Personal Counseling Research Articles

Reverse Phenotyping after Whole-Exome Sequencing in Children with Developmental Delay/Intellectual Disability-An Exception or a Necessity?

This study delves into the diagnostic yield of whole-exome sequencing (WES) in pediatric patients presenting with developmental delay/intellectual disability (DD/ID), while also exploring the utility of Reverse Phenotyping (RP) in refining diagnoses. A cohort of 100 pediatric patients underwent WES, yielding a diagnosis in 66% of cases. Notably, RP played a significant role in cases with negative prior genetic testing, underscoring its significance in complex diagnostic scenarios. The study revealed a spectrum of genetic conditions contributing to DD/ID, illustrating the heterogeneity of etiological factors. Despite challenges, WES demonstrated effectiveness, particularly in cases with metabolic abnormalities. Reverse phenotyping was indicated in half of the patients with positive WES findings. Neural network models exhibited moderate-to-exceptional predictive abilities for aiding in patient selection for WES and RP. These findings emphasize the importance of employing comprehensive genetic approaches and RP in unraveling the genetic underpinnings of DD/ID, thereby facilitating personalized management and genetic counseling for affected individuals and families. This research contributes insights into the genetic landscape of DD/ID, enhancing our understanding and guiding clinical practice in this particular field of clinical genetics.

The Effect Of Tele Education On Increasing The Self-Efficacy Of Pregnant Women In Sumatera Barat Province

Self-confidence is built by knowledge obtained through an accessible educational process, one of which is through tele-education. The treatment given was in the form of education using the whatsapps (WA) application in group forums for classical education and private lines for personal counseling sessions. The research population is all pregnant women in Indonesia. The sample was selected using a convenience sampling technique. A total of 53 subjects were obtained through online media based on inclusion criteria, including: 28-39 weeks of gestation, declared their ability to participate in the tele-education program using the WhatsApps application, and had an active WhatsApps account. The self-efficacy of pregnant women was measured using the Chilbirth Self-Efficacy Inventory (CBSEI) questionnaire presented before and after the intervention. Data were analyzed using Paired T-Test. Most of the respondents were aged 31-35 years, housewives, had high school and university education, and were pregnant for the first time. Analysis test to get sig. (2-tailed) of 0.004 <0.05, and the value of tcount is greater than ttable (3.067> 2.098). Tele education affects the self-efficacy of pregnant women in facing childbirth.

PENINGKATAN KOMUNIKASI INTERPERSONAL MELALUI KONSELING PERSONAL CENTERED TEKNIK REFLECTION OF THOUGHTS AND FEELINGS

Interpersonal communication is an important source for expressing oneself to build, improve and maintain good relationships with other people. Low interpersonal communication problems cause students to be individualistic, namely students who are less open in speaking, less empathetic, less supportive and upholding equality. Starting from this problem. The researcher formulated the aim of this research as to improve students' interpersonal communication through group counseling and using a personal centered counseling approach, the Reflection of Thoughts and Feelings technique. This research uses a one group pre-test and post-test experimental research design. This research used a population of 34 students and a research sample of 7 students. The data analysis technique uses the Wilcoxon test. After carrying out the pre-test and post-test, 2 students (28.57%) had a high level of interpersonal communication and 5 students (71.43%) had a moderate level of communication. Based on the research results, it shows that personal centered counseling, the Reflection of Thoughts and Feelings technique, is effective for improving students' interpersonal communication

Predictability of Extrinsic and Intrinsic Factors on Counseling Competence of School Counselors: A Cross-sectional Study in Vietnam

This study aims to explore the impact of extrinsic and intrinsic factors on the counseling competence of Vietnamese school counselors. A cross-sectional study was conducted on 226 teachers in two Vietnamese provinces. All school counselors have attended school counseling training courses with an average experience of 11.3 years. Linear regression analysis was used to determine the impact of extrinsic and intrinsic factors on counseling competence. The results show that: (i) When considering separately the impact’s possibility of each factor, the model has confirmed the possibility of a positive impact of both factors; (ii) however, when considering the model combining two groups of factors, the role of variables in the extrinsic factors no longer exists, while the role of variables in the intrinsic factors is still available. This study has confirmed the role of intrinsic factors related to the personal counseling competence of school counselors. This finding allows us to propose a solution to improve and develop counseling competence for school counselors focusing on identified intrinsic factors and promoting policies to maintain the positive impact of extrinsic factors in Vietnamese education or countries with similar educational backgrounds.

