The ALFA4Hearing Model (At-a-Glance Labeling for Features of Apps for Hearing Health Care) to Characterize Mobile Apps for Hearing Health Care

Designing a Hearing Health Care Smartphone App With Ecological Momentary Assessment: A Qualitative Study of Audiologists' Perspectives

Purpose:

The purpose of this study was to explore the perspectives of audiologists to provide input into development of a smartphone application (app) to document the real-life listening difficulties and the listening environment of hearing aid candidates and users.

Method:

Two focus groups were conducted. Facilitators utilized a topic guide to generate participants' input and perspectives. The focus groups were audio-recorded and transcribed verbatim. The transcripts were then qualitatively analyzed using content analysis.

Study Sample:

The study samples were 10 audiologists (seven females) with 2- to 10-plus years of hearing aid fitting experience.

Results:

Three main categories were identified: (a) The mobile device app could provide meaningful information to help audiologists to counsel their clients, (b) the app could give clients an insight into their hearing difficulties, and (c) the app could help clients to self-manage their hearing condition.

Conclusion:

These findings suggest that audiologists may better understand their clients' real-life listening difficulties through the use of a mobile device app; however, further research is required to harness the benefits of such an app.

Using smartphone technology to support the adult audiologic rehabilitation journey

OBJECTIVE

Although the availability of mobile device applications (apps) to support people with hearing impairment is rapidly increasing, there are few reports of the use of such apps by the target population. The aim of this paper is to describe research that has applied apps at various stages of the adult rehabilitation journey.

DESIGN

A summary of studies utilising apps to investigate (1) the hearing difficulties and acoustic environments of adults with mild hearing impairment, (2) hearing aid benefit in this population and (3) useability of an app to guide hearing aid handling tasks.

STUDY SAMPLE

Older adults with no previous experience with hearing aids, who owned a smartphone or tablet and were confident in using apps. Participant samples ranged from 10 (hearing aid benefit pilot study, mean age = 70 years) to 30 participants (app useability study, mean age = 69 years).

RESULTS

All studies showed that smartphone apps can provide real-world insights during the early stages of the patient journey and hearing aid management support during the latter stages. App useability was rated positively by participants.

CONCLUSION

Smartphone apps may be used as a feasible complement to face-to-face interaction in audiology practice.

The App Behavior Change Scale: Creation of a Scale to Assess the Potential of Apps to Promote Behavior Change

BACKGROUND

Using mobile phone apps to promote behavior change is becoming increasingly common. However, there is no clear way to rate apps against their behavior change potential.

OBJECTIVE

This study aimed to develop a reliable, theory-based scale that can be used to assess the behavior change potential of smartphone apps.

METHODS

A systematic review of all studies purporting to investigate app's behavior change potential was conducted. All scales and measures from the identified studies were collected to create an item pool. From this item pool, 3 health promotion exerts created the App Behavior Change Scale (ABACUS). To test the scale, 70 physical activity apps were rated to provide information on reliability.

RESULTS

The systematic review returned 593 papers, the abstracts and titles of all were reviewed, with the full text of 77 papers reviewed; 50 papers met the inclusion criteria. From these 50 papers, 1333 questions were identified. Removing duplicates and unnecessary questions left 130 individual questions, which were then refined into the 21-item scale. The ABACUS demonstrates high percentage agreement among reviewers (over 80%), with 3 questions scoring a Krippendorff alpha that would indicate agreement and a further 7 came close with alphas >.5. The scale overall reported high interrater reliability (2-way mixed interclass coefficient=.92, 95% CI 0.81-0.97) and high internal consistency (Cronbach alpha=.93).

CONCLUSIONS

The ABACUS is a reliable tool that can be used to determine the behavior change potential of apps. This instrument fills a gap by allowing the evaluation of a large number of apps to be standardized across a range of health categories.

Apps for Hearing Healthcare

This chapter provides a picture of the evolution of mobile applications (apps) for hearing health care (HHC) in terms of availability, variety, penetration, offered services, and target users. Special emphasis is given to newly developed methods that might assist audiologists and hearing professionals to get meaningful information and guidance for informed adoption of apps for themselves as well as for patients and their families. The chapter also shows how these novel methods can be used to characterize and compare a variety of apps across a wide range of services and target user groups. A representative sample of apps, assessed by using such a standardized framework, is analyzed to derive a multifaceted picture of apps for HHC. The chapter outlines and discusses emerging trends and needs in the area and highlights the open challenges as well as potential opportunities for professionals, researchers, developers, and stakeholders at large.

