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Fuentes-López E, Galaz-Mella J, Ayala S, De la Fuente C, Luna-Monsalve M, Nieman C, Marcotti A. Association between the home-to-healthcare center distance and hearing aid abandonment among older adults. Front Public Health 2024; 12:1364000. [PMID: 38873313 PMCID: PMC11169842 DOI: 10.3389/fpubh.2024.1364000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/01/2024] [Indexed: 06/15/2024] Open
Abstract
Background Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).
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Affiliation(s)
- Eduardo Fuentes-López
- Departamento de Fonoaudiología, Escuela de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Galaz-Mella
- Faculty of Rehabilitation Sciences, School of Speech Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago, Chile
| | - Salvador Ayala
- Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Carlos De la Fuente
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Manuel Luna-Monsalve
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Carrie Nieman
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Anthony Marcotti
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
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Desai N, Beukes EW, Manchaiah V, Mahomed-Asmail F, Swanepoel DW. Consumer Perspectives on Improving Hearing Aids: A Qualitative Study. Am J Audiol 2024:1-12. [PMID: 38768085 DOI: 10.1044/2024_aja-23-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
PURPOSE Hearing aids play a pivotal role in mitigating the impact of hearing loss, yet their adoption and consistent usage remains suboptimal. Understanding the hearing aid needs of individuals with hearing loss is important to support uptake, use, and outcomes. The current study describes users' perspectives on how hearing aids can be improved. METHOD A cross-sectional, qualitative, content analysis design was used for an open-ended question from an online survey, exploring user perspectives on hearing aid improvements. Participants were adult hearing aid users in the United States, surveyed from the HearingTracker and Lexie Hearing user database. RESULTS A total of 628 participants (Mage = 66 years) were surveyed. The majority of participants used bilateral, behind-the-ear hearing aids that were obtained either through a hearing health care professional or online. Three domains, highlighting areas for hearing aid improvement, were identified. (a) The hearing aid features domain described user issues surrounding physical appearance and fit, general features, streaming, battery functionality, adjustments, smartphone applications, and hearing aid-related accessories. There was dissatisfaction with aesthetics and functionality, with a notable desire for improvements in physical appearance and fit (n = 161), and features to improve self-efficacy. (b) The sound quality domain described user issues surrounding sound perception and difficult situations. Participants highlighted unmet needs for clarity, especially in noisy environments (n = 143). (c) The service-delivery domain described user issues surrounding audiology services and general satisfaction, with criticisms centered on the high cost of hearing aids (n = 193) and the credibility of hearing health care professionals. CONCLUSIONS Hearing aid users appreciated current technological advances but expressed a need for improvements, to better align devices with their requirements. Key areas included physical aesthetics, user control over device adjustments, sound clarity, cost accessibility, and trust between the user and hearing health care professional. Future designs should focus on features enhancing user autonomy and self-efficacy.
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Affiliation(s)
- Nabeelah Desai
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Eldré W Beukes
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
- Vision and Hearing Sciences Research Group, Anglia Ruskin University, Cambridge, United Kingdom
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, India
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
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Jorbonyan A, Abolfathi Momtaz Y, Foroughan M, Mehrkian S. Determinants of Continuance Intention to Use Hearing Aids among Older Adults in Tehran (Iran). Healthcare (Basel) 2024; 12:487. [PMID: 38391862 PMCID: PMC10888125 DOI: 10.3390/healthcare12040487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/02/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The present study seeks to evaluate the factors determining the continuance intention to use hearing aids in older adults. This cross-sectional study was carried out in 2021. The technology post-acceptance model (PAM) framework was used to develop a model for the continuance intention to use hearing aids. In total, 300 hearing aid users aged ≥60 years, who were selected via a randomized stratified sampling method, completed the self-evaluation tools used in this study. With a mean age of 71.38 years (SD = 8), the participants comprised 50.7% and 49.3% females and males, respectively. The path analysis results showed that the continuance intention to use hearing aids was positively and significantly influenced by the actual use of hearing aids, the perceived benefits, satisfaction, confirmation, self-efficacy in using hearing aids, an extraverted personality trait, self-perceived hearing handicap, and perceived social support. The main results of the present study can help hearing care providers develop a better understanding of older users to design effective rehabilitation strategies and ensure their continuance intention to use hearing aids.
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Affiliation(s)
- Abdolhakim Jorbonyan
- Department of Geriatric Health, School of Health, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Aging, The University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran
- Malaysian Research Institute on Ageing, University Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Mahshid Foroughan
- Iranian Research Center on Aging, The University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran
| | - Saeideh Mehrkian
- Department of Audiology, The University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran
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Fuentes-López E, Fuente A, Luna-Monsalve M, Cañete OM. Social determinants of health associated with attitudes towards hearing loss and hearing aids in older adults fitted in a Latin American country: validation of the ALHQ questionnaire into Spanish. Int J Audiol 2023; 62:927-937. [PMID: 35834435 DOI: 10.1080/14992027.2022.2097133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association between certain social determinants of health (i.e. educational level, income, and social support) and attitudes towards hearing loss and hearing aids among older adults with hearing loss fitted in a Latin American country. DESIGN Older adults were asked about their attitudes towards hearing loss and hearing aids, years of formal education, income, social support, perception of having a hearing disability, and social pressure when using the hearing aid. To do so, we adapted the Attitudes towards Loss of Hearing Questionnaire (S-ALHQ) into Spanish. All the questionnaires were conducted as structured interview. STUDY SAMPLE Two hundred fifty-two older hearing aids users were recruited from a public hospital in Chile. RESULTS The S-ALHQ showed adequate validity, along with good reliability. The multivariate models showed that educational level and social support were the social determinants of health negatively associated with the attitudes. Aided hearing disability and social pressure to use hearing aids were the co-variables associated with S-ALHQ scores. CONCLUSIONS The study showed a significant relationship between specific social determinants of health and attitudes towards hearing loss and hearing aids. These attitudes should be considered when implementing rehabilitation programs for older adults with hearing loss.