Prevalence and pattern of sleep problems among older persons attending a tertiary hospital in Nigeria

Background: Sleep disturbances are common symptoms in adults and are related to various factors, but they are not an inherent part of the ageing process. Objective: To determine the prevalence and pattern of sleep problems among older persons attending the General Out-patient Clinics in a tertiary health-care facility in Uyo, Nigeria. Materials and Methods: This was a hospital-based cross-sectional descriptive study on older persons attending the GOP clinics of the University of Uyo Teaching Hospital. Using a semi-structured interviewer administered questionnaire, information on the sociodemographic characteristics and the sleep history of the respondents were obtained. Data entry and analysis were done using Epi info® version 3.5.1. Results: The prevalence of sleep problems was 64.5% with early awakening being the commonest sleep problem (50.5%) experienced by the respondents. Conclusion: The prevalence of sleep problems is high in this study, and there is need for counselling of older persons on how to improve their sleeping habits.

Stress Detection for Employee’s using Image Processing and Text Mining

The major goal of this study is to use vivid Machine Learning and Image Processing methods to identify stress in the human body. Our system is an upgraded version of previous stress detection systems that did not include live detection or personal counselling, but this system includes live detection and periodic analysis of employees, as well as detecting physical and mental stress levels in them and providing proper stress management remedies via a survey form. Our method is primarily focused on stress management and creating a healthy and spontaneous work environment for workers in order to get the most out of them during working hours

Comparison of the performance of NIPT and NIPT-plus for fetal chromosomal aneuploidy and high Z-score increases the positive predictive value.

To evaluate non-invasive prenatal testing (NIPT) and expanded non-invasive prenatal testing (NIPT-plus) for detecting aneuploidies at different sequencing depths and assess Z-score accuracy in predicting trisomies 21, 18, 13, 45X, and 47XXX. Pregnancies with positive NIPT or NIPT-plus results detected at the prenatal diagnosis center of Nanfang Hospital were included in this retrospective study, between January 2017 and December 2022. Invasive prenatal diagnostic results were collected. Logistic regression analyses were used to study the relationship between Z-score and positive predictive value (PPV). Optimal cut-off values were obtained based on receiver operating characteristic analysis, and PPVs were calculated in different groups. We evaluated 1348 pregnant women with positive results, including 930 reported by NIPT and 418 reported by NIPT-plus. NIPT reported significantly more rare chromosomal aneuploidies (RCAs), and NIPT-plus had a significantly higher PPV for trisomy 21 (T21). Logistic regression analyses showed a significant association (P < 0.001) between Z-score and PPVs for T21 and trisomy 18 (T18). A linear relationship was observed between fetal fraction (FF) and Z-values in the true positive cases of T21 and T18.The high Z-score group had significantly higher PPVs than the low Z-score group for T21, T18, trisomy 13, and 47XXX, but not for 45X. The Z-score is helpful in assessing NIPT or NIPT-plus results. Therefore, we suggest including the Z-score and FF in the results. By combining the Z-score, FF, and maternal age, clinicians can interpret NIPT results more accurately and improve personal counsel to reduce patients' anxiety.

Strategy for Increasing Customer Financial Literacy on Decisions to Use Financial Products, Especially Savings Products at PT BPD Sumsel Babel Muaradua Branch Office

This study aims to analyze the strategy of improving customer financial literacy on the decision to use savings financial products of PT BPD Sumsel Babel Muaradua Branch Office. PT BPD Sumsel Babel is one of the leading financial institutions in Indonesia whose main objective is to support economic growth in South Sumatra and Bangka Belitung. This research is quantitative descriptive with the methods used are library research, direct observation in the field and documentation. Participant selection technique through purposive sampling model with target questionnaire that is customer. The number of respondents was 255 customers. The questionnaire in this study was processed through the Microsoft Excel application. The expected outcome of this research is the preparation of effective strategies in improving customer financial literacy and the implementation of literacy programs that can have a positive impact on customers. Policy recommendations for Bank Sumsel Babel Muaradua Branch Office involve providing ongoing financial literacy programs, improving educational communications, personal financial counseling services, developing financial literacy applications, and incentives for active customers. Enabling factors include management support, active customer participation, and availability of resources.