Automated Characterization of Mobile Health Apps' Features by Extracting Information From the Web: An Exploratory Study

PURPOSE

The aim of this study was to test the viability of a novel method for automated characterization of mobile health apps.

METHOD

In this exploratory study, we developed the basic modules of an automated method, based on text analytics, able to characterize the apps' medical specialties by extracting information from the web. We analyzed apps in the Medical and Health & Fitness categories on the U.S. iTunes store.

RESULTS

We automatically crawled 42,007 Medical and 79,557 Health & Fitness apps' webpages. After removing duplicates and non-English apps, the database included 80,490 apps. We tested the accuracy of the automated method on a subset of 400 apps. We observed 91% accuracy for the identification of apps related to health or medicine, 95% accuracy for sensory systems apps, and an average of 82% accuracy for classification into medical specialties.

CONCLUSIONS

These preliminary results suggested the viability of automated characterization of apps based on text analytics and highlighted directions for improvement in terms of classification rules and vocabularies, analysis of semantic types, and extraction of key features (promoters, services, and users). The availability of automated tools for app characterization is important as it may support health care professionals in informed, aware selection of health apps to recommend to their patients.

eHealth and the hearing aid adult patient journey: a state-of-the-art review

The number and variety of eHealth services for adults and older adults who use hearing aids (HAs) are growing rapidly. This area holds promise to increase cost-efficiency, enable better access to care, and improve patient outcomes and satisfaction. Despite the increasing interest in this field, an up-to-date picture of recent research in the area of eHealth for adults with HAs is lacking. In this state-of-the-art review we assessed the literature from the past decade about eHealth use in the HA adult patient journey. Systematic searches were conducted in CINAHL, PubMed, Scopus, and Web of Science. A total of 34 peer-reviewed empirical records were identified from the searches and from the reference lists of searched records. Records were characterized based on: eHealth platform (i.e.: offline, Internet-based, or mobile-based), service [i.e.: education and information, screening and assessment, hearing rehabilitation, or general (tele-audiology)], and phase of the patient journey (i.e.: pre-fitting, fitting, or post-fitting). The review highlighted a growing interest in the field, as revealed by an increasing trend over the search period, from 2 records in 2009-2010 up to 17 records in 2015-2016. Internet-based platforms were the most frequently used (present in more than half of the included records), with a stable trend in the period. About one-third of the records introduced services over offline platforms, whereas mobile-based platforms were used only in 6 out of 34 records, suggesting that the clinical uptake of mobile services is still limited compared to more mature offline and Internet-based platforms. Most of the eHealth services observed were related to the areas of education and information (42.5%) and hearing rehabilitation (40.4%), whereas 10.7% were related to screening and assessment, and 6.4% to general tele-audiology services. Many services covered different phases of the patient journey, especially the fitting and post-fitting phases. Overall, this review showed that the field of eHealth in the context of HA rehabilitation in adults has grown in the recent past. Research is still needed to increase the uptake and efficacy of eHealth in clinical practice, especially in terms of technology developments, technical and clinical validation, and optimization of strategies for service delivery.

An overview on the emerging area of identification, characterization, and assessment of health apps

The need to characterize and assess health apps has inspired a significant amount of research in the past years, in search for methods able to provide potential app users with relevant, meaningful knowledge. This article presents an overview of the recent literature in this field and categorizes - by discussing some specific examples - the various methodologies introduced so far for the identification, characterization, and assessment of health apps. Specifically, this article outlines the most significant web-based resources for app identification, relevant frameworks for descriptive characterization of apps' features, and a number of methods for the assessment of quality along its various components (e.g., evidence base, trustworthiness, privacy, or user engagement). The development of methods to characterize the apps' features and to assess their quality is important to define benchmarks and minimum requirements. Similarly, such methods are important to categorize potential risks and challenges in the field so that risks can be minimized, whenever possible, by design. Understanding methods to assess apps is key to raise the standards of quality of health apps on the market, towards the final goal of delivering apps that are built on the pillars of evidence-base, reliability, long-term effectiveness, and user-oriented quality.

Introduction: Hearing Across the Lifespan (HEAL) 2016

PURPOSE

This introduction overviews this special issue on the Hearing Across the Lifespan (HEAL) conference, which was held in Cernobbio, Italy, June 2-4, 2016.