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 17Issue 12October 2012 Get Permissions Add to your Mendeley library History Published in print: Oct 1, 2012 Metrics Current downloads: 44 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2012 American Speech-Language-Hearing AssociationLoading ...

Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.

BackgroundThe use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults.ObjectiveTo explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years.MethodsPostal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the “PC confidence index.” The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent).ResultsThe postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group’s PC and Internet use was 81.0% and 60.9%, respectively; the older group’s PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001).ConclusionsHearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist.

Hearing Loss in Older Adults

Hearing Loss in Older Adults

Hearing health-care delivery in sub-Saharan Africa – a role for tele-audiology

Hearing loss is the most prevalent chronic disability and a major contributor to the global burden of disease. Its effects are far-reaching and can lead to severely restricted developmental outcomes for children and limited vocational prospects for adults. The benefits of intervention are dramatic and can significantly improve developmental outcomes, especially in infants identified early. Hearing health-care services in developing regions such as sub-Saharan Africa are however severely limited, leaving affected individuals without access to secondary and tertiary intervention. Tele-audiology has potential for improved access to specialist hearing health services including identification, diagnosis and intervention. There has been limited experience so far with tele-audiology in industrialized countries. In the sub-Saharan region, the continued growth in Internet connectivity and general technological advances make tele-audiology an important approach to consider in the management of hearing loss. Pilot studies are warranted to investigate the potential obstacles to the widespread implementation of telehealth in the delivery of hearing health care in poorly-resourced communities, in line with World Health Organization initiatives.

Beyond BTEs: Earmold Opportunities in Clinical Practice

Beyond BTEs: Earmold Opportunities in Clinical Practice

Digital Hearing Aid Technology: Medical Perspective

This article provides a nontechnical introduction to digital hearing aids and the impact of digital signal processing on the delivery of hearing health care. Issues related to matching the patient's needs to signal processing solutions are covered, and specific recommendations with respect to criteria by which new hearing aid performance should be evaluated are discussed. The pivitol role played by medical personnel in initiating patient awareness of available options and in directing needs assessment is emphasized.