Belgian 2024 guidance on the use of pre-exposure prophylaxis

ABSTRACT Objectives We aimed to develop a guidance on the use of pre-exposure prophylaxis (PrEP) for HIV tailored to the Belgian context. Methods Different aspects of PrEP care were judged by an expert group of nine Belgian clinicians, seeking consensus for areas of controversies. Results PrEP should be considered in HIV negative patients at high risk of acquiring HIV. Currently, only oral tenofovir/emtricitabine is available in Belgium for PrEP, which can be used daily, or also event-driven in cisgender men and trans women who are not taking exogenous estradiol-based hormones. Personal counselling directed at medication adherence and sexual health should have a central role in PrEP care. At the initial assessment clinicians should give attention to symptoms of an acute HIV infection, the patients’ immunization status and renal function. A regular follow-up must be set up to diagnose HIV seroconversion, treat sexually transmitted infections, and manage side effects of PrEP. Conclusion The Belgian guidance on the use of PrEP provides a point of reference for standard PrEP care in Belgium and will be periodically updated.

Neonatal outcomes following one previous caesarean section

Background/Aims Vaginal birth following a previous caesarean section is considered a safe option for subsequent births following personal planning and counselling. The aim of this study was to compare neonatal outcomes for both elective caesarean and vaginal birth after a previous caesarean section to aid decision making for women/pregnant people. Methods This quantitative study used retrospective data from low-risk pregnant people/women at term with one previous caesarean section (n=392). Logistic regression was used to determine the impact of mode of birth on neonatal outcomes. Further descriptive analyses were carried out to explore the results and reasons for admission to neonatal unit. Results Apgar scores were higher in the vaginal birth group compared to the elective repeat caesarean group. There were no differences in neonatal unit admissions by mode of birth. Conclusions There is minimal difference in neonatal outcomes, regardless of intention for either vaginal birth following a previous caesarean section or elective repeat caesarean. To fully investigate the factors that impacted Apgar scores and neonatal unit admissions for these groups, a much larger sample is needed.

Patients’ preferences for systemic treatment of atopic dermatitis: safety and efficacy count the most

Background The advent of biologics and janus kinase inhibitors has revolutionized treatment of atopic dermatitis (AD). Objective To investigate preferences of patients with AD for attributes of currently approved systemic treatments and assess influencing factors. Methods An online discrete choice experiment was conducted in patients with AD throughout Germany to analyze preferences for outcome (probability of (almost) clear skin at week 16, probability of significant itch improvement, time to onset of itch relief and type of side effects) and process attributes (application method and frequency of laboratory tests). Results Participants (n = 182, 75.3% female) considered side effects (Relative Importance Score (RIS): 31.2), (almost) clear skin (RIS: 24.2) and probability of itch improvement (RIS: 16.0) most important. Application method (RIS: 14.4), time to onset of itch relief (RIS: 7.4) and frequency of laboratory tests (RIS: 6.8) were less relevant. Preferences were significantly influenced by sex, age, psychiatric comorbidity, current therapy and health-related quality of life according to multivariate regression analysis. Conclusions Participants attached great importance to safety and symptom control. However, preferences were also dependent on individual characteristics, underscoring the importance of personal counseling. Conjoined with medical considerations, patients’ preferences have fundamental impact on shared decisions for treatment of AD.