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Affiliation(s)
- Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adrian Fuente
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - Manuel Luna-Monsalve
- Escuela de Fonoaudiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Oscar M Cañete
- Research Unit for ORL - Head and Neck Surgery and Audiology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
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Suresh K, Franck K, Arenberg JG, Song Y, Lee DJ, Crowson MG. Development of a Predictive Model for Individualized Hearing Aid Benefit. Otol Neurotol 2023; 44:e1-e7. [PMID: 36413361 DOI: 10.1097/mao.0000000000003739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To develop a model to predict individualized hearing aid benefit. To provide interpretations of model predictions on global and individual levels. METHODS We compiled a data set of patients with hearing loss who trialed hearing aids and completed the Client Oriented Scale of Improvement (COSI) questionnaire, a validated patient-reported outcome measure of hearing aid benefit. Features included demographic, medical, and audiological measures. The outcome was the COSI score for change in listening ability with hearing aids, scaled from 1 to 5. Model development was performed using fivefold cross-validation repeated three times with hyperparameter tuning. Model performance was assessed using the root mean squared error (RMSE) of the COSI scores. Model interpretation was performed using Shapley Additive Explanations. RESULTS The data set comprised 1,286 patients across 3,523 listening situations. The best performing model was random forest with an RMSE of 0.80, found to be significantly better than the next best model (eXtreme gradient boosting with RMSE of 0.85, p < 0.01). The most important features in predicting hearing aid benefit were shorter duration of hearing aid use, higher pure-tone average in the better hearing ear, and younger age. CONCLUSION We have developed a predictive model for hearing aid benefit that can also provide individualized explanations of model predictions. Predictive modeling could be a useful tool in assessing a patient's candidacy and predicted benefit from hearing aids.
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Affiliation(s)
| | | | - Julie G Arenberg
- Division of Audiology, Massachusetts Eye and Ear, Boston, Massachusetts
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Iliadou E, Su Q, Kikidis D, Bibas T, Kloukinas C. Profiling hearing aid users through big data explainable artificial intelligence techniques. Front Neurol 2022; 13:933940. [PMID: 36090867 PMCID: PMC9459083 DOI: 10.3389/fneur.2022.933940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Debilitating hearing loss (HL) affects ~6% of the human population. Only 20% of the people in need of a hearing assistive device will eventually seek and acquire one. The number of people that are satisfied with their Hearing Aids (HAids) and continue using them in the long term is even lower. Understanding the personal, behavioral, environmental, or other factors that correlate with the optimal HAid fitting and with users' experience of HAids is a significant step in improving patient satisfaction and quality of life, while reducing societal and financial burden. In SMART BEAR we are addressing this need by making use of the capacity of modern HAids to provide dynamic logging of their operation and by combining this information with a big amount of information about the medical, environmental, and social context of each HAid user. We are studying hearing rehabilitation through a 12-month continuous monitoring of HL patients, collecting data, such as participants' demographics, audiometric and medical data, their cognitive and mental status, their habits, and preferences, through a set of medical devices and wearables, as well as through face-to-face and remote clinical assessments and fitting/fine-tuning sessions. Descriptive, AI-based analysis and assessment of the relationships between heterogeneous data and HL-related parameters will help clinical researchers to better understand the overall health profiles of HL patients, and to identify patterns or relations that may be proven essential for future clinical trials. In addition, the future state and behavioral (e.g., HAids Satisfiability and HAids usage) of the patients will be predicted with time-dependent machine learning models to assist the clinical researchers to decide on the nature of the interventions. Explainable Artificial Intelligence (XAI) techniques will be leveraged to better understand the factors that play a significant role in the success of a hearing rehabilitation program, constructing patient profiles. This paper is a conceptual one aiming to describe the upcoming data collection process and proposed framework for providing a comprehensive profile for patients with HL in the context of EU-funded SMART BEAR project. Such patient profiles can be invaluable in HL treatment as they can help to identify the characteristics making patients more prone to drop out and stop using their HAids, using their HAids sufficiently long during the day, and being more satisfied by their HAids experience. They can also help decrease the number of needed remote sessions with their Audiologist for counseling, and/or HAids fine tuning, or the number of manual changes of HAids program (as indication of poor sound quality and bad adaptation of HAids configuration to patients' real needs and daily challenges), leading to reduced healthcare cost.
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Affiliation(s)
- Eleftheria Iliadou
- 1st Department of Otorhinolaryngology-Head and Neck Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Qiqi Su
- Department of Computer Science, University of London, London, United Kingdom
| | - Dimitrios Kikidis
- 1st Department of Otorhinolaryngology-Head and Neck Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Thanos Bibas
- 1st Department of Otorhinolaryngology-Head and Neck Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Christos Kloukinas
- Department of Computer Science, University of London, London, United Kingdom
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