Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 5, 2025
Date Accepted: May 23, 2025
Efficacy of the Web-Based Swedish Individualized Active Communication Education (I-ACE) program in first-time hearing aid users: Randomized Controlled Trial
ABSTRACT
Background:
Hearing loss is estimated to affect more than 20% of the global population. Hearing aid fitting is a common intervention in audiological rehabilitation; however, there are still those who struggle with remaining communication difficulties that require additional intervention. The group rehabilitation program Active Communication Education (ACE) program has been shown to be an effective alternative for addressing these remaining difficulties. The effects of the individualized version, the I-ACE, have yet to be explored in a randomized controlled trial.
Objective:
This study aimed to explore the effects of the internet-based Swedish I-ACE program on the use of communication strategies, self-perceived hearing difficulties and the emotional effects of hearing loss, as well as whether these effects persist long-term.
Methods:
First-time hearing aid users with 6–12 months of experience with hearing aids were invited to participate in a randomized controlled trial. The participants were allocated to either the Swedish I-ACE intervention program or the delayed intervention control group. The I-ACE was delivered through the nationally available online health portal for the public health care system, 1177.se. The efficacy of the I-ACE was determined by change of the primary outcome of emotional consequences and acceptance of hearing loss, and use of communication strategies. The secondary outcome measures included perceived hearing difficulties, hearing aid efficacy and intervention efficacy.
Results:
A total of 57 participants (I-ACE, n=29; delayed intervention control, n=28) were included in the analyses. Compared with the control group, the Swedish I-ACE improved the emotional consequences and acceptance of hearing loss, as well as use of communication strategies (The Communication and Acceptance Scale, CAS, F1, 54=7.264, P=.01; The Communication Strategies Scale, CSS, F1, 53=6.351, P=.02). There were no differences in perceived hearing difficulties or hearing aid efficacy between the two groups. The outcomes remained stable at the 6-month follow-up.
Conclusions:
The results suggest that the I-ACE program can be an effective alternative for reducing emotional consequences of hearing loss and increasing the use of communication strategies to reduce remaining communication difficulties. Clinical Trial: ClinicalTrials.gov NCT05815667.
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