KONSEP KEKUDUSAN MENURUT IMAMAT 18 DAN IMPLIKASINYA TERHADAP KONSELING PRANIKAH KAUM MUDA DI GEREJA BETHEL INDONESIA TABGHA BATAM CENTER

Pre-marital counseling is an activity held for unmarried parties, in connection with their wedding plans. These parties come to the counselor to make their decisions so that they are more stable and can make better adjustments in the future. Marriage counseling or what is commonly called marriage counseling is an effort to help the prospective bride and groom. Marriage counseling is carried out by professional counselors. The goal is that they can develop and be able to solve the problems they face through ways of mutual respect, tolerance, and communication, in order to achieve family motivation, development, independence, and the welfare of all family members.&#x0D; The purpose of personal counseling specifically has the main and foremost goal in mentoring, namely introducing the counselee to Jesus Christ with the power of the Holy Spirit and the grace of God and helping the counselee to become like Christ. This counseling is a service process so that the counselee has a life change and experiences recovery from the intervention of the Holy Spirit and accepts the Lord Jesus as a personal Savior so that the counselee lives and grows in a better spirituality.&#x0D; This service can be done by a counselor or a servant of God to help church members free from dark powers. Through this counseling service, the counselor will check the personal acceptance of Jesus; confession to God; ask forgiveness from God; deliverance prayer service; convinced of a new identity in Christ. Discipleship ministry (follow up) is very important for people who have just been released from the bonds of dark power. The strategy that the church must do is to make disciples or guide personally so that the counselee knows more about Jesus and grows more in Jesus Christ.&#x0D; Holiness is a state or quality of being holy. Holiness is a sign of a believer's spiritual life that must be continuously strived for, including ethical behavior. The Christian life and holiness are an inseparable unity in the believer. God's holiness has a lot to do with the people He chooses. Election/covenant is a unique expression of God's holiness. Because God is holy, God also requires His people to live holy lives (Leviticus 11:44). God shows His holiness in His actions for the salvation of the people He has chosen (Num. 20:13).

Investigating the Association of Assisted Reproduction Techniques and Adverse Perinatal Outcomes.

Infertility affects about 80 million individuals worldwide and 10-15% of couples at reproductive age will seek medical assistance. There is increasing evidence that pregnancies after Assisted Reproduction Techniques (ART) are associated with pre-term birth, low birthweight, congenital defects, and increased mortality rates. The aim of this review is to assess all the published literature and provide an updated review on the effect of assisted conception and perinatal and neonatal outcomes. Comprehensive research on Pubmed/Medline, Scopus, and Google scholar electronic databases was conducted from July 2023 up to September 2023, using the terms assisted reproductive techniques, ART, in vitro fertilization, IVF, intracytoplasmic sperm injection, ICSI, preterm birth, PTB, low birth weight, LBW, chromosomal defects, congenital defects, and hypospadias. In total, 87 full text articles were retrieved and after a careful evaluation, 31 studies were selected for data extraction. Our review demonstrated a higher risk of congenital and chromosomal defects, and a higher incidence of male genital tract defects and heart defects in ART pregnancies. Regarding pre-term birth, our results were contradictory. Although assisted reproduction techniques are associated with increased risks, they are safe regarding perinatal outcomes and couples should not be discouraged from utilizing them. Our results aim to alert clinicians to these specific outcomes and offer more personalized care and counseling to infertile couples and their children.

The impact of specialty training and physician attitudes on fetal cardiac counseling

Objective Fetal cardiac anomalies are the most commonly diagnosed structural anomalies. In these cases, Maternal-Fetal Medicine (MFM) specialists are tasked with counseling patients on a spectrum of diagnoses as well as their prognostic implications. A recent study of pediatric cardiologists demonstrated that personal beliefs regarding termination impact the counseling provided to patients. Our objective was to study whether the personal beliefs of MFMs impact counseling of patients with severe fetal cardiac anomalies and to compare these providers to their cardiology counterparts. Methods We conducted an anonymous cross-sectional survey of MFMs in New England that assessed personal beliefs and counseling practices when diagnosing hypoplastic left heart syndrome (HLHS). We subsequently compared these providers to the previously surveyed cardiologists. Results A total of 34 respondents representing a broad spectrum of age and experience across several states in New England were analyzed. When presented with the statement “some life is always better than no life at all,” 79% (n = 27) of respondents disagreed and all respondents (n = 34) offered termination, palliative care, and treatment options when counseling patients with HLHS. Additionally, while 74% (n = 25) of providers would personally support a decision to terminate a pregnancy with HLHS, 94% (n = 32) would professionally support the decision to pursue termination. MFMs and cardiologists differed in their responses to “some life is better than no life” and the belief that termination should be offered, though differences did not reach statistical significance. However, with respect to the providers’ personal and professional support of the decision to terminate the pregnancy, the groups of respondents varied significantly in their level of support, both professionally and personally with fewer cardiologists supporting this decision. Conclusion When diagnosing a severe and potentially fatal congenital cardiac anomaly, counseling by MFMs was largely unaffected by personal beliefs regarding termination of pregnancy. While this is consistent with previously published data on counseling practices among pediatric cardiology specialists, some important differences between the specialties were seen.

