JMIR Publications

ABSTRACT

Background:

Hearing aid use is known to improve health outcomes for people with hearing loss. Despite that, hearing aid use is sub-optimal, and communication issues and hearing-related activity limitations and participation restrictions often remain. Web-based self-management communication programs may support people with hearing loss to effectively self-manage the impact of hearing loss in their daily lives.

Objective:

To examine the effects of a web-based self-management SUpport PRogram (SUPR) for hearing aid (HA) users aged 50+.

Methods:

Clients of 36 HA dispensing practices were randomized to SUPR (SUPR recipients; n=180 HA users) and 34 to care as usual (controls; n=163 HA users). SUPR recipients received a Practical Support Booklet and online materials delivered via email over the course of their six-month HA rehabilitation trajectory. They were encouraged to appoint a communication partner and were offered optional email contact with the HA dispensing practice. The online materials included three instruction videos on HA handling, five videos on communication strategies, and three peer testimonial videos. Care as usual included a HA fitting rehabilitation trajectory only. Measurements were carried out at baseline, directly post, six months post, and 12 months post intervention. The primary outcome measure was self-reported use of communication strategies (three subscales of the Communication Profile for the Hearing Impaired; CPHI). Secondary outcome measures included self-reported personal adjustment to hearing loss (CPHI), use, satisfaction and benefit of HAs and SUPR (Use questionnaire; International Outcome Inventory for Hearing Aids (IOI-HA))/ Alternative Interventions (IOI-AI)), recommendation of HA dispensing services, self-efficacy for HA handling (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA)), readiness to act on hearing loss (University of Rhode Island Change Assessment adapted for hearing loss), hearing disability (Amsterdam Inventory for Auditory Disability and Handicap (AIADH)), and emotional impact (AIADH; Hearing Handicap and Disability Inventory).

Results:

Linear mixed model analyses (intention to treat) showed no significant differences between the SUPR and the control group in the 12-month course in use of communication strategies (CPHI). Directly post intervention, SUPR recipients showed significantly higher self-efficacy for advanced HA handling than the controls, which was sustained at twelve months (MARS-HA; mean difference directly post-intervention: 5.3 (95% confidence interval 0.3 to 10.4), P=.039). Also, SUPR recipients showed significantly greater HA satisfaction than the controls directly post-intervention (IOI-HA; 0.3 (0.09 – 0.5), P=.006), which was sustained at twelve months, and significantly greater HA use than the controls directly post-intervention (IOI-HA; 0.3 (0.02 – 0.5), P=.033), which was not sustained at twelve months.

Conclusions:

This study provides ground to recommend adding SUPR to standard clinical HA dispensing care, as long-term, modest improvements in HA outcomes were observed. Further research is needed to evaluate what adjustments to SUPR can be done to establish long-term effectiveness on outcomes in the psychosocial domain. Clinical Trial: ISRCTN77340339; http://www.isrctn.com/ISRCTN77340339