Mediterranean diet intervention among World Trade Center responders with post-traumatic stress disorder: Feasibility and outcomes of a pilot randomized controlled trial.

Responders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD). WTC Health Program members (N=62), 45-65years, males 87%, body mass index (BMI) 27-45kg/m2 randomized to MedDiet (n=31) or usual nutrition counseling (n=31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons. A total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17)kg, BMI 33.20 (27.50-41.75)kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62)cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p=0.0002; Control: -1% (-13%-4%), p=0.008 and at follow-up MedDiet: -2% (-14%-12%), p=0.07; Control: -2% (-20%-3%), p=0.006. The overall BMI was reduced by -0.68kg/m2 (-4.61-2.09)kg/m2 p<0.0001 at post-intervention and by -0.60kg/m2 (-6.91-3.39)kg/m2, p<0.0009 at follow-up. Overall, median WC was reduced (p<0.0001); post-intervention -3.81cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p=0.019) and serum ω6/ω3 (p=0.029) at post-intervention. Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects.

EFEKTIVITAS PROGRAM BIMBINGAN PERKAWINAN DI KOTA SAMARINDA

Research on the Effectiveness of Pre-Marital Counseling Programs in Samarinda City through field research methods delineates the pivotal role of this program in preparing prospective couples for marriage and establishing a harmonious family. The research conducted in Samarinda City allowed for data collection from pre-marital counselors and prospective couples who participated in this program. The results indicate the program's success in enhancing the physical, mental, and spiritual readiness of prospective couples. Various teaching methods such as lectures, group discussions, case simulations, and personal counseling sessions provide in-depth insights into various aspects of marriage, practical skills, and relevant spiritual values. However, the evaluation identified several challenges that need addressing, such as improving program accessibility, ensuring consistent implementation, accommodating diverse group needs, and ongoing evaluations. Nonetheless, the pre-marital counseling program in Samarinda City significantly contributes to comprehensively preparing prospective couples, including in knowledge, skills, and legal preparations. Thus, this study underscores the importance of ongoing evaluation and program adaptation to enhance its effectiveness. This supports the development of a more responsive and inclusive program, offering greater benefits to prospective couples as they prepare for married life.

EVALUATION OF THE IMPLEMENTATION OF GUIDANCE COUNSELLING SERVICES ON STUDENTS’ NEEDS IN SOME STATE UNIVERSITIES IN CAMEROON

This study was designed to evaluate the implementation of guidance counselling services on students’ needs in some state universities in Cameroon. The study employed the mixed method with a concurrent nested research design. The target population comprised of 148,740 students with 54 guidance counsellors from university of Buea, University of Yaoundé 1, University of Bamenda and University of Dschang. 12 personnel in charge of guidance counselling in Ministry of Higher Education also constituted the target population. The sample population was made up of 1260 students, 39 practicing guidance counselors, 3 head of service in charge of guidance counselling in the universities and 1 head of service in charge of guidance counselling in the Ministry of Higher Education. An evaluation questionnaire and interview guide were used as instrument for data collection. The statistical package for social science version 25 with the use of descriptive and inferential statistics was use to analyse quantitative data. The descriptive statistical tools used are frequency count, percentages, mean, standard deviation and multiple responses. Pearson test was used to test hypothesis. Qualitative data was analyse using the thematic analysis approach. The findings of the study revealed that information service, orientation service, personal counselling service, administrative service, placement and follow-up service, referral services were all provided but the provision of these services were rated low by both counsellors and students, with students giving a much lower rating mean of 0.16 below the cut-off point of 0.5 on a mean scale of 0-1 than the counsellors mean of 2.44 below the cut-off point of 2.5 on a mean scale of 1-4. The findings of the study also showed that group sessions on guidance curriculum and evaluation services were the least provided service by the guidance counsellors. It was also revealed that the implementation of guidance counselling services had a moderate effect on 345 students. The study recommended that guidance counsellors should integrate contemporary comprehensive counselling methods in order to reach out to many students. There’s also need for the government to formulate clear policies that influence effective implementation of guidance counselling services in Cameroon Universities in order to meet the 21st century needs of students.

Epidemiology and survival of patients with spinal meningiomas: a large retrospective cohort study.

Spinal meningiomas (SMs) are relatively rare central nervous system tumors that usually trigger neurological symptoms. The prevalence of SMs is increasing with the aging of the global population. This study aimed to perform a systematic epidemiologic and survival prognostic analysis of SMs to evaluate their public health impact and to develop a novel method to estimate the overall survival at 3-year, 5-year, and 10-year in patients with SMs. Five thousand one hundred fifty eight patients with SMs were recruited from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019. Firstly, descriptive analysis was performed on the epidemiology of SMs. Secondly, these individuals were randomly allocated to the training and validation sets in a ratio of 7:3. Kaplan-Meier method and Cox regression analysis were utilized in the training set to identify independent prognostic factors and to construct a nomogram for survival prognosis. Subsequently, the discriminative power, predictive performance, and clinical utility of the nomogram were evaluated by receiver operating characteristic curve and decision curve analysis. Finally, a mortality risk stratification system and a web-based dynamic nomogram were constructed to quantify the risk of mortality in patients with SMs. The annual age-adjusted incidence rates of SMs increased steadily since 2004, reaching a rate of 0.40 cases per 100000 population in 2019, with a female-to-male ratio of ~4:1. The age groups of 50-59, 60-69, and 70-79 years old were the most prevalent ages for SMs, accounting for 19.08, 24.93, and 23.32%, respectively. In addition, seven independent prognostic factors were identified to establish a prognostic nomogram for patients with SMs. The decision curve analysis and receiver operating characteristic curve indicated that the nomogram had high clinical utility and favorable accuracy. Moreover, the mortality risk stratification system effectively divided patients into low-risk, middle-risk, and high-risk subgroups. SMs are relatively rare benign spinal tumors prevalent in the white elderly female population. Clinicians could use the nomogram to personalize the prediction of the overall survival probability of patients with SMs, categorize these patients into different mortality risk subgroups, and develop personalized decision-making plans. Moreover, the web-based dynamic nomogram could help to further promote clinical application and assist clinicians in providing personalized counseling, timely monitoring, and clinical assessment for patients.

Self-Management Technical Modules As Personal Guidance and Counseling Media For High School Students

Self-Management Technical Modules As Personal Guidance and Counseling Media For High School Students

Effectiveness of remote post-fitting support for over-the-counter hearing devices

Models of hearing device services require revamping in light of the emergence of over-the-counter (OTC) hearing aids. Much effort has gone into remote fitting for OTC customers, but other post-fitting support services are lacking. Our aim is to explore ways of translating important aspects of audiologic counseling to a format that is not dependent on in-person delivery models. Individuals with mild-to-moderate hearing loss were recruited and randomly assigned to one of three treatment groups: (1) a traditional clinical treatment model, (2) a “hands-off” OTC delivery model, or (3) a remote service model with orientation and personalized counseling materials provided via an app interface. We hypothesize that individuals receiving personalized counseling remotely will be as successful as those receiving traditional clinical counseling, and more successful than typical OTC customers. Preliminary results suggest that participants receiving tailored remote support use advanced hearing aid features more often and report similar levels of satisfaction and perceived benefit compared to the clinical delivery model. The remote delivery model also leads to greater improvement in individual hearing goals. Overall, results from this study suggest that a tailored remote delivery model could be an effective way to introduce hearing aids to new users.